ABDOMINAL COMPLICATIONS OF VENTRICULOPERITONEAL SHUNTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF GASTROINTESTINAL AND HEPATIC INVOLVEMENT. rperaltamd@gmail.com

 

ABDOMINAL COMPLICATIONS OF VENTRICULOPERITONEAL SHUNTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF GASTROINTESTINAL AND HEPATIC INVOLVEMENT.

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Ventriculoperitoneal shunting is a common neurosurgical procedure for hydrocephalus management. While effective, it may lead to serious abdominal complications involving the gastrointestinal and hepatic systems. These include bowel perforation, peritonitis, pseudocyst formation, and liver abscesses. Although multiple case reports and small series have addressed these complications, a comprehensive evidence synthesis is lacking. This systematic review and meta-analysis aims to evaluate the incidence, types, and outcomes of gastrointestinal and hepatic complications following VP shunt placement.

A systematic search will be conducted in PubMed, Embase, Scopus, Web of Science, and Cochrane Library from inception to present. We will include clinical trials, cohort studies, case-control studies, and case series (≥5 patients) reporting relevant complications in VP shunt recipients. Two reviewers will independently screen studies, extract data, and assess quality using the Newcastle-Ottawa Scale. Meta-analysis will be performed using a random-effects model to calculate pooled incidence rates and effect sizes. Heterogeneity will be assessed using the I² statistic, and publication bias via funnel plots and Egger’s test.

The review will synthesize complication rates such as bowel perforation, abdominal pseudocysts, and hepatic abscesses. Subgroup analyses will explore pediatric versus adult populations, indication for shunting, and geographic variation.

Findings will provide the first quantitative summary of abdominal complications of VP shunts, guiding clinical vigilance and informing future shunt design and postoperative surveillance strategies across surgical and medical disciplines.