• 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)
Wapnick S, Grosberg S, Kinney M, Azzara V, LeVeen HH. Renal Failure in Ascites Secondary to Hepatic, Renal, and Pancreatic DiseaseTreatment With a LeVeen Peritoneovenous Shunt. Arch Surg. 1978;113(5):581-585. doi:10.1001/archsurg.1978.01370170043006