Chapter 12 - Shunt Techniques—Cystoperitoneal Shunt

Abstract

In treating arachnoid cysts (AC), cystoperitoneal (CP) shunting is reported to produce good outcomes in terms of symptom improvement and cyst size reduction. However, CP shunting has several drawbacks, including shunt dependency, in addition to the complications associated with all shunts, such as shunt infections and malfunctions. In a survey on facilities’ preferred method for a middle fossa AC, microscopic fenestration was chosen by 66.6%, endoscopic fenestration by 28.8%, and CP shunting just by 6.6%. However, no consensus has been reached regarding the relative merits and demerits of fenestration and cystoperitoneal shunting, as the treatment outcome varies according to each study. Here we discuss the advantages and complications of CP shunting, and especially the complication unique to shunts, the shunt dependency syndrome.