laparoscopic cholecystectomy in a patient with ventriculoperitoneal shunt operated cerebral artery aneurysm.

Abstract

Abstract page: Laparoscopic cholecystectomy in a patient with ventriculoperitoneal shunt operated cerebral artery aneurysm We are describing here elective laparoscopic cholecystectomy with presence of ventriculoperitoneal shunt. Patient had H/O cerebral artery aneurysm, H/O hydrocephalous and H/O placement of programmable type 2 stuart ventriculoperitoneal shunt. He was posted for laparoscopic cholecystectomy. Although ventriculoperitoneal shunt is not formally considered a contraindication for laparoscopic surgery, sometimes shunt failure is also reported which causes high intracranial pressure. Laparoscopic surgery has become preferred method in many operations because it is minimally invasive method with less postoperative pain and post-operative complications (reduced risk of secondary peritoneal adhesions), better recovery, shorter hospital stay and reduced cost of treatment. In this patient the baseline function of shunt was normal. As the shunt was pressure regulated and modern time, there was minimal risk of backflow of CO2 through distal catheter upwards. Throughout surgery, intra-abdominal pressure was maintained up to 10 mm of Hg. Non-invasive methods of monitoring for EEG, BIS and intracranial pressure were used. The patient was successfully managed for laparoscopic cholecystectomy. In postoperative patient was monitored for vital parameters and intracranial tension.