Objective: To describe a safe surgical technique for the management of refractory ascites.

Patients And Method: Two preterminal patients with respiratory compromise caused by refractory ascites had the long saphenous vein transected at mid-thigh and anastomosed to the peritoneum in the region of the internal inguinal ring. This allowed direct drainage of the ascitic fluid into the vascular system (peritoneosaphenous shunt).

Results: The procedure was performed successfully on two patients. The first patient, with cirrhosis, was leading a normal lifestyle without diuretic use at 7 1/2 months' follow-up. The second patient, with cirrhosis and multifocal hepatoma, was fit enough for discharge without medication.

Conclusion: The peritoneo-saphenous shunt deserves further evaluation as a novel and safe surgical technique for the management of refractory ascites.

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