- PVS remains a viable option in refractory ascites—especially when TIPS or transplant are contraindicated—with survival comparable to other palliative modalities.
- Disease severity (MELD) is the dominant prognostic factor, outweighing procedural variables in predicting survival.
- Shunt occlusion is manageable, not a failure—reintervention does not worsen survival, challenging a major historical criticism of PVS.
- Perioperative risk is non-trivial (~10% early mortality) and increases with advanced liver disease, reinforcing the need for careful patient selection.
- Potential physiologic benefit beyond drainage—PVS may improve hemodynamics and, in some cases, liver function or ascites resolution (~8%).
Daily News
Stay up to date with the latest clinical headlines and other information tailored to your specialty.
