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Updated: Jun 22, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Infectious risk to ventriculo-peritoneal shunts from gastrointestinal surgery in the pediatric population
Vincent E Mortellaro1, Mike K Chen, David Pincus
1Department of Surgery, University of Florida College of Medicine, Gainesville, FL 32610-0286, USA.
Insights
Abdominal surgeries in children with ventriculo-peritoneal (VP) shunts rarely lead to infection, especially during elective procedures or simultaneous shunt placement. Close observation is needed for emergent abdominal surgeries to prevent shunt infection.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Infectious Diseases
Background:
- Ventriculo-peritoneal (VP) shunts are common in pediatric hydrocephalus management.
- The risk of shunt infection following abdominal surgery in children is not well-defined.
Purpose of the Study:
- To investigate the infectious implications of abdominal surgeries on VP shunts in pediatric patients.
- To evaluate the safety of simultaneous abdominal surgery and VP shunt placement.
Main Methods:
- Retrospective review of pediatric patients with VP shunts undergoing abdominal surgery over 9 years.
- Analysis of patient demographics, surgical procedures, shunt infection rates, and outcomes.
Main Results:
- Forty-two pediatric patients met the criteria.
- Two shunt infections occurred, both following emergent appendectomies.
- No infections were observed after elective abdominal procedures or simultaneous shunt placement and surgery.
Conclusions:
- Elective abdominal procedures and simultaneous VP shunt insertion are safe in children.
- Emergent abdominal surgeries, particularly appendectomies, require close monitoring for shunt infection.
- Performing gastrointestinal procedures during VP shunt insertion is a safe practice.
Purpose:
The infectious implication of abdominal surgeries on ventriculo-peritoneal (VP) shunts, including simultaneous shunt placement and management of shunt infections, has been ill defined in children.
Methods:
We conducted a 9-year retrospective review of pediatric patients with VP shunts who underwent abdominal surgeries.
Results:
Forty-two patients fit criteria. The median age at shunt placement was 1.75 years, and the median time between shunt placement and abdominal surgery was 24 days. The most common procedures included gastrostomy (17), fundoplication (15), and appendectomy (3). Seven patients had simultaneous abdominal surgery and shunt placement. All patients received preoperative antibiotics. Two children developed shunt infections, both occurred after appendectomy. Both were treated with antibiotics, with one requiring shunt removal. Median length of stay was 24 days but 28 days for those with infections. Thirty-eight patients were discharged home, 3 to chronic care facilities, and 1 died.
Conclusions:
Infections did not occur in children with VP shunts undergoing elective abdominal procedures or procedures simultaneously with shunt insertion. Infections were seen only with emergent appendectomies, suggesting that performing gastrointestinal procedures at the time of VP shunt insertion is safe. Children with VP shunts undergoing emergent surgery for peritoneal infection warrant close observation for shunt infection.
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