Digestive Diseases and Sciences

, Volume 52, Issue 2, pp 518–522 | Cite as

Placement of Gastrostomy Tubes in Patients with Ventriculoperitoneal Shunts Does Not Result in Increased Incidence of Shunt Infection or Decreased Survival

  • Brent E. Roeder
  • Adnan Said
  • Mark Reichelderfer
  • Deepak V. Gopal
Original Paper


The objective of this study was to examine if G-tube (G-tube) placement in patients with ventriculoperitoneal (VP) shunts results in shunt infection or impacts patient survival. We performed a retrospective cohort study. Patients underwent VP shunt and G-tube placement. Incidence of shunt infection and patient survival were calculated. Fifty-five patients qualified for the study. Shunt infection occurred in seven patients (12.5%). The incidence of shunt infection did not differ between surgically placed G-tubes (2/7=29%) and PEG tubes (5/7=71%; P=0.69). There was no difference in the risk of VP infection based on the order of placement (OR=0.61 [0.12–3.02]; P=0.69). No predictors for shunt infection were identified. Kaplan-Meier mortality estimates demonstrated a 21% 1-year mortality rate. There were no predictors of patient survival. We conclude that placement of G-tubes in patients with shunts is safe. The order of placement of G-tube and VP shunt does not affect the incidence of shunt infection or survival.


Gastrostomy tube Ventriculoperitoneal shunt Infection Percutaneous endoscopic gastrostomy 


  1. 1.
    Ponsky JL, Gauderer ML, Stellato TA, Aszodi A (1985) Percutaneous approaches to enteral alimentation. Am J Surg 149:102–105PubMedCrossRefGoogle Scholar
  2. 2.
    Sharma VK, Howden CW (2000) Meta-analysis of randomized controlled trials of antibiotic prophylaxis before percutaneous endoscopic gastrostomy. Am J Gastroenterol 95(11):3133–3136PubMedCrossRefGoogle Scholar
  3. 3.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chr Dis 40(5):373–383CrossRefGoogle Scholar
  4. 4.
    Baird R, Salasidis R (2004) Percutaneous gastrostomy in patients with a ventriculoperitoneal shunt: case series and review. Gastr Endosc 59(4):570–574CrossRefGoogle Scholar
  5. 5.
    Graham SM, Flowers JL, Scott TR, Lin F, Rigamonti D (1993) Safety of percutaneous gastrostomy in patients with a ventriculoperitoneal shunt. Neurosurgery 32(6):932–934PubMedGoogle Scholar
  6. 6.
    Taylor AL, Carroll TA, Jakubowski J, O’Reilly G (2001) Percutaneous endoscopic gastrostomy in patients with ventriculoperitoneal shunts. Br J Surg 88:724–727PubMedCrossRefGoogle Scholar
  7. 7.
    Sane SS, Towbin A, Bergey EA, Kaye RD, Fitz CR, Albright L, Towbin RB (1998) Percutaneous gastrostomy tube placement in patients with ventriculoperitoneal shunts. Pediatr Rad 28:521–523CrossRefGoogle Scholar
  8. 8.
    Chapman PH, Borges LF (1994) Shunt infections: prevention and treatment. Clin Neurosurg 23:652Google Scholar
  9. 9.
    Wolfsen HC, Kozarek MD, Ball TJ, Patterson DJ, Botoman VA, Ryan JA (1990) Long-term survival in patients undergoing percutaneous endoscopic gastrostomy and jejunostomy. Am J Gastroenterol 85(9):1120–1122PubMedGoogle Scholar
  10. 10.
    Kobayashi K, Cooper GS, Chak A, Sivak MV Jr, Wong RC (2002) A prospective evaluation of outcome in patients referred for PEG placement. Gastr Endosc 55(4):500–506CrossRefGoogle Scholar
  11. 11.
    Taylor Ca, Larson DE, Ballard DJ, Bergstrom LR, Silverstein MD, Zinsmeister AR, DiMagno EP (1992) Predictors of outcome after percutaneous endoscopic gastrostomy: a community-based study. Mayo Clin Proc 67(11):1042–1049PubMedGoogle Scholar
  12. 12.
    Kontny U, Hofling B, Gutjahr P, Voth D, Schwartz M, Schmitt HJ (1993) CSF shunt infections in children. Infection 21(2):89–92PubMedCrossRefGoogle Scholar
  13. 13.
    Vanaclocha V, Saiz Sapena N, Leiva J (1996) Shunt malfunction in relation to shunt infection. Acta Neurochirurg 138:829–834CrossRefGoogle Scholar
  14. 14.
    McLaurin RL (1973) Infected cerebrospinal fluid shunts. Surg Neurol 1:191–195PubMedGoogle Scholar
  15. 15.
    O’Brien M, Parent A, Davis B (1979) Management of ventricular shunt infections. Child's Brain 5:304–309PubMedCrossRefGoogle Scholar
  16. 16.
    Grant JP (1988) Comparison of percutaneous endoscopic gastrostomy with Stamm gastrostomy. Ann Surg 207:598–603PubMedCrossRefGoogle Scholar
  17. 17.
    Himal HS, Schumacher S (1987) Endoscopic vs. surgical gastrostomy for enteral nutrition. Surg Endosc 1:33–35PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Brent E. Roeder
    • 1
  • Adnan Said
    • 1
  • Mark Reichelderfer
    • 1
  • Deepak V. Gopal
    • 1
  1. 1.Section of Gastroenterology and HepatologyUniversity of Wisconsin-School of Medicine and Public HealthMadisonUSA

Personalised recommendations