Ventriculoperitoneal shunt failure and infection: a retrospective review at Queen Mary Hospital

Abstract

BACKGROUND: Ventriculoperitoneal shunting is a commonly performed procedure for diversion of cerebrospinal fluid. However shunt failure and infection results in significant morbidity and repeated operations. In this retrospective review study, ventriculoperitoneal shunting procedures performed at Queen Mary Hospital from January 2006 to December 2007 were reviewed. METHOD: All ventriculoperitoneal shunts performed within the period of January 2006 and December 2007 were included. Demographic data was obtained from medical record and department database. Shunt infection was defined as positive bacterial culture from cerebrospinal fluid. RESULTS: Totally 122 ventriculoperitoneal shunts were performed among 92 patients. Blockage was noted in 12 shunts. Shunt infection was documented in 12 cases, yielding an infection rate of 9.8%. No causal relationship was identified between shunt infection and systemic infection. Seven shunts were ligated or revised due to over-shunting. CONCLUSION: Many factors were postulated to be related to ventriculoperitoneal shunt infection or failure. However it is likely to be multifactorial. Upon performing a ventriculoperitoneal shunt, caution should be taken to prevent infection. Valve pressure should be carefully selected to prevent need of further revision due to over-shunting.