Clinical effect of indocyanine green fluorescence navigation combined with modified pancreaticogastrostomy in laparoscopic duodenum-preserving pancreatic head resection
10.3760/cma.j.cn113884-20231204-00153
- VernacularTitle:吲哚菁绿荧光显影导航联合改良胰胃吻合应用于腹腔镜保留十二指肠胰头切除术的临床疗效
- Author:
Jingpo ZHANG
1
;
Jianhua LIU
;
Fuzhe LI
;
Xinbo ZHOU
;
Fengshan LI
Author Information
1. 河北医科大学第一医院肝胆胰外科，石家庄 050000
- Keywords:
Pancreatic neoplasms;
Laparoscopy;
Duodenum-preserving pancreatic head resection;
Indocyanine green;
Fluorescent imaging technology;
Pancreaticogastrostomy
- From:
Chinese Journal of Hepatobiliary Surgery
2024;30(3):197-201
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility, safety and efficacy of indocyanine green (ICG) fluorescence imaging navigation combined with modified pancreaticogastrostomy in laparoscopic duodenum-preserving pancreatic head resection.Methods:The clinical data of 14 patients undergoing laparoscopic duodenum-preserving pancreatic head resection with indocyanine green fluorescence navigation technique combined with modified pancreaticogastrostomy from January 2019 to January 2022 in the Department of Hepatobiliary and Pancreatic Surgery, the First Hospital of Hebei Medical University were retrospectively analyzed, including 4 males and 10 females, aged (40.6±7.1) years. The operation time, intraoperative blood loss, postoperative complications and follow-up were recorded.Results:All 14 operations were successfully completed, and there was no intraoperative ICG allergic reaction. The intraoperative ICG staining facilitated the identification of common bile duct. The operation time was (325.71±23.00) min, and the time of modified pancreaticogastrostomy was (18.32±1.52) min. Intraoperative blood loss was 200 (150, 300) ml. There were no case of intraoperative blood transfusion. Postoperative complications include three cases of grade A pancreatic fistula, one of biliary fistula, and one of biliary stricture. All patients were followed up for one to 18 months, and the median follow-up time was 10 months. One patient had intermittent fever after operation. Magnetic resonance cholangiopancreatography showed biliary stricture in one patient one month after operation, which was managed by endoscopic biliary stent implantation.Conclusion:Indocyanine green fluorescence navigation is safe and feasible in laparoscopic duodenum-preserving pancreatic head resection. Combined with modified pancreaticogastrostomy, it helps skip the jejunal anastomosis and improve the efficiency of surgery.
