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Treatment With a LeVeen Peritoneovenous Shunt

Simon Wapnick, MD; Saul Grosberg, MD; Michael Kinney, MD; Vincent Azzara; Harry H. LeVeen, MD

Arch Surg. 1978;113(5):581-585.

Abstract
• Renal failure occurs in ascites of diverse causes. Functional renal failure (the hepatorenal syndrome) in cirrhotic patients is usually progressive and rapidly fatal. Insertion of a LeVeen shunt significantly reduces weight, as well as abdominal girth, and improves preoperative urine flow (488 vs 2,318 ml/24 hr; P <.001) and natriuresis (12 ± 15 vs 45 ± 33 mEq/liter; P <.003). The shunt should not be inserted in patients with alcoholic hepatitis (bilirubin level > 8 mg/100 ml). Ascitic fluid should be discarded at the time of surgery in patients with impaired cardiac function, a bleeding diathesis, and when liver function is more severely deranged.

(Arch Surg 113:581-585, 1978)

Author Affiliations
From the Departments of Surgery and Medicine, VA Hospital, and Downstate Medical Center, Brooklyn, NY.

Footnotes
Accepted for publication Dec 7, 1977.

Read before the Association of Veterans Administration Surgeons Meeting, Nashville, May 2, 1977.

Reprint requests to Department of Surgery, VA Hospital 800 Poly Pl, Brooklyn, NY 11209 (Dr Wapnick).

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