Fabrizio Panaro1, Enrico Benedetti2, Guillaume Pineton de Chambrun3, Hussein Habibeh1, Piera Leon1, Hassan Bouyabrine1, Astrid Herrero1, Francis Navarro1. 1. Department of General Surgery, Division of Transplantation, University of Montpellier-College of Medicine, Saint Eloi Hospital, Montpellier-Cedex 5, France. 2. Division of Transplantation, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA. 3. Department of Medicine, Division of Gastroenterology, Hospital St. Eloi, Montpellier University Hospital, Augustin Fliche, 34295-Montpellier, France.
Abstract
BACKGROUND: Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making during surgical procedures, in particular to assess organs perfusion. METHODS: We used the ICG fluorescence during liver transplantations in six cirrhotic patients to help assessing the graft biliary duct perfusion in order to identify the appropriate level to perform the anastomosis. We also used ICG fluorescence also in five patients receiving kidney-pancreas transplantation to evaluate the perfusion levels of the duodenal stump of the pancreas graft. RESULTS: Follow-up period for the patients was 12 months. The perioperative period was uneventful, no biliary complications such as leaks or stenosis were reported after liver transplantation, no complications of the entero-enteric anastomoses occurred after pancreatic transplantation. CONCLUSIONS: ICG fluorescence seems to safely provide important objectifiable perfusion information during organ transplantation procedures that can integrate surgeon's expertise. In fact, detecting intra-operatively perfusion defects, it allows real time modifications on technical strategies potentially useful to reduce the feared risk of anastomotic leakage and consequent severe complications.
BACKGROUND: Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making during surgical procedures, in particular to assess organs perfusion. METHODS: We used the ICG fluorescence during liver transplantations in six cirrhotic patients to help assessing the graft biliary duct perfusion in order to identify the appropriate level to perform the anastomosis. We also used ICG fluorescence also in five patients receiving kidney-pancreas transplantation to evaluate the perfusion levels of the duodenal stump of the pancreas graft. RESULTS: Follow-up period for the patients was 12 months. The perioperative period was uneventful, no biliary complications such as leaks or stenosis were reported after liver transplantation, no complications of the entero-enteric anastomoses occurred after pancreatic transplantation. CONCLUSIONS: ICG fluorescence seems to safely provide important objectifiable perfusion information during organ transplantation procedures that can integrate surgeon's expertise. In fact, detecting intra-operatively perfusion defects, it allows real time modifications on technical strategies potentially useful to reduce the feared risk of anastomotic leakage and consequent severe complications.
Entities:
Keywords:
Indocyanine green (ICG); liver; pancreas; perfusion; transplantation
Authors: Peter T W Kim; Giovanna Saracino; Linda Jennings; Michael Ramsay; Gregory J McKenna; Giuliano Testa; Tiffany L Anthony; Nicholas Onaca; Richard M Ruiz; Robert M Goldstein; Marlon F Levy; Goran B Klintmalm Journal: HPB (Oxford) Date: 2014-07-18 Impact factor: 3.647
Authors: T Grochowiecki; Z Gałązka; K Madej; S Frunze; S Nazarewski; T Jakimowicz; L Pączek; M Durlik; J Szmidt Journal: Transplant Proc Date: 2014-10 Impact factor: 1.066
Authors: Michele Diana; Eric Noll; Pierre Diemunsch; Bernard Dallemagne; Malika A Benahmed; Vincent Agnus; Luc Soler; Brian Barry; Izzie Jacques Namer; Nicolas Demartines; Anne-Laure Charles; Bernard Geny; Jacques Marescaux Journal: Ann Surg Date: 2014-04 Impact factor: 12.969
Authors: Zühre Uz; Lucinda Shen; Dan M J Milstein; Krijn P van Lienden; Rutger-Jan Swijnenburg; Can Ince; Thomas M van Gulik Journal: Eur Surg Res Date: 2020-07-13 Impact factor: 1.745