Experience of a reference center on ventriculo-gallbladder shunt as an alternative treatment for peritoneal failure in children

Childs Nerv Syst. 2024 Aug;40(8):2411-2418. doi: 10.1007/s00381-024-06427-3. Epub 2024 May 2.

Abstract

Purpose: Ventriculo-peritoneal shunt is the gold standard for non-obstructive hydrocephalus. Despite advances in material, infection prevention, and valve technologies, failure can still occur. The aim of this article is to present a comprehensive study based on the experience of a reference center in pediatric neurosurgery in Rio de Janeiro with the use of the ventriculo-gallbladder shunt as an alternative to peritoneal failure.

Methods: A retrospective study was conducted from January 2018 to December 2023 of patients diagnosed with cerebrospinal fluid shunt dysfunction due to peritoneal failure and submitted to ventriculo-gallbladder shunt as an alternative in a reference center of Rio de Janeiro.

Results: From 2018 to 2023, 18 peritoneal failures were diagnosed. Among them, 10 patients (55.5%) were selected for ventriculo-gallbladder shunt (VGS). Different causes were responsible for the hydrocephalus in these patients. VGS was placed at a mean age of 35.4 months. Four patients had temporary complications: 2 self-limited diarrheas in the first month and 2 shunt infections. After the resolution of the infection, a new VGS was placed successfully. The average follow-up was 18.8 months (follow-up 9-68 months) without further issues.

Conclusion: VGS is a viable option for patients facing peritoneal failure. This paper provides valuable insights into the surgical technique and outcomes associated with this alternative.

Keywords: Pseudocyst; Ventriculo-atrial shunt; Ventriculo-biliary shunt; Ventriculo-cholecystic shunt.

MeSH terms

  • Cerebrospinal Fluid Shunts* / adverse effects
  • Cerebrospinal Fluid Shunts* / methods
  • Child
  • Child, Preschool
  • Female
  • Gallbladder* / surgery
  • Humans
  • Hydrocephalus* / surgery
  • Infant
  • Male
  • Retrospective Studies
  • Ventriculoperitoneal Shunt / adverse effects
  • Ventriculoperitoneal Shunt / methods