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CASE REPORT
Year : 2022  |  Volume : 9  |  Issue : 4  |  Page : 161-164

Evaluation of gastric perfusion by intraoperative indocyanine green fluorescence imaging in distal pancreatectomy with celiac axis resection with left gastric artery reconstruction in pancreatic cancer – A case report (with Video)


Division of General Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan

Correspondence Address:
Dr. Shao-Ciao Luo
Division of General Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard Sect. 4, Taichung
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JCRP.JCRP_7_22

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A 67-year-old man had suffered from persistent abdominal cramping pain for six months, with radiation to the back. Adenocarcinoma of pancreatic body with celiac encasement was diagnosed. Neoadjuvant chemotherapy was given and regressive tumor size was noted. Further operation of distal pancreatectomy with celiac axis resection (DP-CAR), including transection of the left gastric artery (LGA), was performed. The middle colic artery (MCA) was utilized for reconstruction of LGA, with LGA-MCA anastomosis. Intraoperative indocyanine green (ICG) fluorescence was used to confirm the blood supply. DP-CAR is a complicated procedure for tumor involving celiac axis but would bring benefit if en bloc resection was achieved. Reconstruction of the transected vessels was important to reduce further complications. Intraoperative indocyanine green (ICG) fluorescence imaging is a feasible method of evaluating the blood supply to the stomach and liver after the DP-CAR procedure.


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