Indocyanine green‐fluorescent imaging for a detection of accessory pancreatic duct in pancreas‐preserving duodenectomy

Abstract

Pancreas‐preserving duodenectomy is indicated for select patients with a duodenal tumor in the second portion. In this procedure, identification and closure of the accessory pancreatic duct is important to prevent postoperative pancreatic fistula. A 63‐y‐old man was diagnosed with duodenal mucosal carcinoma in the second portion, with invasion of the major ampullary. We performed pancreas‐preserving duodenectomy. Intraoperatively, indocyanine green‐fluorescent imaging identified the accessory pancreatic duct clearly and it was successfully closed. Postoperative pancreatic fistula did not occur. Indocyanine green‐fluorescent imaging is effective in identifying the accessory pancreatic duct in pancreas‐preserving duodenectomy.

Novel and classic approaches for managing gastrointestinal cancers

“…The following three papers introduce “innovation in surgical procedures.” Ito et al have presented a novel technique to prevent postoperative pancreatic fistulas after pancreas‐preserving duodenectomy. 2 The technique involved identifying the accessory pancreatic duct using indocyanine green fluorescent imaging followed by closing the duct (DOI: 10.1002/ags3.12619 ). Zhang et al have reported about liver resection by considering the anatomy of Laennec's capsule, updating ideas about liver anatomy, and providing a new approach for normalization and standardization of liver surgery methods (DOI: 10.1002/ags3.12618 ).…”

“…The following three papers introduce “innovation in surgical procedures.” Ito et al have presented a novel technique to prevent postoperative pancreatic fistulas after pancreas‐preserving duodenectomy 2 . The technique involved identifying the accessory pancreatic duct using indocyanine green fluorescent imaging followed by closing the duct (DOI: 10.1002/ags3.12619).…”