Indocyanine Green-Enhanced Fluorescence in Laparoscopic Duodenum-Preserving Pancreatic Head Resection: Technique with Vi
- PDF / 366,825 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 3 Downloads / 222 Views
ORIGINAL ARTICLE – PANCREATIC TUMORS
Indocyanine Green-Enhanced Fluorescence in Laparoscopic Duodenum-Preserving Pancreatic Head Resection: Technique with Video Sirui Chen, MD1, Pan Gao, MD2,3, He Cai, MD2,3, Yunqiang Cai, MD2,3, Xin Wang, MD3, and Bing Peng, MD, PhD, FACS3 1
Department of Hepatobiliary Surgery, Mianyang Central Hosptial, Mianyang, China; 2Department of Minimal Invasive Surgery, Shangjin Nanfu Hosptial, Chengdu, China; 3Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, China
ABSTRACT Background. In 1972, Beger et al.1 first described duodenum-preserving pancreatic head resection (DPPHR) for patients with severe chronic pancreatitis. Then DPPHR also was proved capable of providing comparable longterm oncologic outcomes in the setting of benign or lowgrade malignant tumors.2 As an organ-preserving procedure, DPPHR preserves the integrity of the digestive tract and improves the patient’s quality of life compared with pancreaticoduodenectomy (PD),3 although DPPHR is more technically challenging, especially in protecting the bile duct and the pancreaticoduodenal vascular arch.4,5 The indocyanine green (ICG)-enhanced fluorescence imaging system in laparoscopic surgery can identify the biliary and vascular anatomy clearly to ensure a safe cholecystectomy and an adequate vascular supply for colectomy or nephrectomy.6 Nevertheless, to date, no report has described ICG-enhanced fluorescence in laparoscopic duodenum-preserving pancreatic head resection
Sirui Chen, Pan Gao and He Cai contributed equally to this work. Sirui Chen, Pan Gao and He Cai are co-first authors.
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-08360-6) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 10 December 2019 B. Peng, MD, PhD, FACS e-mail: [email protected]
(LDPPHR). This article describes the technique of LDPPHR using a video of a real-time ICG fluorescence imaging system. Methods. A 29-year-old woman received a diagnosis of chronic pancreatitis and an inflammatory mass in the head of the pancreas. A computed tomography (CT) scan showed atrophy of the pancreas, dilation of the main pancreatic duct, and heterogeneous enhancement of the pancreatic head parenchyma (Fig. 1). Her other preoperative examination results were normal except for high blood sugar. To avoid an extended PD for this young patient, LDPPHR was performed. The patient was placed in supine position with her two legs apart. The observing trocar (10 mm) was located at the inferior umbilicus. Four trocars (two 5-mm trocars and two 12-mm trocars) were distributed symmetrically at the midclavicular line and anterior axillary line. Another 5-mm trocar located at the subxiphoid was used for traction of the stomach with a rubber band. Before the operation, ICG (5 mg) was injected intravenously from the elbow vein. The gastrocolic ligament was opened, and the hepatic flexure of the colon was taken down
Data Loading...
