{"title":"用吲哚菁绿评价胃切除术后胰十二指肠切除术中残胃灌注1例。","authors":"Ryo Katayama, Takeshi Aoki, Kazuhiro Matsuda, Kimiyasu Yamazaki, Yuta Enami, Akira Fujimori, Tomokazu Kusano, Ryohei Watanabe, Hiromi Date, Koji Nogaki, Yoshihiko Tashiro, Hideki Shibata, Kodai Tomioka, Takahito Hirai, Marie Uchida, Kazuhiko Saito, Tatsuya Yamazaki, Shodai Nagaishi, Yukari Shinohara, Hiroki Yamaue","doi":"10.21873/anticanres.17763","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>Pancreatectomy after gastrectomy has been reported as a risk factor for ischemic complications in the remnant stomach. Severe complications may arise if the remnant stomach develops impaired blood flow. Herein, we describe a case of pancreaticoduodenectomy (PD) following proximal gastrectomy (PG) in which indocyanine green (ICG) fluorescence was useful for evaluating remnant gastric perfusion.</p><p><strong>Case report: </strong>An 81-year-old woman was diagnosed with a neuroendocrine tumor (NET) of the pancreatic head 7 months after undergoing robot-assisted proximal gastrectomy (RPG) for gastric cancer. Preoperative computed tomography (CT) revealed no distant metastases or lymphadenopathy, but the tumor was close to the main pancreatic duct; therefore, PD was planned. The stomach wall was approached along the subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) line. After clamping the stomach at the planned resection line, ICG was injected intravenously to evaluate perfusion. Fluorescence was observed only near the gastrojejunostomy, indicating inadequate blood flow; thus, the transection line was revised based on ICG fluorescence, and the remnant stomach was resected. Pathological findings confirmed NET, G1, pT1cN1aM0, Stage IIIB. Three months postoperatively, the patient showed no ischemia-related complications and remains under outpatient follow-up.</p><p><strong>Conclusion: </strong>ICG fluorescence imaging may be a useful intraoperative tool for evaluating remnant gastric perfusion during pancreatic resection following gastrectomy.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":"45 9","pages":"4057-4062"},"PeriodicalIF":1.7000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment of Remnant Gastric Perfusion Using Indocyanine Green During Pancreaticoduodenectomy After Gastrectomy: A Case Report.\",\"authors\":\"Ryo Katayama, Takeshi Aoki, Kazuhiro Matsuda, Kimiyasu Yamazaki, Yuta Enami, Akira Fujimori, Tomokazu Kusano, Ryohei Watanabe, Hiromi Date, Koji Nogaki, Yoshihiko Tashiro, Hideki Shibata, Kodai Tomioka, Takahito Hirai, Marie Uchida, Kazuhiko Saito, Tatsuya Yamazaki, Shodai Nagaishi, Yukari Shinohara, Hiroki Yamaue\",\"doi\":\"10.21873/anticanres.17763\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aim: </strong>Pancreatectomy after gastrectomy has been reported as a risk factor for ischemic complications in the remnant stomach. Severe complications may arise if the remnant stomach develops impaired blood flow. Herein, we describe a case of pancreaticoduodenectomy (PD) following proximal gastrectomy (PG) in which indocyanine green (ICG) fluorescence was useful for evaluating remnant gastric perfusion.</p><p><strong>Case report: </strong>An 81-year-old woman was diagnosed with a neuroendocrine tumor (NET) of the pancreatic head 7 months after undergoing robot-assisted proximal gastrectomy (RPG) for gastric cancer. Preoperative computed tomography (CT) revealed no distant metastases or lymphadenopathy, but the tumor was close to the main pancreatic duct; therefore, PD was planned. The stomach wall was approached along the subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) line. After clamping the stomach at the planned resection line, ICG was injected intravenously to evaluate perfusion. Fluorescence was observed only near the gastrojejunostomy, indicating inadequate blood flow; thus, the transection line was revised based on ICG fluorescence, and the remnant stomach was resected. Pathological findings confirmed NET, G1, pT1cN1aM0, Stage IIIB. Three months postoperatively, the patient showed no ischemia-related complications and remains under outpatient follow-up.</p><p><strong>Conclusion: </strong>ICG fluorescence imaging may be a useful intraoperative tool for evaluating remnant gastric perfusion during pancreatic resection following gastrectomy.</p>\",\"PeriodicalId\":8072,\"journal\":{\"name\":\"Anticancer research\",\"volume\":\"45 9\",\"pages\":\"4057-4062\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anticancer research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21873/anticanres.17763\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anticancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/anticanres.17763","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Assessment of Remnant Gastric Perfusion Using Indocyanine Green During Pancreaticoduodenectomy After Gastrectomy: A Case Report.
Background/aim: Pancreatectomy after gastrectomy has been reported as a risk factor for ischemic complications in the remnant stomach. Severe complications may arise if the remnant stomach develops impaired blood flow. Herein, we describe a case of pancreaticoduodenectomy (PD) following proximal gastrectomy (PG) in which indocyanine green (ICG) fluorescence was useful for evaluating remnant gastric perfusion.
Case report: An 81-year-old woman was diagnosed with a neuroendocrine tumor (NET) of the pancreatic head 7 months after undergoing robot-assisted proximal gastrectomy (RPG) for gastric cancer. Preoperative computed tomography (CT) revealed no distant metastases or lymphadenopathy, but the tumor was close to the main pancreatic duct; therefore, PD was planned. The stomach wall was approached along the subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) line. After clamping the stomach at the planned resection line, ICG was injected intravenously to evaluate perfusion. Fluorescence was observed only near the gastrojejunostomy, indicating inadequate blood flow; thus, the transection line was revised based on ICG fluorescence, and the remnant stomach was resected. Pathological findings confirmed NET, G1, pT1cN1aM0, Stage IIIB. Three months postoperatively, the patient showed no ischemia-related complications and remains under outpatient follow-up.
Conclusion: ICG fluorescence imaging may be a useful intraoperative tool for evaluating remnant gastric perfusion during pancreatic resection following gastrectomy.
期刊介绍：
ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed.
ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies).
Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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