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Updated: Jun 21, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
What About the Gallbladder? A Case Series of Experience and Outcomes in Pediatric Ventriculogallbladder Shunts
Krysta M Sutyak1, Stephen A Fletcher2, David I Sandberg2
1Division of General & Thoracic Pediatric Surgery, Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) and Children's Memorial Hermann Hospital, Houston, Texas.
Insights
Ventriculogallbladder shunts offer a viable alternative for pediatric hydrocephalus when traditional shunts fail or are contraindicated due to abdominal issues. This study shows promising outcomes for this alternative shunt placement in complex cases.
Area of Science:
- Pediatric Neurosurgery
- Medical Devices
- Surgical Innovation
Background:
- Traditional hydrocephalus shunts (peritoneum, atrium, pleural) may be contraindicated in pediatric patients with complex surgical histories or small body size.
- Alternative distal shunt placement is needed for these challenging cases.
Purpose of the Study:
- To describe the experience and outcomes of ventriculogallbladder shunt (VGBS) placement in pediatric patients.
- To evaluate the feasibility of VGBS in patients with contraindications for traditional shunt locations.
Main Methods:
- Retrospective review of pediatric patients (<18 years) who underwent VGBS placement.
- Data collected included demographics, medical history, prior shunt history, indication for VGBS, revisions, and duration.
- Descriptive statistics were used to analyze the data.
Main Results:
- Five male patients with a median age of 6.9 months underwent VGBS placement.
- All patients had intra-abdominal pathology complicating traditional shunt placement.
- Three of five VGBS remained functional long-term, with two patients requiring conversion to ventriculopleural shunts.
Conclusions:
- The gallbladder serves as a feasible and vital option for distal ventricular shunt placement in pediatric patients.
- VGBS is a crucial consideration for children with small size or intra-abdominal pathologies that preclude traditional shunt locations.
Introduction:
Hydrocephalus treatment via shunting to the peritoneum, atrium, or pleural space may be contraindicated in pediatric patients with complex surgical history or small size. We aim to describe experience and outcomes of ventriculogallbladder shunt (VGBS) placement.
Methods:
A retrospective review was performed of all patients (<18 y) who underwent VGBS placement at a single quaternary children's hospital (January 1, 2014-October 31, 2025). Patients were identified by Current Procedural Terminology code and operative records. Demographics, past medical history, prior shunt history, indication for VGBS, subsequent revisions, and duration were collected. Descriptive statistics were utilized.
Results:
Five male patients were identified with a median age at VGBS placement of 6.9 mo (interquartile range [IQR] 5.9, 9.0). Four patients developed hydrocephalus secondary to neonatal intraventricular hemorrhage and one from obstructive intracranial malignancy. All patients had intra-abdominal pathology: three necrotizing enterocolitis, one omphalocele and intestinal atresia, and one dysfunctional peritoneum. One patient had a ventriculoperitoneal shunt, ventriculoatrial shunt, and ventriculopleural shunt prior to VGBS, three patients had prior ventriculoperitoneal shunt, and one patient had no prior shunts. Of the four patients with prior shunt placement, the median age at first drainage procedure was 4.1 mo (IQR 3.0, 4.8) with a median of 4.5 revisions (IQR 3.5, 7.5) prior to VGBS. Three of the five VGBS remain functional after 2.4, 4.8, and 7.2 y with two patients undergoing conversion to ventriculopleural shunts (1.4 and 6.8 y postplacement).
Conclusions:
The gallbladder is a feasible and vital consideration for distal ventricular shunt placement in children of small size and/or intra-abdominal pathology which prohibit traditional locations.