{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T01:33:39Z","timestamp":1768008819965,"version":"3.49.0"},"reference-count":13,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T00:00:00Z","timestamp":1593043200000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,5,26]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>Hydrocephalus is a prevalent health problem that is frequently encountered by paediatric neurosurgeons during infancy and childhood. We report a case of an 11-year-old boy with high cerebrospinal fluid protein hydrocephalus secondary to optic glioma that required a ventriculoperitoneal (VP) shunt. The patient had multiple failures of VP shunt and developed massive ascites. Alternatively, the hydrocephalus was treated by ventriculo-gallbladder (VG) shunt in the presence of sludge which was removed from the gallbladder before placement of the shunt. After VG shunt insertion, the patient expressed signs of infection with elevated liver profile, which emphasised the presence of gallstones. While the shunt was kept in its place without any complications, the gallstones were successfully removed by an endoscopic retrograde cholangiopancreatography. In conclusion, the presence of sludge is not a contraindication for VG shunt placement, and, if the VG shunt was complicated with gallstones, it could be treated without the need for cholecystectomy.<\/jats:p>","DOI":"10.1136\/bcr-2020-234775","type":"journal-article","created":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T05:34:46Z","timestamp":1593063286000},"page":"e234775","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Management of ventriculo-gallbladder shunt in the presence of gallstones"],"prefix":"10.1136","volume":"13","author":[{"given":"Sondus","family":"Alraee","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahar","family":"Alshowmer","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Alnamshan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moutasem","family":"Azzubi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,6,24]]},"reference":[{"key":"2025082623250980000_13.6.e234775.1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.pjnns.2017.04.007","article-title":"Our initial experience with ventriculo-epiplooic shunt in treatment of hydrocephalus in two centers","volume":"51","author":"Grigorean","year":"2017","journal-title":"Neurol Neurochir Pol"},{"key":"2025082623250980000_13.6.e234775.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(97)90175-5"},{"key":"2025082623250980000_13.6.e234775.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0204926","article-title":"Age-Specific global epidemiology of hydrocephalus: systematic review, metanalysis and global birth surveillance","volume":"13","author":"Isaacs","year":"2018","journal-title":"PLoS One"},{"key":"2025082623250980000_13.6.e234775.4","first-page":"185","article-title":"Comparing the efficiency of two treatment methods of hydrocephalus: shunt implantation and endoscopic third ventriculostomy","volume":"10","author":"Gholampour","year":"2019","journal-title":"Basic Clin Neurosci"},{"key":"2025082623250980000_13.6.e234775.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-004-0996-1"},{"key":"2025082623250980000_13.6.e234775.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(87)80110-0"},{"key":"2025082623250980000_13.6.e234775.7","first-page":"435","article-title":"Ventriculo cholecystic shunt in the management of hydrocephalus","volume":"44","author":"Pal","year":"2007","journal-title":"Indian Pediatr"},{"key":"2025082623250980000_13.6.e234775.8","first-page":"138","article-title":"Successful application of the Ventriculo-Gallbladder shunt: a salvage procedure","volume":"30","author":"Guclu","year":"2020","journal-title":"Turk Neurosurg"},{"key":"2025082623250980000_13.6.e234775.9","doi-asserted-by":"crossref","DOI":"10.3171\/foc.2007.22.4.14","article-title":"A rare, delayed complication of a ventriculogallbladder shunt. 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