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Updated: Aug 6, 2025

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Can we consider ventriculo-gallbladder shunt a first-line treatment in selected patients? Case report of a successful
Mohamed Maher Hadhri1,2, Zohra Souei3, Mohamed Boukhit3
1Department of Neurosurgery, Fattouma Bourguiba University Hospital, Avenue Farhat Hached, 5000, Monastir, Tunisia. hadmaher83@gmail.com.
Introduction:
Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative to treat hydrocephalus when the peritoneum and/or other distal sites can no longer receive shunts. In some specific conditions, it may be conceded as a first-line treatment.
Case Presentation:
We report the case of a 6-month-old girl with progressive post-hemorrhagic hydrocephalus who presented a concomitant chronic abdominal symptom. Specific investigations ruled out acute infection and led to the diagnosis of chronic appendicitis. Both problems were managed in a one-stage salvage procedure consisting of laparotomy sanctioning to treat the abdominal pathology and seize the opportunity to perform a VGS as a first option since the abdomen is prone to ventriculoperitoneal shunt (VPS) failure.
Conclusion:
Only few cases have reported the use of VGS as the first option to handle uncommon complex cases due to abdominal or cerebrospinal fluid (CSF) conditions. We wish to draw attention to VGS as an effective procedure not only in children with multiple shunt failures but also as first-line management in some selected cases.

