Evaluation of the Blood Flow in the Remnant Pancreas Using ICG Fluorescence Imaging during Pancreaticoduodenectomy with Splenic Artery Resection and without Pancreatico-jejunostomy for Pancreatic Cancer—Report of a Case

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 81; no. 8; pp. 1611 - 1615
• Main Authors: AKIYA, Masayuki, MATSUKI, Ryota, KOGURE, Masaharu, SUZUKI, Yutaka, MORI, Toshiyuki, SAKAMOTO, Yoshihiro
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2020
• Subjects: ICG fluorescence imaging; no reconstruction of the residual pancreas; pancreaticoduodenectomy with splenic artery resection (PD-SAR)
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.81.1611

We performed pancreaticoduodenectomy with splenic artery resection (PD-SAR) for invasive pancreatic body cancer. The blood flow of the spleen and the residual pancreas was evaluated using indocyanine green (ICG) fluorescence imaging. The luminescence of the spleen was sufficient, however, that of the residual pancreas was poor within 1cm from the cut margin. We closed the stump of the remnant pancreas with sutures to avoid severe pancreatic leakage associated with pancreatico-jejunostomy. No postoperative splenic infarction nor pancreatic fistula occurred, and the glucose tolerance was preserved. It would be useful to introduce intraoperative ICG fluorescence imaging to evaluate the blood flow of the residual pancreas and the spleen during PD-SAR.