Related Experiment Video

Updated: Jun 18, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
14:59

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

Percutaneous endoscopic gastrostomy and ventriculoperitoneal shunts: a dangerous combination?

Alastair Cairns1, Joseph Geraghty, Ahmed Al-Rifai

  • 1Gastroenterology Department, Salford Royal NHS Foundation Trust, Manchester, UK. cairns_aj@yahoo.co.uk

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
|December 8, 2009
PubMed

Insights

Combining ventriculoperitoneal shunts (VPS) and percutaneous endoscopic gastrostomies (PEG) may increase VPS infection risk. Delaying PEG insertion for at least 10 days after VPS placement can reduce infection rates in neurosurgical patients.

Area of Science:

  • Neurosurgery
  • Gastroenterology
  • Infectious Disease

Background:

  • Combined use of ventriculoperitoneal shunts (VPS) and percutaneous endoscopic gastrostomies (PEG) is common in neurosurgical patients requiring enteral feeding.
  • The safety and infection risk associated with simultaneous or sequential VPS and PEG insertion remain a concern.
  • This study investigates the largest European series to date on combined VPS and PEG procedures.

Purpose of the Study:

  • To determine the safety of combined VPS and PEG insertion.
  • To assess the risk of ventriculoperitoneal shunt infection following percutaneous endoscopic gastrostomy placement.
  • To provide evidence-based recommendations for the timing of PEG insertion in patients with VPS.

Main Methods:

  • Retrospective review of 302 patients undergoing VPS insertion between 2002 and 2007.
  • Analysis of 24 patients who subsequently received PEG insertion.
  • Comparison of shunt infection rates in patients with and without PEG, and by timing of procedures.

Main Results:

  • Five out of 24 patients (20.8%) developed a shunt infection after PEG insertion.
  • This infection rate is significantly higher than the overall institutional rate of 7% (P = 0.017).
  • No significant increase in infection was observed when PEG insertion was delayed by more than 10 days (2/14 patients).

Conclusions:

  • Delaying PEG insertion for at least 10 days post-VPS placement may be prudent to minimize shunt infection risk.
  • PEG insertion should not be avoided in stable patients with pre-existing VPS due to concerns about cerebrospinal fluid or shunt infection.
  • Careful consideration of procedural timing is essential for patient safety in combined VPS and PEG cases.
Abstract

Related Concept Videos

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding01:15

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

Parentral Nutrition: Centeral and Peripheral Parental Nutrition

Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...