Systematic Reviews
Copyright ©The Author(s) 2023.
World J Gastrointest Surg. Aug 27, 2023; 15(8): 1799-1807
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1799
Table 1 Study characteristics of included articles
Ref.
Country of origin
Study design
Study population
Disease process
Strasberg et al[25], 2002United StatesProspective cohortPatients undergoing pancreatoduodenectomy with pancreatojejunostomy at a single institution 1996 to 2000Malignant (n = 107): Pancreatic cancer (n = 48); ampullary cancer (n = 28); NET (n = 6); villous adenoma (n = 6); MCN (n = 6); bile duct cancer (n = 5); duodenal adenocarcinoma (n = 3); serous cystadenoma (n = 3); IPMN (n = 1); GIST (n = 1). Benign (chronic pancreatitis, n = 16)
Subar et al[24], 2015FranceCase reportOne patient undergoing laparoscopic pancreatoduodenectomy with pancreatojejunostomyMalignant (ampullary adenocarcinoma)
Rho et al[23], 2019KoreaCase reportOne patient undergoing laparoscopic pancreatoduodenectomy with pancreatojejunostomyMalignant (distal cholangiocarcinoma)
Doussot et al[27], 2021FranceProspective cohortConsecutive patients undergoing open pancreatoduodenectomy with pancreatojejunostomy at a single institution from January 2020 to November 2020Malignant (n = 30, periampullary malignancies)
Iguchi et al[26], 2021JapanCase reportOne patient undergoing open middle segment-preserving pancreatectomy with pancreatojejunostomyMalignant (pancreatic ductal adenocarcinoma in head of pancreas with IPMN in the tail of pancreas)
Table 2 Intraoperative perfusion assessment and management of hypoperfusion
Ref.
Measurement of hypoperfusion
Description of technique
Total number of patients
Number with hypoperfusion
Management of hypoperfusion
Strasberg et al[25]Visual assessment by surgeonBlood supply was considered adequate when pulsatile arterial bleeding was present both superior and inferior to the pancreatic duct on the cut surface of the pancreas. The bleeding was required to be brisk (of a level that required sutures to stop the bleeding). If there was no bleeding, or if the bleeding points were of an oozing type that could be controlled without sutures, the blood supply was considered inadequate12347Further 1.5-2 cm of pancreas transected
Subar et al[24]ICGPeripheral injection of 2 mL (0.5 mg) of Infracyanine™ (concentration was 0.25 mg/mL). The infrared camera is then focused on the transected margin of the pancreas11Ischaemic segment resected further
Rho et al[23]ICGICG in jVR 25.0 mg (Doingin-dang Pharmaceutical Company, Siheung, Gyeonggi, Republic of Korea) given via peripheral IV injection at least three minutes before confirmation of pancreatic perfusion. Waited at least 30 s to determine perfusion with IMAGE1 STM H3-LINK and D-LIGHT P system (KARL STORZ SE & Co.KR, Tuttlingen, Germany)11Reinforcement using surgical glue (Greenplast QVR 2 mL, GREEN CROSS Corp., Yongin, Gyeonggi, Republic of Korea)
Doussot et al[27]ICGPancreas stump was inspected after ICG IV injection (INFRACYANINE 0.1 mg/kg; Serb, Paris, France) using a microscope with near-infrared light source allowing real-time ICG perfusion assessment with near-infrared light images306One patient had further 3 cm pancreatic stump resection
Iguchi et al[26]ICG10 mg of ICG was administered IV. The presence of fluorescence in the pancreatic remnant was definitively confirmed with a fluorescence camera10NA
Table 3 Post-operative outcomes
Ref.
Total number developing POPF
Number hypoperfused developing POPF
Delayed gastric emptying
Post-pancreatectomy haemorrhage
90-d mortality
Strasberg et al[25]42 (1.6)1101
Subar et al[24]00 (0)00NR
Rho et al[23]11 grade A1 grade B0NR
Doussot et al[27]12 (9 grade A and 3 grade B)3 (1 grade A and 2 grade B)5 (17)2 (1 grade B and 1 grade C)0
Iguchi et al[26]1 grade B1 grade B00Alive at 2 mo