Placement of a ventriculoperitoneal shunt with laparoscope assistance for idiopathic normal pressure hydrocephalus after cholecystectomy

Abstract

  A 68‒year‒old man was admitted to our Department of Orthopedics for gait disturbance and underwent laminectomy for spinal canal stenosis. However, his symptoms did not improve after surgery, and a computed tomography (CT) scan revealed idiopathic normal pressure hydrocephalus (iNPH). We planned to place a ventriculoperitoneal (VP) shunt but the patient had a fever before the surgery could take place. He was then diagnosed with acute cholecystitis and cholecystectomy was performed. The VP shunt for iNPH was placed after the patient’s cholecystitis improved. A laparoscopic procedure was used because of malabsorption and malposition of the peritoneal tube due to adhesions of the peritoneum. All of the patient’s symptoms resolved and he was discharged without any complications. Laparoscopic assistance is useful for peritoneal tube placement with V‒P shunting in patients with peritoneal adhesions.