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Is ICG-enhanced image able to help predicting pancreatic fistula in laparoscopic pancreaticoduodenectomy?

Authors
 Seoung Yoon Rho  ;  Sung Hyun Kim  ;  Chang Moo Kang  ;  Woo Jung Lee 
Citation
 Minimally Invasive Therapy & Allied Technologies, Vol.28(1) : 29-32, 2019 
Journal Title
 Minimally Invasive Therapy & Allied Technologies 
ISSN
 1364-5706 
Issue Date
2019
Keywords
Indocyanine green ; anastomosis site perfusion ; laparoscopic pancreaticoduodenectomy ; pancreaticojejunostomy ; postoperative pancreatic fistula
Abstract
Laparoscopic pancreaticoduodenectomy (PD) has been reported to be technically feasible and safe. Successful pancreatico-enteric anastomosis in particular is important for safe PD. Intraoperative perfusion of the remnant pancreas can be evaluated with ICG technology and be applied in pancreatic reconstruction in PD. A 68-year old female patient with distal common bile duct cancer underwent laparoscopic pylorus-preserving pancreaticoduodenectomy. After pancreaticojejunostomy (PJ), we checked perfusion of the anastomosis line using an ICG imaging system and noticed a perfusion defect at the anterior wall. The patient developed a grade A postoperative pancreatic fistula, but was discharged without major sequelae. Even though pancreatic perfusion after laparoscopic PJ appeared adequate based on white light, hypo-perfusion was noted under infrared light. Our experience suggests that ICG technology may be more sensitive than white light for detecting pancreatic perfusion in pancreatic anastomoses. However, the clinical implications of this require further investigation.
Full Text
https://www.tandfonline.com/doi/full/10.1080/13645706.2018.1479271
DOI
10.1080/13645706.2018.1479271
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169534
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