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Biomedical subjects

S Hillaire

Publications and source records attributed to S Hillaire.

22 records · Page 2Linked to original sources
PubMed1989

[Cost of the peritoneovenous shunt in patients with cirrhosis].

The cost of peritoneovenous shunting was evaluated in 15 cirrhotic patients with intractable ascites. With the assessment presently used in French Public Hospitals which is based on a contractual reimbursement by the Social Security per day of hospitalization, the cost of peritoneovenous shunting was F 37,227.40. Using the more refined method of cost analysis, the cost of the operative procedure was F 9,564 and that of postoperative hospitalization was F 8,067. Total expenses calculated by the cost analysis method (F 17,631) were much less that the reimbursement paid by Social Security. This study allowed to determine the actual cost of Surgical treatment of ascites, where expenses were greatest, and how to reduce them. Results of this report should be used when comparing cost and efficacy of medical and surgical treatments.

Adult↗
PubMed1988

[Peritoneovenous shunting in intractable ascites of cirrhosis. Results of a prospective study on improving prognostic factors].

A peritoneovenous (LeVeen) shunt was inserted in 39 patients with cirrhosis and intractable ascites. Based on the results of previous experience, the following procedures were performed to improve outcome: 1) intraoperative drainage of most of the ascites; 2) short-term antibiotic prophylaxis by cefotetan; 3) the use of a titanium venous catheter tip. There was no operative mortality. Operative morbidity was minimal. Mean postoperative in-hospital stay was 19 +/- 5 days. Two patients had recurrence of ascites. This resulted from obstruction of the valve in one patient and of occlusion of the venous catheter in the second patient. One-year probability of shunt failure was 5.8 p. 100. Among the long-term complications, variceal bleeding was the most frequent as it occurred in 8 patients and was responsible for death in 6. One-year probability of variceal bleeding was 18.6 p. 100. Overall one-year survival was 68 p. 100, 79 p. 100 in the group of 19 patients with Pugh scores of 8 and less, 58 p. 100 in the group of 20 patients with Pugh scores greater than 8. These results suggest that technically improved peritoneovenous shunting is a low operative risk surgical procedure with high efficiency in the treatment of intractable ascites in cirrhosis.

Adult↗