Ventriculogallbladder shunt fracture: bile peritonitis

Kulwin, Charles; Margaron, Franklin C.; Leys, Charles M.; Boaz, Joel C.; Fulkerson, Daniel H.

doi:10.3171/2013.10.peds13289

Cited by 8 publications

(4 citation statements)

References 5 publications

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“…Commonly in these cases surgeons use the gallbladder to drain CSF as last resort, electing the atrium or the pleural cavity for second viable receptacle. This disinclination to VGS is not counselled by standard guidelines, but mainly as consequence of potential complications (table 2) and technical concerns [3,4,6,7,9,12,12,14,21,23,24]. From our perspective, VGS placement technique, as detailed by Morosanu et al [14], was little different compared to VPS.…”

Section: Discussionmentioning

confidence: 77%

Can we consider ventriculo-gallbladder shunt a first-line treatment in selected patients? Case report of a successful management

et al. 2023

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Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative to treat hydrocephalus when the peritoneum and/or other distal sites can no longer receive shunts. In some speci c conditions, it may be conceded as a rst-line treatment. Case presentation:We report the case of a 6-month-old girl with progressive post-hemorrhagic hydrocephalus and who presented a concomitant chronic abdominal symptom. Speci c investigations ruled out acute infection and led to the diagnosis of chronic appendicitis. Both problems were managed in a one-stage salvage procedure consisting of laparotomy sanctioning to treat the abdominal pathology and seize the opportunity to perform a VGS as a rst option since the abdomen is prone to ventriculoperitoneal shunt (VPS) failure. Conclusion:Only few cases have reported the use of VGS as the rst option to handle uncommon complex cases due to abdominal or Cerebro-Spinal Fluid (CSF) conditions. We wish to draw attention to VGS as an effective procedure not only in children with multiple shunt failures but also as rst-line management in some selected cases.

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Section: Discussionmentioning

confidence: 77%

Can we consider ventriculo-gallbladder shunt a first-line treatment in selected patients? Case report of a successful management

et al. 2023

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“…Subsequently, not only would the CSF be diverted into the peritoneal cavity but bile would also leak into the abdomen. This can cause serious complications such as bile peritonitis as described by Kulwin et al [35]. Some authors have also reported a pediatric case where the straight connector was retained in the gallbladder after the shunt was disconnected [55].…”

Section: Technique and Perioperative Aspectsmentioning

confidence: 97%

“…The report written in 1985 appears to be the only case that succumbed as a direct result of the shunt system [9]. Kulwin et al report the case of a patient with a gallbladder shunt that developed bile peritonitis due to a fracture of the catheter below the valve and required to be removed and converted to a VA shunt [35]. MRSA ventriculitis has been cited in a 13-month-old patient who presented septic to the hospital.…”

Section: Specific Vcs Complicationsmentioning

confidence: 99%

Evaluation of the ventriculocholecystic shunt—an overview of present practice in adult and pediatric hydrocephalus

2021

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In the context of hydrocephalus, there are a multitude of therapeutic options that can be explored in order to improve patient outcomes. Although the peritoneum is the current elected clinical solution, various receptacles have been utilized when experiencing contraindications. Along with the ventriculoatrial or ventriculopleural, the ventriculocholecystic shunt was also described as an alternative. In order to make a decision on a place for drainage, the surgeon must be knowledgeable on details from modern literature. The main target of this review was to summarize the currently available information on this topic and assess the status of the gallbladder as a viable option for cerebrospinal fluid diversion.

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“…This length may be insufficient when the child's height increases because the catheter can be pulled out completely or disconnected. 17 Another potential problem is disconnection of the catheter from the connector on the chest. Therefore, use of VGB shunts in children with significant remaining expected growth may be considered more carefully.…”

Section: Ventriculogallbladder Shunt: Clinical Physiology and Efficacymentioning

confidence: 99%

Ventriculogallbladder Shunt: Percutaneous Transhepatic Placement of the Distal Catheter

Ogagan

Kulkarni

Owusu-Adjei

et al. 2021

Operative Neurosurgery

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BACKGROUND: Ventriculogallbladder (VGB) shunts are currently placed as a salvage procedure in treatment of hydrocephalus when all other options are exhausted. Although VGB shunts work well when successfully implanted, they are still rarely used because of the technical challenges with the traditional surgical technique. OBJECTIVE: To implant VGB shunts using a minimally invasive technique that is safer and less technically challenging. METHODS: We discussed our utilization of a percutaneous transhepatic approach to placement of the distal catheter into the gallbladder as a new technique that offers a solution to the established but surgically demanding current approach. We presented a complex patient with multiple failed shunts who underwent placement of a VGB shunt. RESULTS: The shunt was successfully placed and did not incur any complications or require any revisions in 5 yr. CONCLUSION: Given the safety and ease of this minimally invasive approach, we believe percutaneous transhepatic approach in VGB shunts should be considered as a reasonable option in patients with complex hydrocephalus.

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Ventriculogallbladder shunt fracture: bile peritonitis

Cited by 8 publications

References 5 publications

Can we consider ventriculo-gallbladder shunt a first-line treatment in selected patients? Case report of a successful management

Can we consider ventriculo-gallbladder shunt a first-line treatment in selected patients? Case report of a successful management

Evaluation of the ventriculocholecystic shunt—an overview of present practice in adult and pediatric hydrocephalus

Ventriculogallbladder Shunt: Percutaneous Transhepatic Placement of the Distal Catheter

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