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Peritoneo-venous shunting of ascites was performed in 16 patients using the Hakim-Cordis ascites valve system. After an average of 4.3 months four patients presented with closure of the valve or deconnection of the system that is to say, complications caused by the valve system. Early postoperative complications occurred in 7 patients; they usually can be avoided. Correct placement of the system has to be controlled intraoperatively by x-ray examination. If the ascites fluid contains much protein, repeated depressing and releasing of the antechamber has to be performed in order to avoid obstruction. The probability of diffuse intravascular coagulation (DIC) after valve placement can be predicted by measuring certain coagulation parameters preoperatively after intravenous infusion of ascites. We conclude, that because of high flow rate, easy placement of the small-sized catheter and up to now good clinical results the Hakim valve system offers an enrichment of the therapeutic methods in resistant ascites.
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