COMPLICATIONS OF LUMBOPERITONEAL SHUNTS - RETROSPECTIVE STUDY OF 195 PATIENTS (214 PROCEDURES)

Background and purpose. We report our experience with the lumboperiton eal shunt (LPS) in 195 patients. The aim of this retrospective study w as to assess and compare the rate of complications and to discuss 4 in dications. Material nod method. Between January 1983 and July 1994, 19 5 patients including 14 pediatric cases were treated with a LPS. Sex r atio was 1.24. The mean age at insertion was 59.5 years (from 6 months to 85 years) and the followup in this series was from 6 months to 12. 5 years. The indications for a LPS were: chronic idiopathic hydrocepha lus (115 cases), post-hemorrhagic hydrocephalus (37 cases), cerebrospi nal fluid fistula(ll cases), post-traumatic hydrocephalus (9 cases), p ost-surgical hydrocephalus (8 cases), hydrocephalus of the child (6 ca ses), post-meningitis hydrocephalus (4 cases), benign intracranial hyp ertension (4 cases), post-radiotherapy hydrocephalus (1). Forty patien ts (20.5 %) presented with at least one complication. A total of 47 co mplications were observed : chronic subdural effusion (8 cases), menin gitis (10 cases), mechanical failures (28 cases), acquired Chiari abno rmality(1 case). Mechanical complications varied with the type of shun t. Conclusion. Complications of LPS in adults are less frequent than i s usually reported after ventricular atrial or peritoneal shunting. In adults, LPS can be used as the first valuable treatment in case of ch ronic communicating hydrocephalus. LPS is also valuable in the treatme nt of benign intracranial hypertension or recurrent CSF fistulae. Conv ersely, in the pediatric cases general and specific complications are frequent, so an indication for LPS must be strictly discussed.