{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:39:04Z","timestamp":1792809544799,"version":"4.5.0"},"reference-count":37,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The management of hydrocephalus resulting from intraventricular hemorrhage related to extreme prematurity remains demanding. Given the complexities of controlling hydrocephalus in this population, less commonly used procedures may be required. The authors examined the utility of ventriculogallbladder (VGB) shunts in a series of such children.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors retrospectively reviewed the medical records of all children who underwent surgery for hydrocephalus in the period from 2011 through 2019 at Children\u2019s Healthcare of Atlanta. Six patients who underwent VGB shunt placement were identified among a larger cohort of 609 patients who had either a new shunt or a newly changed distal terminus site. The authors present an analysis of this series, including a case of laparoscopy-assisted distal VGB shunt revision.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The mean age at initial shunt placement was 5.1 months (range 3.0\u20139.4 months), with patients undergoing a mean of 11.8 shunt procedures (range 5\u201317) prior to the initial VGB shunt placement at a mean age of 5.3 years (range 7.9 months\u201312.8 years). All 6 patients with VGB shunt placement had hydrocephalus related to extreme prematurity (gestational age < 28 weeks). At the time of VGB shunt placement, all had complex medical and surgical histories, including poor venous access due to congenital or iatrogenic thrombosis or thrombophlebitis and a peritoneum hostile to distal shunt placement related to severe necrotizing enterocolitis. VGB complications included 1 case of shunt infection, identified at postoperative day 6, and 2 cases of distal shunt failure due to retraction of the distal end of the VGB shunt. In all, there were 3 conversions back to ventriculoperitoneal or ventriculoatrial shunts due to the 2 previously mentioned complications, plus 1 patient who outgrew their initial VGB shunt. Three of 6 patients remain with a VGB shunt, including 1 who underwent laparoscopy-assisted distal shunt revision 110.5 months after initial VGB shunt insertion.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Placement of VGB shunts should be considered in the armamentarium of procedures that may be used in the particularly difficult cohort of children with hydrocephalus related to extreme prematurity. VGB shunts show utility as both a definitive treatment and as a \u201cbridge\u201d procedure until the patient is larger and comorbid abdominal and\/or vascular issues have resolved sufficiently to allow conversion back to ventriculoperitoneal or ventriculoatrial shunts, if needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.9.peds20522","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T02:09:30Z","timestamp":1614305370000},"page":"511-517","source":"Crossref","is-referenced-by-count":7,"title":["Utility of ventriculogallbladder shunts in complex cases of hydrocephalus related to extreme prematurity"],"prefix":"10.3171","volume":"27","author":[{"given":"Andrew","family":"Reisner","sequence":"first","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Neurosurgery, and"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis D.","family":"Smith","sequence":"additional","affiliation":[{"name":"Surgery, Emory University School of Medicine, Atlanta; and"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Wrubel","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan E.","family":"Buster","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Sawvel","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura S.","family":"Blackwell","sequence":"additional","affiliation":[{"name":"Neuropsychology, Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nealen G.","family":"Laxpati","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barunashish","family":"Brahma","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua J.","family":"Chern","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Neurosurgery, and"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"ICD-10: International Statistical Classification of Diseases and Related Health Problems. 10th revision","author":"World Health Organization","year":"2004","unstructured":"World Health Organization\n\n\n. \nICD-10: International Statistical Classification of Diseases and Related Health Problems. 10th revision\n. \n2nd ed.\n \nWorld Health Organization\n; 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