title: Cholecystectomy in patients with prior ventriculoperitoneal shunts.
abstract: BACKGROUND
  There is little published evidence regarding intraoperative and postoperative complications in patients with ventriculoperitoneal shunts who undergo cholecystectomy.
  
  
  METHODS
  Nationwide Department of Veterans Affairs databases were searched to identify patients with International Classification of Diseases, 9th revision, Clinical Modification codes for a VP shunt who later had a cholecystectomy during fiscal years 1994 to 2003. Charts on these patients were obtained and reviewed.
  
  
  RESULTS
  Twenty-three patients were deemed evaluable. Of these, 8 had laparoscopic converted to open cholecystectomies. All conversions were owing to dense adhesions. There were 2 cases of postoperative shunt infection that required shunt removal and replacement.
  
  
  CONCLUSIONS
  The rate of conversion from laparoscopic to open cholecystectomy was 57% in this study, significantly higher than the reported rate of conversion for patients without shunts in Department of Veterans Affairs Medical Centers (5%). Cholecystectomy in adult patients with a preexisting ventriculoperitoneal shunt appears to result in a shunt infection rate similar to that reported after shunt insertion or revision.
authors.affiliation: Department of Surgery, Saint Louis University Medical Center, MO 63110-0250, USA.
authors.forename: Emad
authors.initials: E
authors.lastname: Allam
authors.forename: Akshar
authors.initials: A
authors.lastname: Patel
authors.forename: Gavin
authors.initials: G
authors.lastname: Lewis
authors.forename: Eriola
authors.initials: E
authors.lastname: Mushi
authors.forename: Riccardo A
authors.initials: RA
authors.lastname: Audisio
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Virgo
authors.forename: Frank E
authors.initials: FE
authors.lastname: Johnson
mesh_terms: D000368:Aged; D002763:Cholecystectomy / Q000379:methods; D017081:Cholecystectomy, Laparoscopic; D016208:Databases, Factual; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D017287:Ventriculoperitoneal Shunt