A Case of Duodenal Obstruction due to Pancreatic Cancer with Peritoneal Metastasis in which Intraoperative ICG Fluorescence Intestinography was Useful to Decide the Indication of Gastrojejunostomy

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  • 術中ICG蛍光造影が胃空腸吻合の適否決定に有用であった膵癌腹膜転移の1例
  • 症例 術中ICG蛍光造影が胃空腸吻合の適否決定に有用であった膵癌腹膜転移の1例
  • ショウレイ ジュッチュウ ICG ケイコウゾウエイ ガ イ クウチョウ フンゴウ ノ テキヒ ケッテイ ニ ユウヨウ デ アッタ スイガン フクマク テンイ ノ 1レイ

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Abstract

A 68-year-old woman suffering from frequent bouts of vomiting due to metastatic pancreatic cancer was referred to our hospital. Abdominal CT examination showed duodenal invasion of pancreatic cancer and multiple peritoneal metastases with massive ascites. Contrast study showed complete obstruction of the duodenum. Although gastrojejunostomy would be indicated for symptomatic palliation of the patient, preoperative examination could not assure the intestinal patency beyond the duodenum. Indocyanine green (ICG) was administered intravenously two days prior to operation, and intraoperative fluorescence imaging showed fluorescence signal in the descending colon. Thus, since the good passage from the duodenum to the colon was indicated, she underwent gastrojejunostomy. The bypass functioned well, and she could take meals until she was transferred to other hospital 42 days after the operation.

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