Department of Pediatric Neurosurgery, National Institute of Health for Women, Children and Adolescent Fernandes Figueira/Fiocruz, Rio de Janeiro, Brazil.
Department of Pediatric Neurosurgery, Jesus Municipal Hospital, Rio de Janeiro, Brazil.
Childs Nerv Syst. 2024 Aug;40(8):2411-2418. doi: 10.1007/s00381-024-06427-3. Epub 2024 May 2.
Ventriculo-peritoneal shunt is the gold standard for non-obstructive hydrocephalus. Despite advances in material, infection prevention, and valve technologies, failure can still occur. The aim of this article is to present a comprehensive study based on the experience of a reference center in pediatric neurosurgery in Rio de Janeiro with the use of the ventriculo-gallbladder shunt as an alternative to peritoneal failure.
A retrospective study was conducted from January 2018 to December 2023 of patients diagnosed with cerebrospinal fluid shunt dysfunction due to peritoneal failure and submitted to ventriculo-gallbladder shunt as an alternative in a reference center of Rio de Janeiro.
From 2018 to 2023, 18 peritoneal failures were diagnosed. Among them, 10 patients (55.5%) were selected for ventriculo-gallbladder shunt (VGS). Different causes were responsible for the hydrocephalus in these patients. VGS was placed at a mean age of 35.4 months. Four patients had temporary complications: 2 self-limited diarrheas in the first month and 2 shunt infections. After the resolution of the infection, a new VGS was placed successfully. The average follow-up was 18.8 months (follow-up 9-68 months) without further issues.
VGS is a viable option for patients facing peritoneal failure. This paper provides valuable insights into the surgical technique and outcomes associated with this alternative.
脑室-腹腔分流术是治疗非梗阻性脑积水的金标准。尽管在材料、感染预防和阀门技术方面取得了进展，但仍然可能出现故障。本文的目的是基于里约热内卢儿科神经外科参考中心的经验，全面研究使用脑室-胆囊分流术作为治疗腹膜失败的替代方法。
对 2018 年 1 月至 2023 年 12 月因腹膜失败导致脑脊液分流功能障碍并在里约热内卢参考中心接受脑室-胆囊分流术替代治疗的患者进行回顾性研究。
2018 年至 2023 年期间，诊断出 18 例腹膜失败病例。其中，10 例患者（55.5%）选择进行脑室-胆囊分流术（VGS）。这些患者的脑积水有不同的原因。VGS 平均在 35.4 个月时放置。4 例患者出现暂时性并发症：2 例在第一个月出现自限性腹泻，2 例出现分流感染。感染得到解决后，成功地放置了新的 VGS。平均随访时间为 18.8 个月（随访时间 9-68 个月），无进一步问题。
VGS 是腹膜失败患者的可行选择。本文提供了有关这种替代方案的手术技术和结果的宝贵见解。
