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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2020; 9(03): 170-174
DOI: 10.1055/s-0040-1713562
Original Article

A Retrospective Study on Ventriculoperitoneal Shunt Complications in a Tertiary Care Centre

Authors

  • Pankaj Kumar

    1   Department of Neuro Surgery, Atal Bihari Vajpyee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India

  • Sharad Pandey   *

    1   Department of Neuro Surgery, Atal Bihari Vajpyee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India

  • Nitin Bhakal

    1   Department of Neuro Surgery, Atal Bihari Vajpyee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India

  • Sourabh Shrivastava

    1   Department of Neuro Surgery, Atal Bihari Vajpyee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India

  • L. N. Gupta

    1   Department of Neuro Surgery, Atal Bihari Vajpyee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India

  • Ravi Prakash Jha

    2   Department of Community Medicine, Division of Biostatistics, Dr Baba Sahib Ambedkar Medical College, Delhi, India
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Abstract

Background Ventriculoperitoneal shunt (VPS) is a common technique employed to treat the second most common congenital brain malformation, “hydrocephalus.” Postshunt insertion, the consequent complications and factors contributing to shunt malfunction are much fought occurrences. The current study was planned to assess the effectiveness of the procedure, analyze the complications of VP shunt, and recognize the factors influencing shunt malfunction.

Materials and Methods The present study was a retrospective observational study, which was conducted at the Department of Neurosurgery, PGIMER RML Hospital, New Delhi, from August 2016 to July 2018. Patients with hydrocephalus requiring shunt intervention were included in the study. A Chhabra “slit n spring” hydrocephalus shunt system was inserted in all patients. All patients with VP shunts were followed to assess for any postshunt complications.

Results Out of 541 patients for whom VP shunt was inserted over a period of 2 years, 126 (23.3%) patients developed complications. The most common cause of hydrocephalus for which VP shunt was done was tubercular meningitis (39.3%, n = 63), followed by ventriculitis (12.38%, n = 20), congenital hydrocephalus (8.87%, n = 14) and aqueductal stenosis (5.54%, n = 03). The most common complication in our study was obstruction of proximal end of the catheter by debris, which was noted in 50 patients (39.68%). The second most common complication was poor peritoneal absorption or obstruction of lower end (21.43%, n = 27 cases). Abscess along the shunt was seen in 21 patients (16.67%). Complications were mostly documented in cases with hydrocephalus due to tubercular meningitis (TBM) (39.3%, 63 patients) and ventriculitis (12.38%, 20 patients). Other complications were hyperemia with superficial ulceration or complete exposure of skin overlying the tube (11.9%, n = 15), overdrainage of the ventricles leading to chronic subdural hematoma (n = 14, 11.11%), and infection around the distal catheter (4.76%, n = 6).

Conclusion VPS procedure led to a complication in several patients, with the most common being obstruction of proximal catheter and poor peritoneal absorption or obstruction of lower end followed by abscess and infection.

Keywords

ventriculoperitoneal shunt - hydrocephalus - complications

* Previously with Department of Neuro Surgery, Sir Sunder Lal Hospital, IMS, BHU, Varanasi, Uttar Pradesh 221005, India.




Publication History

Article published online:
28 September 2020

© 2020. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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