Real-time indocyanine green fluorescence technique reduces anastomotic leakage in bilioenteric anastomosis: A case report and literature review.


Journal

Photodiagnosis and photodynamic therapy
ISSN: 1873-1597
Titre abrégé: Photodiagnosis Photodyn Ther
Pays: Netherlands
ID NLM: 101226123

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 03 03 2023
revised: 25 04 2023
accepted: 09 05 2023
medline: 3 7 2023
pubmed: 16 5 2023
entrez: 15 5 2023
Statut: ppublish

Résumé

Anastomotic leakage is a serious complication that can occur in bilioenteric anastomosis surgery, leading to significant morbidity and mortality. Currently, practitioners rely on subjective measures to determine anastomotic perfusion and mechanical integrity, which have limitations. The use of indocyanine green fluorescence technology has become increasingly widespread in clinical practice, especially in gastrointestinal-related surgery. This technique has a unique role in evaluating the blood perfusion of anastomoses and reducing the incidence of anastomotic leakage. However, there have been no reports of its use in bilioenteric anastomosis surgery. Further research is needed to investigate the potential benefits of indocyanine green fluorescence technology in improving outcomes and reducing complications in this type of surgery. a 50-year-old female patient underwent total laparoscopic radical resection of cholangiocarcinoma. During the surgery, indocyanine green fluorescence technology was used to complete the biliary intestinal anastomosis under full visual and dynamic monitoring. The patient recovered well after the operation without experiencing biliary leakage or other complications. The present case study underscores the potential advantages associated with the incorporation of intraoperative real-time indocyanine green (ICG) technology in bilioenteric anastomosis surgery. By facilitating enhanced visualization and assessment of anastomotic perfusion and mechanical stability, this state-of-the-art technique may help mitigate the occurrence of anastomotic leaks while simultaneously improving patient outcomes. Notably, intravenous administration of ICG at a dose of 2.5 mg/kg, administered 24 h prior to surgery, has been found to yield optimal visualization outcomes.

Sections du résumé

BACKGROUND BACKGROUND
Anastomotic leakage is a serious complication that can occur in bilioenteric anastomosis surgery, leading to significant morbidity and mortality. Currently, practitioners rely on subjective measures to determine anastomotic perfusion and mechanical integrity, which have limitations. The use of indocyanine green fluorescence technology has become increasingly widespread in clinical practice, especially in gastrointestinal-related surgery. This technique has a unique role in evaluating the blood perfusion of anastomoses and reducing the incidence of anastomotic leakage. However, there have been no reports of its use in bilioenteric anastomosis surgery. Further research is needed to investigate the potential benefits of indocyanine green fluorescence technology in improving outcomes and reducing complications in this type of surgery.
CASE SUMMARY METHODS
a 50-year-old female patient underwent total laparoscopic radical resection of cholangiocarcinoma. During the surgery, indocyanine green fluorescence technology was used to complete the biliary intestinal anastomosis under full visual and dynamic monitoring. The patient recovered well after the operation without experiencing biliary leakage or other complications.
CONCLUSION CONCLUSIONS
The present case study underscores the potential advantages associated with the incorporation of intraoperative real-time indocyanine green (ICG) technology in bilioenteric anastomosis surgery. By facilitating enhanced visualization and assessment of anastomotic perfusion and mechanical stability, this state-of-the-art technique may help mitigate the occurrence of anastomotic leaks while simultaneously improving patient outcomes. Notably, intravenous administration of ICG at a dose of 2.5 mg/kg, administered 24 h prior to surgery, has been found to yield optimal visualization outcomes.

Identifiants

pubmed: 37187271
pii: S1572-1000(23)00336-8
doi: 10.1016/j.pdpdt.2023.103609
pii:
doi:

Substances chimiques

Indocyanine Green IX6J1063HV
Photosensitizing Agents 0

Types de publication

Review Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

103609

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no competing interests.

Auteurs

Zhen Ma (Z)

Lanzhou University Second Hospital, Lanzhou 730030, China; Department of Surgical Oncology, Lanzhou University Second Hospital, Lanzhou 730030, China; Key Laboratory of the Digestive System Tumours of Gansu Province, China.

Junge Deng (J)

Lanzhou University Second Hospital, Lanzhou 730030, China; Department of Surgical Oncology, Lanzhou University Second Hospital, Lanzhou 730030, China.

Bin Ma (B)

Lanzhou University Second Hospital, Lanzhou 730030, China; Department of Surgical Oncology, Lanzhou University Second Hospital, Lanzhou 730030, China; Key Laboratory of the Digestive System Tumours of Gansu Province, China.

Hao Chen (H)

Lanzhou University Second Hospital, Lanzhou 730030, China; Department of Surgical Oncology, Lanzhou University Second Hospital, Lanzhou 730030, China; Key Laboratory of the Digestive System Tumours of Gansu Province, China. Electronic address: ery_chenh@lzu.edu.cn.

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Classifications MeSH