Abstract
Background: Ventriculoperitoneal shunting is the main technique for extra-thecal cerebrospinal fluid (CSF) diversion. Even though VP shunts are the standard of care for many types of hydrocephalus, they tragically have many problems that require surgery more frequently than initial shunt insertions. The objective of this study was to analyze the hydrocephalic children who had undergone Ventriculo peritoneal shunt surgeries with regard to the etiology, clinical profile and complication. Methods: This is a prospective observational study that was conducted at department of Pediatric Neuro Surgery, Bangladesh Shishu Hospital & Institute (BSH&I) for a period of 5 years from January 2017 to January 2022. This study included 92 patients out of 240 patients of hydrocephalus (HCP) who underwent VP shunt placement and had complications. Results: A total of 92 patients (38.3%) out of 240 patients who presented with various patterns of complications over the period of the study were examined. The average age was 15.5±8.1 months, with 62 (67.4%) male and 30 (32.6%) female and mortality rate was 4.2%. 75 (81.5%) of the 92 patients experienced single complication, while the remaining 17(18.5%) had multiple complications. Forty-five (48.9%) patients had ventricular end malfunction and 26 (28.3%) patients had peritoneal end malfunction, 21(22.8%) patients had both ventricular and peritoneal end malfunction. Patient of early infective complications were 24(26.1%) and late infective complications were 6(6.5%). Moreover, numbers of early and late mechanical complication were 25(27.2%) and 37(40.2%) respectively. Conclusion: Pediatric patients frequently experience difficulties from VP shunts despite the best efforts of neurosurgeons worldwide to reduce these issues. A great care should be taken during insertion of the shunt system starting from scrubbing to avoid complications. Despite complications, the VP shunt remains the main surgical procedure used for hydrocephalus management.
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