Kawasaki Yota, Maemura Kosei, Kurahara Hiroshi, Mataki Yuko, Iino Satoshi, Sakoda Masahiko, Shinchi Hiroyuki, Natsugoe Shoji
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan.
ANZ J Surg. 2018 Oct;88(10):1017-1021. doi: 10.1111/ans.14364. Epub 2018 Jan 8.
The aim of this study was to confirm whether intraoperative fluorescence vascular imaging using indocyanine green (FVI-ICG) is useful for evaluating splenic perfusion after spleen-preserving distal pancreatectomy (SPDP) performed with the Warshaw technique (SPDP-W).
We evaluated the blood perfusion of the spleen with an intraoperative FVI-ICG system after SPDP-W. All of the patients underwent dynamic computed tomography (CT) scans at one post-operative week and one post-operative month to evaluate the post-operative blood perfusion of the spleen. Then, the post-operative perfusion status of the spleen according to CT and the intraoperative fluorescence status of the spleen were compared.
Five patients were enrolled in this study. None of the patients required secondary splenectomies. We detected a tendency towards a close relationship between the intraoperative fluorescence level of the spleen according to FVI-ICG performed after SPDP-W and post-operative splenic perfusion as evaluated by CT. Improved splenic perfusion was seen at one post-operative month in all cases, including a case in which poor splenic perfusion was initially detected.
We detected a close relationship between the fluorescence level of the spleen on intraoperative FVI-ICG and the post-operative perfusion status of the spleen among patients who underwent SPDP-W. Intraoperative FVI-ICG could help surgeons to safely preserve the spleen after SPDP-W.
本研究的目的是确认使用吲哚菁绿的术中荧光血管成像（FVI-ICG）对于评估采用华沙技术进行的保留脾脏的远端胰腺切除术（SPDP-W）后脾脏灌注是否有用。
我们在SPDP-W术后使用术中FVI-ICG系统评估脾脏的血液灌注。所有患者在术后一周和术后一个月接受动态计算机断层扫描（CT）以评估脾脏的术后血液灌注。然后，比较根据CT得出的脾脏术后灌注状态和脾脏的术中荧光状态。
本研究纳入了5名患者。所有患者均无需二次脾切除术。我们发现，SPDP-W术后通过FVI-ICG得出的脾脏术中荧光水平与CT评估的术后脾脏灌注之间存在密切关系的趋势。在所有病例中，术后一个月均可见脾脏灌注改善，包括最初检测到脾脏灌注不良的病例。
我们发现在接受SPDP-W的患者中，术中FVI-ICG上脾脏的荧光水平与脾脏的术后灌注状态之间存在密切关系。术中FVI-ICG可帮助外科医生在SPDP-W术后安全地保留脾脏。
