Indocyanine green real-time-guided laparoscopic duodenum-preserving pancreatic head resection

Yuanbiao Zhang; Jungang Zhang; Kai Jiang; Weiding Wu

doi:10.4103/jmas.jmas_205_21

Indocyanine green real-time-guided laparoscopic duodenum-preserving pancreatic head resection

J Minim Access Surg. 2022 Oct-Dec;18(4):632-634. doi: 10.4103/jmas.jmas_205_21.

Authors

Yuanbiao Zhang¹, Jungang Zhang², Kai Jiang², Weiding Wu³

Affiliations

¹ Department of Hepatobiliary and Pancreatic Surgery, School of Medicine, The Second Affiliated Hospital, Zhejiang University; Department of Hepatobiliary and Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.
² Department of Hepatobiliary and Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.
³ Department of Hepatobiliary and Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang; Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.

Abstract

Duodenum-preserving pancreatic head resection (DPPHR) is very complicated due to its difficulty to find the lower common bile duct (CBD), and to preserve the blood supply of the duodenum and CBD. Recently, indocyanine green (ICG) has been widely applied for navigation during biliary system and liver surgery. However, the application of ICG-guided laparoscopic DPPHR has not been established. Herein, we report an intraoperative angiography technique using ICG fluorescence imaging to visualise blood flow, tissue perfusion, CBD navigation and bile leakage assessment.

Keywords: Duodenum-preserving pancreatic head resection; indocyanine green; navigation.