Leak after sleeve gastrectomy with positive intraoperative indocyanine green test: Avoidable scenario?
Gastric fistula
Indocyanine green test
Laparoscopic sleeve gastrectomy
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
21
04
2022
revised:
02
05
2022
accepted:
02
05
2022
pubmed:
15
5
2022
medline:
15
5
2022
entrez:
14
5
2022
Statut:
ppublish
Résumé
The staple line gastric leak (GL) is estimated to be the most serious complication of the sleeve gastrectomy. The use of indocyanine green (ICG) has been introduced in minimally invasive surgery to show the vascularization of the stomach in real time and its application to the gastroesophageal junction (GE) during Laparoscopic Sleeve Gastrectomy (LSG) seems very promising. We present the case of a 40-year-old female underwent laparoscopic sleeve gastrectomy. Intraoperative indocyanine green test showed a small dark area in the proximal third of the staple line reinforced with fibrin glue. Two weeks later the patient presented to the emergency room (ED) with abdominal pain, fever, vomiting, intolerance to oral intake and the evidence of a leak on the abdomen Computer Tomography (CT). The UIN for ClinicalTrial.gov Protocol Registration and Results System is: NCT05337644 for the Organization UFoggia. This case report shows that intraoperative ICG test can be helpful in determining which patients are at greater risk of the leak and, more importantly, the cause of the leak but further tests are needed to determine if the ICG predicts leak due to ischemia.
Sections du résumé
BACKGROUND
BACKGROUND
The staple line gastric leak (GL) is estimated to be the most serious complication of the sleeve gastrectomy. The use of indocyanine green (ICG) has been introduced in minimally invasive surgery to show the vascularization of the stomach in real time and its application to the gastroesophageal junction (GE) during Laparoscopic Sleeve Gastrectomy (LSG) seems very promising.
CASE PRESENTATION
METHODS
We present the case of a 40-year-old female underwent laparoscopic sleeve gastrectomy. Intraoperative indocyanine green test showed a small dark area in the proximal third of the staple line reinforced with fibrin glue. Two weeks later the patient presented to the emergency room (ED) with abdominal pain, fever, vomiting, intolerance to oral intake and the evidence of a leak on the abdomen Computer Tomography (CT). The UIN for ClinicalTrial.gov Protocol Registration and Results System is: NCT05337644 for the Organization UFoggia.
CONCLUSIONS
CONCLUSIONS
This case report shows that intraoperative ICG test can be helpful in determining which patients are at greater risk of the leak and, more importantly, the cause of the leak but further tests are needed to determine if the ICG predicts leak due to ischemia.
Identifiants
pubmed: 35567877
pii: S2210-2612(22)00414-X
doi: 10.1016/j.ijscr.2022.107168
pmc: PMC9111972
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT05337644']
Types de publication
Journal Article
Langues
eng
Pagination
107168Informations de copyright
Copyright © 2022. Published by Elsevier Ltd.
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