COMPLICATION OF VENTRICULOPERITONEAL (VP) SHUNT IN DEVELOPING COUNTRIES - OUR OBSERVATION

Dr. Sukriti Das*, Dr. Rathin Halder, Dr. Shamsul Islam Khan, Dr. Sharbari Dey, Dr. Uzzal Kumar Shadhu Khan, Dr. Saiful Hoque, Dr. Kaniz Fatema Ishrat Zahan, Dr. Mahmudul Haque Morshed

ABSTRACT

Objective: Ventriculoperitoneal (VP) shunt is very commonly performed neurosurgical operation in developing countries. Complications due to shunt infection and obstruction are associated with high morbidity and mortality. This observational study was performed by collecting data from multiple institutes in Bangladesh. Materials and Methods: It is a clinical retrospective observational study. This study was conducted on 150 patients of both genders with different ages who presented with signs and symptoms of shunt malfunction between 2018 and 2020. A complete clinical assessment was done, a final diagnosis was made, and a treatment of individual patients was planned accordingly. Patients were followed up within 1 week and 1 month post-operatively. Data was analyzed using the SPSS (version 22.0). Results: VP shunt surgery was done in 150 patients. Among them twenty-five (16.6%) patients had various forms of complications. Fifteen (60%) patients had complications related to the proximal catheter and the reservoir while 10 (40%) patients had complications related to distal catheter. The most common complications were exposed proximal shunt reservoir 16% and exposed distal catheter 8%, followed by proximal shunt obstruction 8% and distal obstruction 4%. The most common cause of Hydrocephalus was Congenital about 86.66 %, in which 16.1 % patients faced complications after surgery. Twenty-three (92%) patients were managed surgically, 21 (91%) patients of them showed marked improvement at the end of the first month postoperatively, while two (8%) patients needed another surgical intervention. Conclusion: During VP shunt surgery utmost care should be taken during procedure of the shunt surgery starting from scrubbing to closure of skin to avoid complications. Despite complications, the VP shunt insertion remains the main surgical option used for hydrocephalus management.

Keywords: Hydrocephalus, Cerebrospinal Fluid (CSF), Ventriculoperitoneal Shunt, Ventriculoperitoneal shunt complications.