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To evaluate the effect of peritoneonvenous shunt (Denver Shunt) placement on metrics of sarcopenia in patients with refractory ascites.IRB-approved single-institution retrospective analysis of all patients undergoing Denver Shunt (n = 29) and a comparator cohort of cirrhotics undergoing serial paracentesis (n = 42) from 2009-2019 with baseline and follow-up cross sectional imaging of at least 3 months. Axial muscle area measurements (psoas, paraspinal, total abdominal wall) were performed using free-hand region of interest technique. Patient records were reviewed for demographics, referring indication, laboratory studies, and performance status. Statistical analyses were performed with Student's t test, Welch's unequal variances, Fisher's exact, and Wilcoxon signed ranks.The most common indications for Denver Shunt placement were metastatic disease or cirrhosis. For all shunt patients, there were no significant differences in aggregate psoas muscle area (13.4 vs. 14 cmIn patients with refractory ascites who are not candidates for TIPS placement, Denver Shunt mitigates loss of truncal muscle and in some instances promotes muscle growth. |
