Ventriculo-gallbladder shunt: case series and literature review.

Abdominal pseudocysts Hydrocephalus Shunt complications Ventriculo-cholecystic shunt Ventriculo-gallbladder shunt

Journal

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
ISSN: 1433-0350
Titre abrégé: Childs Nerv Syst
Pays: Germany
ID NLM: 8503227

Informations de publication

Date de publication:
08 Feb 2024
Historique:
received: 14 12 2023
accepted: 17 01 2024
medline: 8 2 2024
pubmed: 8 2 2024
entrez: 8 2 2024
Statut: aheadofprint

Résumé

The ventriculoperitoneal shunt (VPS) is the gold-standard surgical technique to treat hypertensive hydrocephalus; however, it may fail in 20 to 70% of cases. The present study shows an alternative for patients with contraindications to VPS. A case series of nine patients. The medical records of all patients under 17 years of age who underwent ventriculo-gallbladder (VGB) shunt at a pediatric hospital from January 2014 to October 2022 were reviewed. There were 6 (66.7%) males and 3 (33.3%) females. The average age of 73.6 months or 6.1 years at the time of surgery. They had undergone, on average, 5.1 VPS reviews before the VGB shunt. Five (55.5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage (11.1%), and ventriculoenteric fistula (22.2%); all these patients got better at surgical reapproach, and in two of them, the VGB shunt was re-implanted. This case series shows a lower risk of death and a similar risk of complications compared to other alternative shunts. This article spotlighted VGB as a viable alternative when VPS fails or has contraindications.

Sections du résumé

BACKGROUND BACKGROUND
The ventriculoperitoneal shunt (VPS) is the gold-standard surgical technique to treat hypertensive hydrocephalus; however, it may fail in 20 to 70% of cases. The present study shows an alternative for patients with contraindications to VPS.
METHODS METHODS
A case series of nine patients. The medical records of all patients under 17 years of age who underwent ventriculo-gallbladder (VGB) shunt at a pediatric hospital from January 2014 to October 2022 were reviewed.
RESULTS RESULTS
There were 6 (66.7%) males and 3 (33.3%) females. The average age of 73.6 months or 6.1 years at the time of surgery. They had undergone, on average, 5.1 VPS reviews before the VGB shunt. Five (55.5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage (11.1%), and ventriculoenteric fistula (22.2%); all these patients got better at surgical reapproach, and in two of them, the VGB shunt was re-implanted.
CONCLUSION CONCLUSIONS
This case series shows a lower risk of death and a similar risk of complications compared to other alternative shunts. This article spotlighted VGB as a viable alternative when VPS fails or has contraindications.

Identifiants

pubmed: 38329505
doi: 10.1007/s00381-024-06297-9
pii: 10.1007/s00381-024-06297-9
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

Symss NP, Oi S (2015) Is there an ideal shunt? A panoramic view of 110 years in CSF diversions and shunt systems used for the treatment of hydrocephalus: from historical events to current trends. Childs Nerv Syst 31(2):191–202
doi: 10.1007/s00381-014-2608-z pubmed: 25547875
Kulkarni AV, Riva-Cambrin J, Browd SR et al (2014) Hydrocephalus clinical research network. Endoscopic third ventriculostomy and choroid plexus cauterization in infants with hydrocephalus: a retrospective Hydrocephalus Clinical Research Network study. J Neurosurg Pediatr 14(3):224–229
doi: 10.3171/2014.6.PEDS13492 pubmed: 24995823
Morosanu CZ, Priscu A, Florian IS (2021) Evaluation of the ventriculocholecystic shunt – an overview of present practice in adult and pediatric hydrocephalus. Neurosurg Rev 44(5):2533–2543
doi: 10.1007/s10143-021-01472-x pubmed: 33481136 pmcid: 8490219
Hasslacher-Arellano JF, Aguilar-Arellano G, Rodriguez-Funes JF et al (2015) Ventriculo-gallbladder shunt: an alternative for the treatment of hydrocephalus. Cirurgia y Cirujanos (English Edition) 116:1–5
Topp G, Entezami P, Ambati S et al (2023) Cerebrospinal fluid leakage from scrotum secondary to ventriculoperitoneal shunt migration. Asian J Neurosurg
Maruyama H, Nakata Y, Kanazawa A et al (2015) Ventriculoperitoneal shunt outcomes among infants. Acta Med Okayama 69(2):87–93
pubmed: 25899630
Yim B, Gooch MR, Dalfino JC et al (2016) Optimizing ventriculoperitoneal shunt placement in the treatment of idiopathic intracranial hypertension: an analysis of neuroendoscopy, frameless stereotaxy, and intraoperative CT. Neurosurg Focus FOC 40(3)
Calayag M, Paul AR, Adamo MA (2015) Intraventricular hemorrhage after ventriculoperitoneal shunt revision: a retrospective review. J Neurosurg Pediatr 16(1):42–45
doi: 10.3171/2014.11.PEDS14246 pubmed: 25860981
Ketoff JA, Klein RL, Maukkassa KF (1997) Ventricular cholecystic shunts in children. J Pediatr Surg 32(2):181–183
doi: 10.1016/S0022-3468(97)90175-5 pubmed: 9044118
Rivero-Garvía M, Pancucci G, Morcilo J et al (2014) Ventriculobiliary shunts, another option. Pediatr Neurosurg 50(3):152–156
doi: 10.1159/000381030
Olavarria G, Reitman AJ, Goldman S, Tomita T (2005) Post-shunt ascites in infants with optic chiasmal hypothalamic astrocytoma: role of ventricular gallbladder shunt. Childs Nerv Syst 21:382–384
doi: 10.1007/s00381-004-0996-1 pubmed: 15449089
Lyngdoh BT, Islam MS (2012) Ventriculocholecysto shunt: a solution to recurrente shunt complications in comorbid post-tubercular hydrocephalus with tubercular adhesive peritonitis. Acta Neurochir 154:2267–2270
doi: 10.1007/s00701-012-1506-y pubmed: 23053281
Reisner A, Smith AD, Wrubel DM et al (2021) Utility of ventriculogallbladder shunts in complex cases of hydrocephalus related to extreme prematurity. J Neurosurg Pediatr 27:511–517
doi: 10.3171/2020.9.PEDS20522 pubmed: 33636696
Gabay S, Zhebrykov D, Constantini S, Roth J (2023) Ventriculosinus shunts: their role in selected patients. J Neurosurg Pediatr 31(3):238–244
doi: 10.3171/2022.11.PEDS22406 pubmed: 36681965
Alraee S, Alshowmer S, Alnamshan M, Azzubi M (2020) Management of ventriculo-gallbladder shunt in the presence of gallstones. BMJ Case Rep 13(6):1–4
doi: 10.1136/bcr-2020-234775
Entezami P, Devejian N, Rubino S et al (2020) Vegetation of ventriculoatrial shunt managed via multidisciplinary surgical approach. World Neurosurg 144:15–18
doi: 10.1016/j.wneu.2020.08.040 pubmed: 32791225
Aldana PR, James HE, Postlethwait RA (2008) Ventriculogallbladder shunts in pediatric patients. J Neurosurg Pediatr 1:284–287
doi: 10.3171/PED/2008/1/5/284 pubmed: 18377303
Demetriades AK, Haq IZ, Jarosz J et al (2013) The ventriculocholecystic shunt: two case reports and a review of the literature. Br J Neurosurg 27(4):505–508
doi: 10.3109/02688697.2013.771135 pubmed: 23445328
Fountas KN, Kassam MA, Grigorian AA (2007) A rare, delayed complication of a ventriculogallbladder shunt. Neurosurg Focus 22(4):1–3
doi: 10.3171/foc.2007.22.4.14
Henderson D, Budu A, Horridge M et al (2019) The ventriculo-cholecystic shunt: does CSF volume matter? Childs Nerv Syst 35(9):1557–1560
doi: 10.1007/s00381-019-04317-7 pubmed: 31350574
Girotti ME, Singh RR, Rodgers BM (2009) The ventriculo-gallbladder shunt in the treatment of refractory hydrocephalus: a review of the current literature. Am Surg 75(8):734–737
doi: 10.1177/000313480907500819 pubmed: 19725301
West KW, Turner MK, Vane DW et al (1987) Ventricular gallbladder shunts: an alternative procedure in hydrocephalus. J Pediatr Surg 22(7):609–612
doi: 10.1016/S0022-3468(87)80110-0 pubmed: 3612454
Wladis EJ, Adamo MA, Weintraub L (2021) Optic nerve gliomas. J Neurol Surg B Skull Base 82(1):91–95
doi: 10.1055/s-0040-1722634 pubmed: 33777621 pmcid: 7987392
Stringel G, Turner M, Crase T (1993) Ventriculo-gallbladder shunts in children. Childs Nerv Syst 9:331–333
doi: 10.1007/BF00302035 pubmed: 8269415
Choux M, Genitori L, Lang D, Lena G (1992) Shunt implantation: reducing the incidence of shunt infection. J Neurosurg 77(6):875–880
doi: 10.3171/jns.1992.77.6.0875 pubmed: 1432129
Spenazato VBJ, Rodrigues AR, Vilela BP et al (2022) Ventriculo-gallbladder shunt: a case report of a neglected technique. Arch Pediatr Neurosurg
Ahmed N, Chaurasia B, Shalike N et al (2019) Rare complications of VP shunt surgery resulting in significant morbidity and mortality: report of four cases and review of literature. Int J Neurol Neurosurg 11(4):293–301

Auteurs

Sandrieli Afornali (S)

Department of Neurosurgery, Pequeno Príncipe Hospital, Curitiba, Paraná, Brazil.
Department of Neurosurgery, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.

R Fedatto Beraldo (RF)

Department of Neurosurgery, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.

A Keijiro Maeda (AK)

Department of Neurosurgery, Pequeno Príncipe Hospital, Curitiba, Paraná, Brazil.
Department of Neurosurgery, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.

C Alberto Mattozo (CA)

Department of Neurosurgery, Pequeno Príncipe Hospital, Curitiba, Paraná, Brazil.
Department of Neurosurgery, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.

R Nascimento Brito (RN)

Department of Neurosurgery, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.

Anil Ergen (A)

Department of Neurosurgery, Derince Research Hospital, Kocaeli, Turkey.

M Charles Pereira (MC)

Department of Otolaryngology - Head and Neck Surgery, Albany Medical Centre, Albany, NY, USA.

Bipin Chaurasia (B)

Department of Neurosurgery, Neurosurgery Clinic, Birta, Birgunj, 44300, Nepal. trozexa@gmail.com.

Classifications MeSH