====== Ventriculo-gallbladder shunt ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/14S2P3JOHoFjMo1R7WAdKYqQ7wblkI7xm9HKNd8BaY6771mg4v/?limit=15&utm_campaign=pubmed-2&fc=20240214003959}}
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The [[ventriculoperitoneal shunt]] (VPS) is the [[gold standard]] [[neurosurgical technique]] to treat hypertensive hydrocephalus; however, it may fail in 20 to 70% of cases. The present study shows an alternative for patients with contraindications to VPS.

A case series of nine patients. The medical records of all patients under 17 years of age who underwent ventriculo-[[gallbladder]] (VGB) shunt at a pediatric hospital from January 2014 to October 2022 were reviewed.

Results: There were 6 (66.7%) males and 3 (33.3%) females. The average age of 73.6 months or 6.1 years at the time of surgery. They had undergone, on average, 5.1 VPS reviews before the VGB shunt. Five (55.5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage (11.1%), and ventriculoenteric fistula (22.2%); all these patients got better at surgical reapproach, and in two of them, the VGB shunt was re-implanted.

This [[case series]] shows a lower risk of death and a similar risk of complications compared to other alternative shunts. This article spotlighted VGB as a viable alternative when VPS fails or has contraindications
((Afornali S, Beraldo RF, Maeda AK, Mattozo CA, Brito RN, Ergen A, Pereira MC, Chaurasia B. Ventriculo-gallbladder shunt: case series and literature review. Childs Nerv Syst. 2024 Feb 8. doi: 10.1007/s00381-024-06297-9. Epub ahead of print. PMID: 38329505.))
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Sometimes, there are complex cases that may need innovative solutions in order to implant the distal catheter of the shunt: in these situations, the gallbladder is a well-described option and it can be safely used.

Pancucci et al., reported the case of a 4-month-old baby with a wide optic-chiasmal hypothalamic glioma generating hydrocephalus with high protein values in CSF. Ventriculobiliary shunting was decided, and the distal catheter was directed by the assistance of laparoscopic surgery.

The outcome was satisfactory.

Laparoscopic placement of a distal catheter in the gallbladder has not been described in the literature; herein, they describe the tenets and the technical tips of this approach
((Pancucci G, Plaza-Ramirez E, Driller C, Miranda-Lloret P, Botella-Asunción C. 
Laparoscopy-assisted placement of a ventriculobiliary shunt: a technical note.
Childs Nerv Syst. 2019 May 3. doi: 10.1007/s00381-019-04173-5. [Epub ahead of
print] PubMed PMID: 31049668.
)).