title: [Ventriculo-gallbladder shunt: An alternative for the treatment of hydrocephalus].
abstract: BACKGROUND
  In the management of hydrocephalus, the ventriculo-gallbladder shunt is justified in situations where the ventriculo-peritoneal shunt is not useful due to peritoneal involvement and/or when the ventriculo-auricular and ventriculo-pleural shunts are contraindicated.
  
  
  METHODS
  A 27 year-old female with hydrocephalus at birth, managed with ventricle-peritoneal shunt, modified 3 times throughout her life due to repeated infections and other different reasons. She was admitted due to colitis caused by Clostridium difficile, presenting concomitant signs of intracranial hypertension and neurological impairment. This led to a review and change of the ventriculo-peritoneal shunt system, with distal dysfunction due to peritoneal thickening. Atrial and pleural shunts were not indicated because the risk of infection. As an alternative, it was decided to place the distal end of the catheter in the gallbladder. The patient recovered her neurological functions after the surgery.
  
  
  CONCLUSIONS
  Drainage alternatives may be needed in 5% of patients with valvular shunt dysfunction. The ventriculo-gallbladder is a good and viable option because it has an absorptive capacity of 1500cc liquid daily, besides being an excellent drainage through the bile duct. The abdominal surgery is easy to perform, and it is an alternative option in the failure of the ventriculo-peritoneal shunt.
authors.affiliation: Servicio de Neurocirugía, Hospital Ángeles León, Guanajuato, México. Electronic address: hasslacherjf@yahoo.com.
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Hasslacher-Arellano
authors.affiliation: Servicio de Medicina Interna, Hospital Ángeles León, Guanajuato, México.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Arellano-Aguilar
authors.affiliation: Servicio de Cirugía, Hospital Ángeles León Guanajuato, México.
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Funes-Rodríguez
authors.affiliation: Servicio de Cirugía, Hospital Ángeles León Guanajuato, México.
authors.forename: Santiago
authors.initials: S
authors.lastname: López-Forcén
authors.affiliation: Servicio de Neurocirugía, Instituto Mexicano del Seguro Social, Unidad Medica de Alta Especialidad T1 León, Guanajuato, México.
authors.forename: Fernando
authors.initials: F
authors.lastname: Torres-Zapiain
authors.affiliation: Servicio de Medicina de Rehabilitación, Facultad de Medicina de León, Universidad de Guanajuato, Guanajuato, México.
authors.forename: Luis Gerardo
authors.initials: LG
authors.lastname: Domínguez-Carrillo
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000209:etiology; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D016360:Clostridioides difficile; D020878:Device Removal; D004761:Enterocolitis, Pseudomembranous / Q000209:etiology; D004868:Equipment Failure; D005260:Female; D005704:Gallbladder; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000151:congenital / Q000601:surgery*; D019586:Intracranial Hypertension / Q000209:etiology; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents
keywords: Derivación ventrículo-vesicular; Disfunción valvular; Hidrocefalia; Hydrocephalus; Valvular shunt dysfunction; Ventriculo-gallbladder shunt