脑室-胆囊分流术：脑脊液量重要吗？
The ventriculo-cholecystic shunt: does CSF volume matter?
作者信息
Henderson Duncan, Budu Alexandru, Horridge Michelle, Jesurasa Anthony, Sinha Saurabh, Ushewokunze Shungu, Fisher Ross
机构信息
Sheffield Children's Hospital, Clarkson Street, Sheffield, S10 2TQ, UK.
出版信息
Childs Nerv Syst. 2019 Sep;35(9):1557-1560. doi: 10.1007/s00381-019-04317-7. Epub 2019 Jul 27.
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.
引言
对于小儿患者中腹膜功能失效的脑积水管理具有挑战性。一种选择是进行脑室-胆囊分流术。然而，关于胆囊容纳脑脊液（CSF）的能力知之甚少。
方法
进行了一项回顾性病例系列研究，纳入了在谢菲尔德儿童医院这一单一中心接受脑室-胆囊分流术的所有小儿患者。
结果
我们确定了3例接受脑室-胆囊分流术的患者。2例患者的分流器存活超过1年，其术前体外脑室引流（EVD）量分别为每小时8毫升和10毫升。1例患者术后第4天因远端功能障碍分流失败，其术前EVD超过每小时30毫升。
结论
在考虑为患者进行脑室-胆囊分流术时，如果已知脑脊液输出量较高，例如根据EVD测量结果，应谨慎行事。
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