Laparoscopic-assisted lumboperitoneal shunt insertion with concomitant sleeve gastrectomy in obese patients with idiopathic intracranial hypertension: a retrospective comparative study with promising results

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Abstract

Background
Lumboperitoneal shunts (LPS) have been described for the management of idiopathic intracranial hypertension (IIH). However, it is not a definitive treatment option for that disease. As IIH is strongly associated with obesity, laparoscopic sleeve gastrectomy (LSG) could be a promising option for IIH patients. Our study aimed to assess the safety and efficacy of the concomitant laparoscopic-assisted LPS and LSG, and to compare it to laparoscopic-assisted LPS alone in the management of obese patients with IIH.
Patients and methods
Thirty obese IIH patients were included in our retrospective analysis. Group A included 15 patients undergoing concomitant LPS and LSG, while group B included the remaining patients undergoing LPS alone. All patients were followed-up for 6 months with assessments of their manifestations and complications.
Results
Both study groups had comparable preoperative variables. There was a significant prolongation in the operative time in group A. The same group had excellent short-term weight loss. All preoperative manifestations, including headache, visual disturbances, and tinnitus, showed either resolution or significant improvement in both groups. The papilledema grades showed a significant decline in both groups. However, the improvement was more pronounced in group A after 3 and 6 months. The incidence of postoperative complications did not differ between the two groups.
Conclusion
Concomitant LPS and LSG are safe and effective combination for the management of IIH. The former provides early relief of symptoms, while the latter achieves effective and durable weight loss, which has a positive impact on IIH manifestations.

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