Early Outcome of Ventriculoperitoneal (VP) Shunt in Terms of Improvement and Complications

Abstract

Objective: To analyze the outcome of ventriculoperitoneal (VP) shunts in terms of improvement and complications.
 Material and Methods: This retrospective observational study is done in MTI Mardan medical complex and Prime teaching hospital from September 2017 to March 2020. The hospital record of all patients who underwent ventriculoperitoneal shunts was reviewed for improvement and complications. Patients undergoing ventriculoperitoneal shunt for normal pressure hydrocephalus were excluded from this study. Revision of ventriculoperitoneal shunt was the primary endpoint of the study.
 Results: A total of 167 patients were operated on for ventriculoperitoneal shunts with males 106 (63.47%) and females 61 (36.52%). Age ranged from 1 month to 75 years with a mean of 14 years. The most common indication for surgery was congenital hydrocephalus in 102 patients (61.1%) while brain tumors caused hydrocephalus in 25 (15%) patients. Common presenting symptoms were the increase in head size in 75 (44.9%), and headaches in 84 (50.2%) patients. Symptomatic (headache, vomiting, and increase in OFC) improvement occurred in 145 patients (86.82%). Shunt revision was needed in 50.29% (84 patients) in one year.
 Conclusion: VP shunt is a life-saving procedure and is an effective treatment of hydrocephalus but is not risk-free. Almost half of the shunted patients will need revision surgery in one year period.
 Keywords: Hydrocephalus, Ventriculoperitoneal Shunt, Occipitofrontal Circumference (OFC).

Incidence of Ventriculoperitoneal (VP) Shunt Infection In Vancomycin-Drenched VP Shunts

“…16 Another meta-analysis of 11 observational studies, however, showed a statistically significant difference between the two groups, depicting results in favor of antibioticimpregnated shunts. 17 The present study aimed to ascertain the frequency of VP shunt infection in vancomycindrenched VP shunts because, despite numerous attempts to reduce them, cerebrospinal fluid (CSF) shunt infections still account for 5-15% of cases of shunt surgery morbidity. We modified our current shunt infection prevention policy to include topical vancomycin (intrashunt and perishunt) to decrease the rate of shunt infections of patients at our institution.…”