Laparoscopic cholecystectomy in patients with ventriculoperitoneal shunts: A case series

• Published in: Hellenic journal of surgery Vol. 89; no. 3-4; pp. 163 - 165
• Main Authors: Lykoudis, P. M., Nastos, C., Dellaportas, Dionysios, Vezakis, A., Ayiomamitis, G. D., Papaconstantinou, I., Theodosopoulos, T., Polydorou, A., Polymeneas, G.
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01-07-2017
• Subjects: Hepato-Biliary Surgery; Medicine; Medicine & Public Health; Surgery; case report; Laparoscopic cholecystectomy; gallstones; ventriculoperitoneal shunt
• ISSN: 0018-0092; 1868-8845
• DOI: 10.1007/s13126-017-0405-3

Introduction
Patients with ventriculoperitoneal shunts (VPS) are at risk of associated complications during laparoscopic surgery. Although these cases are rare, the surgeon should be aware of the pathophysiology of such complications in order to recognize and avoid them.
Case presentation
Three patients with a VPS who underwent laparoscopic cholecystectomy are presented. Two of the patients suffered from symptomatic gallstone disease, and the third, the oldest, from acute calculus cholecystitis. All patients had a VPS because of hydrocephalus. There were no intraoperative complications in this series.
Discussion
This small case series presents a rare condition that can be the cause of complications during laparoscopic surgery. Septic complications, including VPS infection and cerebrospinal fluid (CSF) infection, pneumocephalus, CSF pseudocyst, and adhesions due to the presence of the VPS, are all possible occurrences. These are discussed, with a short literature review.