Laparoscopic Cholecystectomy in a Patient with Lumbar Peritoneal Shunt (LP Shunt): A Case Report

Abstract

Musharraf Husain, Tajamul Rashid*, Sanjana Agarwal, Sonali Ohri and Nikhat Sartaj

Background: Benign Intracranial Hypertension is a condition causing symptomatic raised intracranial pressure and many such patients are managed by ventriculoperitoneal or lumbar peritoneal shunts. Performing laparoscopic procedures in patients with ventriculoperitoneal or lumbar peritoneal shunt was considered to be risky and was avoided. There are very few documented cases worldwide in which laparoscopic cholecystectomy has been carried out in patients with a lumbar peritoneal shunt.

Case report: A 39 years old female patient presented to the surgery department of the HAH Centenary Hospital, New Delhi with complaints of pain in the right upper abdomen on and off for one year. Consequently, on evaluation she was diagnosed as a case of symptomatic cholelithiasis and was planned for elective laparoscopic cholecystectomy. She was previously diagnosed with Benign Intracranial hypertension and was managed by lumbar peritoneal shunt at the level of L4-L5. A 4 Port standard laparoscopic cholecystectomy was done taking care of not damaging the shunt. Intraoperative and postoperative courses were uneventful.

Conclusion: Based on our experience, we suggest that laparoscopic procedures like cholecystectomy can be safely and successfully performed in patients with Lumbar Peritoneal shunt after getting neurosurgery clearance. No clamping of shunt or alteration of technique is required during the procedure.