Management of Postoperative Ventriculoperitoneal Shunt Complications in Pediatric Patients

Ebrahim, Abd Elkafy Sharaf Eldin; Shokhaiby, Usama M El; Alkholy, Ahmed Aly

doi:10.21608/ejhm.2019.43990

Cited by 1 publication

(2 citation statements)

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“…There was no statistically significant difference between Failed Group and Improved Group regarding Vomiting, Fever and Fits. [7]. All cases in our study showed increased intracranial pressure (ICP), which was also seen in the study by Popa et al (2009) [12], who observed acute hydrocephalus in their patients.…”

Section: Resultssupporting

confidence: 89%

“…Adhesion was a common finding in 80.0% of cases, consistent with Abouhashem et al [5], who reported peritoneal adhesion in most cases of distal mechanical failure. Shunt obstruction, either proximal or distal, was the most common postoperative complication [7], and infection was also a significant cause of shunt failure [10]. Various studies have reported on the prevalence of shunt-related complications, and careful assessment and management are essential to improve outcomes and reduce morbidity in patients with VP shunts.…”

Section: Resultsmentioning

confidence: 99%

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Laparoscopic Management of Post Operative Obstructed Distal End of Ventriculoperitoneal Shunt Tube in Hydrocephalic Patients

SAYED,

RADWAN,

El Maghrabi

et al. 2023

Benha Journal of Applied Sciences

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Background: Hydrocephalus is a common condition in which there is an abnormal accumulation of cerebrospinal fluid in the brain. Ventriculoperitoneal (VP) shunt surgery is a standard treatment for hydrocephalus, but post-operative obstructed distal ends of VP shunt tubes can lead to complications.Laparoscopy has emerged as a potential diagnostic and therapeutic tool in managing such obstructions. This study aimed to comprehensively outline the role of laparoscopy in the diagnosis and management of obstructed distal ends of VP shunt tubes in hydrocephalic patients. Methods: The study was conducted at Benha University and Benha Children Hospitals between 2016 and 2021. A cohort of 40 hydrocephalic patients who had undergone VP shunt surgery and experienced abdominal obstruction at the distal end of their VP shunts were included. Diagnosis involved clinical abdominal examination, neurosurgical evaluation, and radiological examinations (abdominal X-ray, abdominal ultrasound, and brain CT scan). Laparoscopic procedures were performed to address the specific obstructions. Results: Among the 40 patients, laparoscopy successfully diagnosed and treated the obstructed distal ends of VP shunt tubes in 31 cases (77.5%). The laparoscopic interventions resulted in resolution of symptoms and signs of active hydrocephalus in these patients, as confirmed by radiological assessments. Out of the remaining 9 cases, 6 required additional laparoscopic revisions, while 3 patients were prepared for ventriculo-arterial shunts. No conversions to open surgery were needed, and there were no mortality cases. Mild post-operative complications were observed in 6 patients, which resolved with antibiotic and antipyretic therapy. Conclusions: Laparoscopy is a valuable diagnostic and therapeutic approach in the management of obstructed distal ends of VP shunt tubes in hydrocephalic patients.

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Section: Resultssupporting

confidence: 89%