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Denver shunt procedure for malignant pleural effusion and ascites Masayoshi Yamamoto 1 1Department of Radiology Teikyo University School of Medicine Keyword: ドレナージ , 胸腔・腹腔シャント , 腹腔・静脈シャント pp.1461-1466
Published Date 2023/12/10
DOI https://doi.org/10.18888/rp.0000002581
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The peritoneovenous shunt(PVS)is a subcutaneous shunt tube linked to a one-way pressure valve, connecting the abdominal cavity with the vena cava. This enables persistent discharge of ascitic fluid into the venous system, mainly the superior vena cava. The available kit in Japan is sold by Becton Dickinson, consisting of the peritoneovenous shunt valve kit and pleuroperitoneal shunt valve kit. Post-placement management of the shunt requires maintaining a pressure gradient between 3~5 cmH2O. Manual pumping ensures valve adherence, restricting backflow, while a pressure difference exceeding 5 cmH2O opens the valve for continuous flow, preventing tube occlusion. Indications for PVS include insufficient treatment effect from drug or radiation therapy, significant discomfort from ascites, and situations requiring frequent drainage. It’s contraindicated in cases of infectious ascites, peritonitis, DIC patients, and acute renal failure. Technical success rate is high, and symptomatic relief is achieved in over 80% cases. PVS is pivotal in improving the quality of life of cancer patients, as it alleviates symptoms.


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