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Article
March 13, 1948

A MODIFICATION OF THE CROSBY-COONEY OPERATION FOR INTRACTABLE ASCITES DUE TO CIRRHOSIS OF THE LIVER

JAMA. 1948;136(11):767-768. doi:10.1001/jama.1948.72890280004009
Abstract

In 1946 Crosby and Cooney1 revived interest in an operative procedure for the treatment of intractable ascites and reported several cases in which considerable improvement was obtained following operation. The procedure which they described had been employed from time to time for several decades but for a number of reasons had never become popular. They eliminated one of the difficulties by employing a glass button with a cap on it to prevent plugging of the lumen by omentum.

The principle underlying the operation is the transport of ascitic fluid from the peritoneal cavity through a glass button to a subcutaneous pocket where it can be absorbed by the lymphatics. When the operation is successful, the patient is spared the unpleasantness of and repeated need for paracenteses and, secondly, has in a sense a slow constant clysis of a fluid which may contain a significant amount of protein. In some

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