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  • Title: [Intraoperative Assessment of Blood Flow in the Remnant Stomach Using Indocyanine Green and Regional Oxygen Saturation Monitoring at Distal Pancreatectomy Following Gastrectomy].
    Author: Ezaki S, Tomimaru Y, Noguchi K, Nagase H, Ogino T, Hirota M, Oshima K, Tanida T, Noura S, Imamura H, Iwazawa T, Akagi K, Dono K.
    Journal: Gan To Kagaku Ryoho; 2019 Dec; 46(13):2045-2047. PubMed ID: 32157054.
    Abstract:
    A92 -year-old man was diagnosed with pancreatic cancer 14 years after undergoing distal gastrectomy for gastric cancer. His remnant stomach was fed by the cardiac branch of the left inferior phrenic artery, short gastric artery, and posterior gastric artery. We planned distal pancreatectomy(DP). Intraoperative indocyanine green(ICG)fluorography showed that the remnant stomach was perfused under the clamp of the splenic artery. We also confirmed that regional oxygen saturation (rSO2)of the remnant stomach was not decreased by the clamp. Based on the findings, we judged that blood flow in the remnant stomach was preserved at the clamp. We then performed DP with preservation of the remnant stomach. Postoperative complications associated with the remnant stomach were not observed. The patient is alive without any postoperative recurrences of pancreatic cancer or trouble associated with the remnant stomach 22 months after the surgery. This case suggested that ICG fluorography and rSO2 monitoring are useful to evaluate blood flow in the remnant stomach.
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