Abdominal Pseudocyst Post Ventriculoperitoneal Shunt: A Systematic Review

Abdominal pseudocyst (APC) is a rare complication of ventriculoperitoneal shunt (VPS). The purpose of this study is to provide an updated systematic review to provide a comprehensive understanding of this complication and to guide clinical decisions. A comprehensive search was conducted to cover articles published between October 1969 and December 2022. The search was conducted according to PRISMA guidelines and resulted in the identification of 162 eligible papers that met the study criteria. The study included 208 patients with a mean age of 12 years. The majority were pediatric patients (62.8%). 15.9% of patients had a functioning VPS at the time of diagnosis. The patients who had a history of shunt revision had a significantly longer time from VPS insertion to APC formation (P value <0.05). Adults were noted to have longer periods from VPS insertion to APC formation. 60.4% of patients had abdominal symptoms, 10.2% had neurological symptoms, and 29.4% had a combination of both. 124 patients had a negative CSF culture at the time of diagnosis, with a significant association between hydrocephalus cause and CSF culture results (P value <0.05). The treatment modalities predominantly included exploratory laparotomy with pseudocyst resection and shunt revision, along with various alternative approaches. The recurrence rate was 9.1%, with a recovery rate of 71.2%. This research sheds light on a rare surgical complication of VPS that requires a high level of suspicion. The study's results improve our understanding of APC in the context of VPS surgery.