Skip to main content

Advertisement

SpringerLink
Log in

Ventriculo-gallbladder shunt: case series and literature review

  • Research
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

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

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

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

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

No datasets were generated or analyzed during the current study.

References

  1. 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

    Article  PubMed  Google Scholar 

  2. 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

    Article  PubMed  Google Scholar 

  3. 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

    Article  PubMed  PubMed Central  Google Scholar 

  4. 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

    Google Scholar 

  5. Topp G, Entezami P, Ambati S et al (2023) Cerebrospinal fluid leakage from scrotum secondary to ventriculoperitoneal shunt migration. Asian J Neurosurg

  6. Maruyama H, Nakata Y, Kanazawa A et al (2015) Ventriculoperitoneal shunt outcomes among infants. Acta Med Okayama 69(2):87–93

    PubMed  Google Scholar 

  7. 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)

  8. Calayag M, Paul AR, Adamo MA (2015) Intraventricular hemorrhage after ventriculoperitoneal shunt revision: a retrospective review. J Neurosurg Pediatr 16(1):42–45

    Article  PubMed  Google Scholar 

  9. Ketoff JA, Klein RL, Maukkassa KF (1997) Ventricular cholecystic shunts in children. J Pediatr Surg 32(2):181–183

    Article  CAS  PubMed  Google Scholar 

  10. Rivero-Garvía M, Pancucci G, Morcilo J et al (2014) Ventriculobiliary shunts, another option. Pediatr Neurosurg 50(3):152–156

    Article  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. Gabay S, Zhebrykov D, Constantini S, Roth J (2023) Ventriculosinus shunts: their role in selected patients. J Neurosurg Pediatr 31(3):238–244

    Article  PubMed  Google Scholar 

  15. 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

    Article  Google Scholar 

  16. Entezami P, Devejian N, Rubino S et al (2020) Vegetation of ventriculoatrial shunt managed via multidisciplinary surgical approach. World Neurosurg 144:15–18

    Article  PubMed  Google Scholar 

  17. Aldana PR, James HE, Postlethwait RA (2008) Ventriculogallbladder shunts in pediatric patients. J Neurosurg Pediatr 1:284–287

    Article  PubMed  Google Scholar 

  18. 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

    Article  CAS  PubMed  Google Scholar 

  19. Fountas KN, Kassam MA, Grigorian AA (2007) A rare, delayed complication of a ventriculogallbladder shunt. Neurosurg Focus 22(4):1–3

    Article  Google Scholar 

  20. Henderson D, Budu A, Horridge M et al (2019) The ventriculo-cholecystic shunt: does CSF volume matter? Childs Nerv Syst 35(9):1557–1560

    Article  PubMed  Google Scholar 

  21. 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

    Article  PubMed  Google Scholar 

  22. West KW, Turner MK, Vane DW et al (1987) Ventricular gallbladder shunts: an alternative procedure in hydrocephalus. J Pediatr Surg 22(7):609–612

    Article  CAS  PubMed  Google Scholar 

  23. Wladis EJ, Adamo MA, Weintraub L (2021) Optic nerve gliomas. J Neurol Surg B Skull Base 82(1):91–95

    Article  PubMed  PubMed Central  Google Scholar 

  24. Stringel G, Turner M, Crase T (1993) Ventriculo-gallbladder shunts in children. Childs Nerv Syst 9:331–333

    Article  CAS  PubMed  Google Scholar 

  25. Choux M, Genitori L, Lang D, Lena G (1992) Shunt implantation: reducing the incidence of shunt infection. J Neurosurg 77(6):875–880

    Article  CAS  PubMed  Google Scholar 

  26. Spenazato VBJ, Rodrigues AR, Vilela BP et al (2022) Ventriculo-gallbladder shunt: a case report of a neglected technique. Arch Pediatr Neurosurg

  27. 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

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Pequeno Príncipe Hospital, Curitiba, Paraná, Brazil

    Sandrieli Afornali, A. Keijiro Maeda & C. Alberto Mattozo

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

    Sandrieli Afornali, R. Fedatto Beraldo, A. Keijiro Maeda, C. Alberto Mattozo & R. Nascimento Brito

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

    Anil Ergen

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

    M. Charles Pereira

  5. Department of Neurosurgery, Neurosurgery Clinic, Birta, Birgunj, 44300, Nepal

    Bipin Chaurasia

Authors
  1. Sandrieli Afornali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Fedatto Beraldo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Keijiro Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Alberto Mattozo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. Nascimento Brito
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anil Ergen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Charles Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bipin Chaurasia
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed equally to the preparation of the manuscript.

Corresponding author

Correspondence to Bipin Chaurasia.

Ethics declarations

Human ethics

The Research Ethics Committee approved the present study under the number CAAE 67970923.9.0000.0097.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Afornali, S., Beraldo, R.F., Maeda, A.K. et al. Ventriculo-gallbladder shunt: case series and literature review. Childs Nerv Syst 40, 1525–1531 (2024). https://doi.org/10.1007/s00381-024-06297-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-024-06297-9

Keywords

Search

Navigation