In hepatobiliary surgery, fluorescence imaging enables identification of subcapsular liver tumors through accumulation of indocyanine green after preoperative intravenous injection in cancerous tissues of hepatocellular carcinoma and in noncancerous hepatic parenchyma around intrahepatic cholangiocarcinoma and liver metastases. Indocyanine green-fluorescence imaging can also be used for visualizing extrahepatic bile duct anatomy and hepatic segmental boundaries, enhancing the accuracy of open and laparoscopic hepatectomy.
The patient was a 61-year-old man with a history of duodenal ulcer. In 2008, he suffered from perforated duodenal ulcer, for which conventional closure, omental patch repair and intraperitoneal drainage were performed. Helicobacter pylori was negative in histopathology. After discharge he had been taken rabeprazole 10mg/day. Esophago-gastro-duodenoscopy 18 months later showed pyloric stenosis, but fiber-scope could pass through the stenosis. Therefore, rabeprazole was discontinued. At 6 months later, he developed reavent pyloric stenosis due to duodenal ulcer. Although duodenal ulcer was treated with medicine, pyloric stenosis did not improve, for which laparoscopic selsective proximal vagotomy and pyloroplasty were performanced. Since then he is far from duodenal ulcer with good oral intake during the last 1 year and 6 month.
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