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January 10, 1977

LaVeen Continuous Peritoneal-Jugular ShuntImprovement of Renal Function in Ascitic Patients

Author Affiliations

From the Departments of Surgery (Dr Wapnick) and Gastroenterology Service (Drs Grosberg and LeVeen), Veterans Administration, Brooklyn, and the Downstate Medical Center, State University of New York; and the Public Health Hospital, Staten Island (Dr Kinney), New York.

JAMA. 1977;237(2):131-133. doi:10.1001/jama.1977.03270290031021

30 consecutive patients with cirrhosis of the liver complicated by refractory ascites, hepatorenal syndrome, or both, received a LeVeen peritonealvenous shunt. After surgery, these patients demonstrated a decreased abdominal girth (108 vs 93 cm, P <.001), decreased body weight (80 vs 70 kg, P <.001), and increased urinary flow (607 vs 4,254 ml, P <.001). All patients had previously failed to show substantial benefit with 7 to 124 days of medical care. The mean BUN value was significantly decreased, from 39 to 23 mg/100 ml (P <.005). Aldosterone retention was reduced from a mean value of 32 to 12.8 ng/100 ml. The LeVeen continuous peritoneal-venous shunt is an important innovation that completely relieves refractory ascites in cirrhotic patients and reverses the pathophysiology of the hepatorenal syndrome.

(JAMA 237:131-133, 1977)