Ventriculo – Gallbladder shunt
•Ventriculo-gallbladder shunt offers a unique approach to treating hydrocephalus when other shunt options are not viable.•The gallbladder's ability to absorb and lyse proteins in cerebrospinal fluid makes it particularly effective in cases with high-protein CSF.•Literature indicates that it is...
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| Published in: | Journal of clinical neuroscience Vol. 121; pp. 83 - 88 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Scotland
Elsevier Ltd
01-03-2024
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | •Ventriculo-gallbladder shunt offers a unique approach to treating hydrocephalus when other shunt options are not viable.•The gallbladder's ability to absorb and lyse proteins in cerebrospinal fluid makes it particularly effective in cases with high-protein CSF.•Literature indicates that it is a safe and efficient surgical technique, suitable for both adult and pediatric patients.•Complications such as gallstone formation and infections are reported but manageable, with no higher infection rate than other shunt types.•It has some specific characteristic techniques that must be know by the surgery team and shows promise for cases with excessive liquor production.
Abstract Introduction: Permanent liquor diversion is associated with a high risk of failure and often requires re-intervention. The ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative for treating hydrocephalus when the peritoneum or other distal sites are no longer suitable for receiving shunts. This article aims to report a case from a neurosurgery referral service in Brazil and review the literature on this issue. Methods: A systematic literature review was conducted in accordance with the PRISMA statement. The PubMed, Embase, and Web of Science databases were searched for data screening and extraction. The reported case was conducted with ethical approval from the neurosurgical hospital's ethics committee. Results: G.B.S, male, 43 years old, no comorbidities, who has been dealing with a 12-year history of hydrocephalus, with post-surgical chronic fungal meningitis. Two years ago, he underwent a ventriculoatrial shunt (VAS) placement due to multiple ventriculoperitoneal shunt (VPS) failures. Endocarditis was suspected, and the VAS was removed. As an alternative, VGS was implanted 6 months ago, and since then, there has been no need for a new system review. The gallbladder has an absorptive capacity of 1500 cc of liquid daily, which is more than the normal daily production of cerebrospinal fluid (CSF). Therefore, it is a good alternative when the ventriculoperitoneal shunt is not feasible due to postsurgical peritoneal adhesions or when there are contraindications for ventriculoatrial shunts. Conclusion: VGS is an alternative for patients who cannot undergo the most common surgical interventions, such as VPS. Keywords: Ventriculo-gallbladder; Shunt; Hydrocephalus; Ventriculo-vesicular; Gallbladder. |
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| Bibliography: | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Undefined-5 ObjectType-Report-1 ObjectType-Article-3 |
| ISSN: | 0967-5868 1532-2653 |
| DOI: | 10.1016/j.jocn.2024.02.002 |