The ventriculo-cholecystic shunt: does CSF volume matter?

Childs Nerv Syst. 2019 Sep;35(9):1557-1560. doi: 10.1007/s00381-019-04317-7. Epub 2019 Jul 27.

Abstract

Introduction: The management of hydrocephalus in paediatric patients where the peritoneum has failed can be challenging. One option is to perform a ventriculo-cholecystic shunt. However, little is known about the capacity of the gall bladder to accommodate cerebrospinal fluid (CSF).

Methods: A retrospective case series was performed to include all paediatric patients who received a ventriculo-cholecystic shunt at a single centre, Sheffield Children's Hospital.

Results: We identified three patients who had a ventriculo-cholecystic shunt inserted. The shunt survived past 1 year in two patients, who had pre-operative external ventricular drain (EVD) outputs of 8 and 10 ml/h respectively. One patient shunt failed at day four post-op due to distal dysfunction, his pre-operative EVD was over 30 ml/h.

Conclusions: When considering a patient for a ventriculo-cholecystic shunt, caution should be taken if a high CSF output is known, for example, as per an EVD measurement.

Keywords: Hydrocephalus; Shunt failure; Ventriculo-cholecystic shunt; Ventriculo-peritoneal shunt.

Publication types

  • Case Reports

MeSH terms

  • Cerebrospinal Fluid Shunts*
  • Child
  • Child, Preschool
  • Gallbladder / surgery*
  • Humans
  • Hydrocephalus / surgery*
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Treatment Outcome