Denver Peritoneovenous Shunt Performed Under Local Anaesthesia for Intractable Ascites Following Esophagogastrectomy

We herein described a 70-year-old male patient with lower thoracic esophageal cancer (T1aN2M0, Stage II) and gastric cancer in the upper body (T1bN0M0, Stage IA), who underwent subtotal esophagectomy and proximal gastrectomy with reconstruction using colon interposition in January, 2011. He exhibited abdominal distension in April, 2011. Ultrasonography revealed massive ascites, the cytology of which was class II, and mediastinal lymph node recurrence was detected using PET/CT. Although the patient received DCF chemotherapy (2 courses of 5-FU 600 mg/m2 days 1-5, docetaxel 60 mg/ m2 day1, and cisplatin 50 mg/m2 day 4) and achieved a complete response in the mediastinal lymph nodes, no improvements were noted in massive ascites. Lymphorrhea was not detected by lymphangiography. Although a definite diagnosis had not been obtained, a Denver peritoneovenous shunt (DPVS) was placed in August, 2011. A marked amelioration in ascites was observed following surgery, and the patient was subsequently discharged without complications. DPVS is a simple procedure that can be successfully applied to the treatment of intractable ascites.