Comparison of Surgical Outcomes of ventriculoperitoneal (VP) Shunt at Choudhary’s Point vs. Keen’s Point


  • Rana Zubair Mahmood Neurosurgery Unit-2, Punjab Institute of Neurosciences (PINS), Lahore Pakistan
  • Faheem Ahmed Usmani
  • Mukhtiyar Ahmed Lakho
  • Talha Abbas
  • M. Yasin Khan
  • Sarfraz Khan
  • Touqeer Ahmed Neurosurgery Unit-2, Punjab Institute of Neurosciences (PINS), Lahore Pakistan



ventriculoperitoneal, Post Operative Day, Cerebro Spinal Fluid, Endoscopic Third Ventriculostomy, External Ventricular Drain


Objectives:  The study compared the outcomes of VP shunt at Choudhary’s vs Keen’s point.

Material and Methods:  A quasi-observational study was conducted on 50 patients who presented to NS-2, PINS, with the complaint of hydrocephalus. The study was conducted for 3 months from 1st November 2021 to 31th Jan 2022.

Results:  Mean age was 40 years. In 25 (50%) patients, VP shunts were done through Choudhary’s point while in 25 (50%) patients VP shunts were done through Keen’s point. All patients were evaluated on day 3rd POD, 7th POD, 15th POD, and 90th POD.  All patients were improved on 3rd POD. On the 7th POD, 15 (30%) patients deteriorated and showed signs of raised ICP. In these patients, the upper end of VP shunts is again revised due to blockage. On 15th POD, the upper end of VP shunts was blocked in 3 (6%) patients and their upper end was revised. On 90th POD, 2 (4%) patients were presented with upper-end blockage, and again shunt revision was done.  VP shunts in all these patients were done through keen’s point approach. Blockage of the lower end of VP shunt occurred in 10% of patients in which 8% were operated through Keen’s point approach while resting 2% of patients were operated through Choudhary’s point approach. 

Conclusion:  VP shunts through Choudhary’s point approach yield good results as compared to Keen's point approach. This site is described by professor Muhammad Anwar Choudhary, as more convenient for insertion of VP shunt.


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