case_images: PMC11770029_01
case_images: Isolated pancreatic trauma. (A) Abdominal computed tomography (CT) showing discontinuity at the junction site of the pancreas neck and body (the green arrow). (B) Pancreatic disconnection seen on laparoscopic exploration; proximal pancreatic remnant (the green arrow); distal pancreatic remnant (the green arrow head).
case_images: fsurg-11-1448064-g001.jpg
case_images: PMC11770029_01_fsurg-11-1448064-g001.jpg
case_images: F1
case_images: Abdominal CT suggested pancreatic neck and body parenchymal discontinuity, peripancreatic effusion, and hemoperitoneum (Figure 1A). The intraoperative investigation found a large amount of abdominal hemorrhage (approximately 1,000 ml), scattered fatty saponification spots on the greater omentum, and complete transection at the junction of the pancreas neck and body (Figure 1B).
case_images: Confirmation of pancreatic stump blood perfusion by ICG fluorescence signaling. (A,B) The proximal pancreatic stump had significant ICG fluorescence signaling, while the distal pancreatic stump had almost no ICG fluorescence signaling. (C) Removal of devitalized distal pancreatic parenchyma. (D) Reconfirmation of distal pancreatic stump blood perfusion using ICG fluorescence signaling. ICG, indocyanine green.
case_images: fsurg-11-1448064-g002.jpg
case_images: PMC11770029_01_fsurg-11-1448064-g002.jpg
case_images: F2
case_images: The ICG fluorescent signal was identified to confirm the blood flow of the proximal and distal pancreatic stumps (Figures 2A,B). Guided by this, we removed approximately 2 cm of damaged pancreatic parenchyma without fluorescent signals around the transection site (Figures 2C,D).