Safety of co-placement of ventriculoperitoneal shunt and percutaneous radiologic gastrostomy

Background: There is little evidence about the safety of co-placement of percutaneous radiologic gastrostomy in patients with ventriculoperitoneal shunt. Purpose: To investigate the safety of co-placement of percutaneous radiologic gastrostomy tube and ventriculoperitoneal shunt. Material and Methods: Between July 2006 and June 2018, 1015 patients underwent percutaneous radiologic gastrostomy placement at our institution. Those who had undergone both ventriculoperitoneal shunt and percutaneous radiologic gastrostomy placement were selected. Patient data, including baseline characteristics, percutaneous radiologic gastrostomy types, temporal relationship between the procedures, and ventriculoperitoneal shunt infection, were retrospectively reviewed. Results: Nineteen patients received percutaneous radiologic gastrostomy and ventriculoperitoneal shunt co-placement. The percutaneous radiologic gastrostomy types were pigtail-retained gastrostomy (n = 12) and pull-type gastrostomy (n = 7). Ventriculoperitoneal shunt was placed before percutaneous radiologic gastrostomy in 15 patients (79%) and vice versa in four patients (21%). Mean interval between the two procedures was 361 days (range 3–1833 days). Only one case (5.3%) of ventriculoperitoneal shunt infection occurred and it was successfully managed conservatively. There was no significant difference in the incidence of complications between the ventriculoperitoneal shunt before percutaneous radiologic gastrostomy group and the opposite group (P = 0.789). Moreover, there was no significant difference in complication rates between the two gastrostomy catheter types (P = 0.368). Conclusions: Co-placement of percutaneous radiologic gastrostomy and ventriculoperitoneal shunt seems safe and should not be considered a contraindication. Moreover, the percutaneous radiologic gastrostomy and ventriculoperitoneal shunt should be placed as far from each other as possible.