Usefulness of Fluorescence Vascular Imaging for Preserving the Remnant Stomach After Distal Pancreatosplenectomy: A Case Report

Due to recent developments in medical treatment, the number of patients that undergo multiple surgical procedures for secondary metachronous cancer is increasing. In cases in which patients undergo distal pancreatosplenectomy after distal gastrectomy, surgeons might have concerns about whether they are able to preserve the remnant proximal stomach because the main feeding vessels will have been divided in the previous procedure. Herein, we report a case in which a patient underwent distal pancreatosplenectomy 20 years after undergoing distal gastrectomy, and the remnant proximal stomach was successfully preserved with the help of intraoperative fluorescence vascular imaging using indocyanine green (FVI-ICG). A 65-year-old female was referred to our hospital due to upper gastric pain and was diagnosed with cancer of the pancreatic body. She had undergone distal gastrectomy 20 years earlier for early stage gastric cancer. Therefore, the blood supply to the remnant stomach left after the distal pancreatectom...