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Indocyanine Green Fluorescent Angiography During Laparoscopic Sleeve Gastrectomy: Preliminary Results

  • Marino Di FuriaEmail author
  • Lucia Romano
  • Andrea Salvatorelli
  • Denise Brandolin
  • Davide Lomanto
  • Giovanni Cianca
  • Mario Schietroma
  • Francesco Carlei
  • Antonio Giuliani
Original Contributions
  • 18 Downloads

Abstract

Introduction

Indocyanine green (ICG) fluorescent angiography has been routinely applied for various laparoscopic procedures to evaluate the tissue blood supply. A promising branch for this technology is represented by bariatric surgery, especially to estimate the risk of gastric leak after laparoscopic sleeve gastrectomy (LSG), which seems mainly related to ischemia of the stomach.

Materials and Methods

43 consecutive patients from January 2018 to March 2019 underwent in our institution LSG with intravenous injection of 5 ml ICG after the realization of gastric tube to evaluate the blood supply of the gastric tube.

Results

In all 43 cases, there have been no adverse events related to ICG. The vascular supply to stomach was estimated “satisfactory” along the stapled line in all cases. However, one patient showed signs and symptoms indicative of gastric leak in the fifth post-op day and diagnosis was confirmed by CT scan with Gastrografin.

Conclusions

From our preliminary data, the intraoperative view of the blood supply of the stomach does not seem to represent a prognostic factor for the risk of gastric leak, suggesting a complex multifactorial etiology (intragastric hypertension? Abnormal inflammatory response?) which needs further data to be established.

Keywords

Sleeve Gastrectomy Indocyanine green fluorescent angiography Obesity Gastric leakage 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Marino Di Furia
    • 1
    Email author
  • Lucia Romano
    • 1
  • Andrea Salvatorelli
    • 1
  • Denise Brandolin
    • 1
  • Davide Lomanto
    • 2
  • Giovanni Cianca
    • 1
  • Mario Schietroma
    • 1
  • Francesco Carlei
    • 1
  • Antonio Giuliani
    • 1
  1. 1.Department of General Surgery, Hospital San Salvatore L’AquilaUniversity of L’AquilaL’AquilaItaly
  2. 2.Department of Surgery, Division of Upper Gastrointestinal SurgeryNational University HospitalSingaporeSingapore

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