Graham S M, Flowers J L, Scott T R, Lin F, Rigamonti D
Department of Surgery, University of Maryland School of Medicine, Baltimore.
Neurosurgery. 1993 Jun;32(6):932-4. doi: 10.1227/00006123-199306000-00008.
The placement of percutaneous endoscopic gastrostomy tubes in patients with a ventriculoperitoneal shunt implicitly raises concerns about the potential for infection, shunt malfunction, and neurological decompensation. As there is no detailed information on this subject, the safety of percutaneous endoscopic gastrostomy was prospectively studied in 15 consecutive patients who had a ventriculoperitoneal shunt. Ten shunts entered the right upper abdomen, and five were on the left. A percutaneous gastrostomy tube was placed in the left upper abdomen for a minimum of 1 week (mean, 2.2 weeks) after shunt insertion. In the immediate postoperative period, no wound or intra-abdominal complications occurred. One patient developed acute neurological decompensation because of proximal shunt malfunction, and one patient died from cardiopulmonary complications unrelated to the placement of shunts or gastrostomy tubes. Among the 14 survivors, there have been no shunt malfunctions or septic complications during a mean follow-up period of 8.6 months. It would appear that percutaneous endoscopic gastrostomy tubes can be placed in patients with a ventriculoperitoneal shunt without undue concern for short- or long-term infectious or neurological sequelae. In addition, the presence of a shunt on the left side does not necessarily interfere with the safe placement of a percutaneous endoscopic gastrostomy tube.
在脑室腹腔分流术患者中放置经皮内镜胃造口管，不可避免地引发了人们对感染、分流器故障和神经功能失代偿可能性的担忧。由于关于这一主题没有详细信息，我们对15例连续的脑室腹腔分流术患者进行了前瞻性研究，以探讨经皮内镜胃造口术的安全性。10根分流管进入右上腹，5根在左侧。在分流术后，于左上腹放置经皮胃造口管至少1周（平均2.2周）。术后即刻，未发生伤口或腹腔内并发症。1例患者因近端分流器故障出现急性神经功能失代偿，1例患者死于与分流管或胃造口管放置无关的心肺并发症。在14名幸存者中，平均随访8.6个月期间，未出现分流器故障或感染性并发症。看来，在脑室腹腔分流术患者中放置经皮内镜胃造口管，无需过度担心短期或长期的感染或神经后遗症。此外，左侧存在分流管并不一定会干扰经皮内镜胃造口管的安全放置。
