Ventriculoperitoneal shunt complications: a local study at Qena University Hospital: a retrospective study

Abstract

Abstract Background Shunting of cerebrospinal fluid (CSF) has reduced the morbidity and mortality of hydrocephalus. Ventriculoperitoneal (VP) shunt is the most commonly used procedure for shunting, but it has potential complications that may need multiple surgical interventions. Methods It is a clinical retrospective observational study that was conducted on 30 patients of both genders with different ages who presented with signs and symptoms of shunt malfunction between 2012 and 2016. A complete clinical assessment was done, a final diagnosis was made, and a treatment of individual patients was planned accordingly. Patients were followed up within 1 week and 1 month post-operatively. Data was analyzed using the SPSS (version 16.0). Results VP shunt was inserted for 205 patients. Thirty (14.6%) patients had various forms of complications. Fifteen (50%) patients had complications related to the proximal catheter and the reservoir while 15 (50%) patients had complications related to distal catheter. The most common complications were exposure of the shunt 23.3% (13.3% exposed shunt reservoir and 10% exposed distal catheter) followed by shunt obstruction 13.3% (6.66% proximal and 6.66% distal). Twenty-eight (93.3%) patients were managed surgically, 24 (85%) patients of them showed marked improvement at the end of the first month postoperatively, while four (15%) patients needed another surgical intervention. Conclusions Insertion of V-P shunt is routinely done by all neurosurgeons. A great care should be taken during insertion of the shunt system starting from scrubbing to avoid complications. Despite complications, the VP shunt remains the main surgical procedure used for hydrocephalus management.

Keywords

• Hydrocephalus
• Cerebrospinal fluid shunts
• Ventriculoperitoneal shunt
• Ventriculoperitoneal shunt complications