Creation of gastric conduit free-graft with intraoperative perfusion imaging during pancreaticoduodenectomy in a patient post esophagectomy

Abstract

HighlightsPancreaticoduodenectomy in a patient post esophagectomy.Microvascular anastomosis of the gastroepiploic pedicle was performed to the middle colic vessels.Intraoperative perfusion imaging during pancreaticoduodenectomy.

Management and Reconstruction of a Gastroesophageal Junction Adenocarcinoma Patient Three Years after Pancreaticoduodenectomy: A Surgical Puzzle

“…Other challenging options when the right gastroepiploic vessels are compromised include the use of supercharged jejunal interposition conduits [7] or microvascular reconstruction methods for the right gastroepiploic vessels [8, 9]. Oesophagogastrectomy and pancreaticoduodenectomy are individually extensive operations, and their combination either simultaneously or metachronously poses unique challenges.…”

“…Technically, surgical strategies have been described in the setting of previous oesophagogastrectomy for the performance of pancreaticoduodenectomy [ 6 ], mostly involving the use of colon as conduit, and in the form of case reports. Other challenging options when the right gastroepiploic vessels are compromised include the use of supercharged jejunal interposition conduits [ 7 ] or microvascular reconstruction methods for the right gastroepiploic vessels [ 8 , 9 ]. Oesophagogastrectomy and pancreaticoduodenectomy are individually extensive operations, and their combination either simultaneously or metachronously poses unique challenges.…”

Gastric Tube–Preserving Pancreaticoduodenectomy Using Intraoperative Blood Perfusion Imaging After Esophagectomy

“…Thus, with this system, blood flow can be assessed on the basis of the light intensity, and necrosis caused by tissue ischemia can be prevented. Pagkratis et al 6 used the SPY system, similar to HEMS, to evaluate blood flow of the gastric tube after PD. No complications were observed in their case.…”