Abstract
We herein report a case of refractory ascites after hepatectomy successfully treated with the peritoneovenous shunt. A 69-year-old man underwent the anatomical anterocaudal subsegment resection for hepatocellular carcinoma (HCC) associated with hepatitis C viral infection. A considerable amount of ascites (about 1 L per day) persisted and the patient’s general condition deteriorated, despite the administration of diuretics, albumin and fresh-frozen plasma, and three sets of intravenous reinjection of ascites under extracorporeal ultrafiltraion of ascetic fluid obtained by paracentesis. A subcutaneous peritoneovenous (PV) shunt was inserted 56 days after hepatectomy. Although PV shunt was obstructed due to methicillin resistant staphylococcus aureus infection, reinsertion of PV shunt decreased the ascites and improved the patient’s general condition. The placement of PV shunt is recommended as an effective treatment for refractory ascites after hepatectomy.
