open access

Vol 51, No 4 (2017)
Original research articles
Submitted: 2016-09-14
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Our initial experience with ventriculo-epiplooic shunt in treatment of hydrocephalus in two centers

Valentin Titus Grigorean, Aurelia Mihaela Sandu, Mihai Popescu, Ioan Stefan Florian, Cristian Dumitru Lupascu, Corina Lupascu Ursulescu
DOI: 10.1016/j.pjnns.2017.04.007
·
Neurol Neurochir Pol 2017;51(4):290-298.

open access

Vol 51, No 4 (2017)
Original research articles
Submitted: 2016-09-14

Abstract

Introduction

Hydrocephalus represents impairment in cerebrospinal fluid (CSF) dynamics. If the treatment of hydrocephalus is considered difficult, the repeated revisions of ventriculo-peritoneal (VP) shunts are even more challenging.

Objective

The aim of this article is to evaluate the efficiency of ventriculo-epiplooic (VEp) shunt as a feasible alternative in hydrocephalic patients.

Material and methods

A technical modification regarding the insertion of peritoneal catheter was imagined: midline laparotomy 8–10cm long was performed in order to open the peritoneal cavity; the great omentum was dissected between its two layers; we placed the distal end of the catheter between the two epiplooic layers; a fenestration of 4cm in diameter into the visceral layer was also performed.

A retrospective study of medical records of 15 consecutive patients with hydrocephalus treated with VEp shunt is also presented.

Results

Between 2008 and 2014 we performed VEp shunt in 15 patients: 5 with congenital hydrocephalus, 8 with secondary hydrocephalus and 2 with normal pressure hydrocephalus. There were 7 men and 8 women. VEp shunt was performed in 13 patients with multiple distal shunt failures and in 2 patients, with history of abdominal surgery, as de novo extracranial drainage procedure. The outcome was favorable in all cases, with no significant postoperative complications.

Conclusions

VEp shunt is a new, safe and efficient surgical technique for the treatment of hydrocephalus. VEp shunt is indicated in patients with history of recurrent distal shunt failures, and in patients with history of open abdominal surgery and high risk for developing abdominal complications.

Abstract

Introduction

Hydrocephalus represents impairment in cerebrospinal fluid (CSF) dynamics. If the treatment of hydrocephalus is considered difficult, the repeated revisions of ventriculo-peritoneal (VP) shunts are even more challenging.

Objective

The aim of this article is to evaluate the efficiency of ventriculo-epiplooic (VEp) shunt as a feasible alternative in hydrocephalic patients.

Material and methods

A technical modification regarding the insertion of peritoneal catheter was imagined: midline laparotomy 8–10cm long was performed in order to open the peritoneal cavity; the great omentum was dissected between its two layers; we placed the distal end of the catheter between the two epiplooic layers; a fenestration of 4cm in diameter into the visceral layer was also performed.

A retrospective study of medical records of 15 consecutive patients with hydrocephalus treated with VEp shunt is also presented.

Results

Between 2008 and 2014 we performed VEp shunt in 15 patients: 5 with congenital hydrocephalus, 8 with secondary hydrocephalus and 2 with normal pressure hydrocephalus. There were 7 men and 8 women. VEp shunt was performed in 13 patients with multiple distal shunt failures and in 2 patients, with history of abdominal surgery, as de novo extracranial drainage procedure. The outcome was favorable in all cases, with no significant postoperative complications.

Conclusions

VEp shunt is a new, safe and efficient surgical technique for the treatment of hydrocephalus. VEp shunt is indicated in patients with history of recurrent distal shunt failures, and in patients with history of open abdominal surgery and high risk for developing abdominal complications.

Get Citation

Keywords

Epiploon, Greater omentum, Hydrocephalus, Ventriculo-epiplooic shunt, Ventriculo-peritoneal shunt failure

About this article
Title

Our initial experience with ventriculo-epiplooic shunt in treatment of hydrocephalus in two centers

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 4 (2017)

Pages

290-298

DOI

10.1016/j.pjnns.2017.04.007

Bibliographic record

Neurol Neurochir Pol 2017;51(4):290-298.

Keywords

Epiploon
Greater omentum
Hydrocephalus
Ventriculo-epiplooic shunt
Ventriculo-peritoneal shunt failure

Authors

Valentin Titus Grigorean
Aurelia Mihaela Sandu
Mihai Popescu
Ioan Stefan Florian
Cristian Dumitru Lupascu
Corina Lupascu Ursulescu

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