Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous Obstruction

This case report discusses intraoperative indocyanine green (ICG) fluorescence angiography to confirm the patency of a proximal splenorenal shunt in an 11-year-old patient with extrahepatic portal venous obstruction. The patient, managed previously with endoscopic sclerotherapy and propranolol, expe...

Full description

Saved in:
Bibliographic Details
Main Authors: Anjan Kumar Dhua, Vishesh Jain, Devendra Kumar Yadav, Prabudh Goel, Sandeep Agarwala
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-03-01
Series:Journal of Indian Association of Pediatric Surgeons
Subjects:
Online Access:https://journals.lww.com/10.4103/jiaps.jiaps_232_24
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849769119091523584
author Anjan Kumar Dhua
Vishesh Jain
Devendra Kumar Yadav
Prabudh Goel
Sandeep Agarwala
author_facet Anjan Kumar Dhua
Vishesh Jain
Devendra Kumar Yadav
Prabudh Goel
Sandeep Agarwala
author_sort Anjan Kumar Dhua
collection DOAJ
description This case report discusses intraoperative indocyanine green (ICG) fluorescence angiography to confirm the patency of a proximal splenorenal shunt in an 11-year-old patient with extrahepatic portal venous obstruction. The patient, managed previously with endoscopic sclerotherapy and propranolol, experienced recurrent gastrointestinal bleeding, necessitating surgical intervention. A proximal splenorenal shunt was created following splenectomy, and portal pressures dropped significantly from 33 to 14 mmHg postshunt creation. ICG was injected intraoperatively to assess shunt patency, and fluorescence imaging using the Olympus VISERA ELITE III system confirmed proper blood flow through the shunt. This technique and portal pressure measurements validated the patency without using Doppler ultrasound. ICG angiography offers a reliable alternative for intraoperative vascular assessment, expanding its application in pediatric surgery. This report underscores the novelty of using ICG in pediatric shunt surgeries and its potential in various shunt procedures.
format Article
id doaj-art-78b74b5ce3e54ad795f83aab6e0cd104
institution DOAJ
issn 0971-9261
1998-3891
language English
publishDate 2025-03-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Journal of Indian Association of Pediatric Surgeons
spelling doaj-art-78b74b5ce3e54ad795f83aab6e0cd1042025-08-20T03:03:34ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92611998-38912025-03-0130225725910.4103/jiaps.jiaps_232_24Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous ObstructionAnjan Kumar DhuaVishesh JainDevendra Kumar YadavPrabudh GoelSandeep AgarwalaThis case report discusses intraoperative indocyanine green (ICG) fluorescence angiography to confirm the patency of a proximal splenorenal shunt in an 11-year-old patient with extrahepatic portal venous obstruction. The patient, managed previously with endoscopic sclerotherapy and propranolol, experienced recurrent gastrointestinal bleeding, necessitating surgical intervention. A proximal splenorenal shunt was created following splenectomy, and portal pressures dropped significantly from 33 to 14 mmHg postshunt creation. ICG was injected intraoperatively to assess shunt patency, and fluorescence imaging using the Olympus VISERA ELITE III system confirmed proper blood flow through the shunt. This technique and portal pressure measurements validated the patency without using Doppler ultrasound. ICG angiography offers a reliable alternative for intraoperative vascular assessment, expanding its application in pediatric surgery. This report underscores the novelty of using ICG in pediatric shunt surgeries and its potential in various shunt procedures.https://journals.lww.com/10.4103/jiaps.jiaps_232_24extrahepatic portal venous obstructionfluorescence angiographyindocyanine greenpediatric surgerysplenorenal shuntvascular patency
spellingShingle Anjan Kumar Dhua
Vishesh Jain
Devendra Kumar Yadav
Prabudh Goel
Sandeep Agarwala
Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous Obstruction
Journal of Indian Association of Pediatric Surgeons
extrahepatic portal venous obstruction
fluorescence angiography
indocyanine green
pediatric surgery
splenorenal shunt
vascular patency
title Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous Obstruction
title_full Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous Obstruction
title_fullStr Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous Obstruction
title_full_unstemmed Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous Obstruction
title_short Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous Obstruction
title_sort harnessing indocyanine green fluorescence for checking intraoperative patency of splenorenal shunt for extrahepatic portal venous obstruction
topic extrahepatic portal venous obstruction
fluorescence angiography
indocyanine green
pediatric surgery
splenorenal shunt
vascular patency
url https://journals.lww.com/10.4103/jiaps.jiaps_232_24
work_keys_str_mv AT anjankumardhua harnessingindocyaninegreenfluorescenceforcheckingintraoperativepatencyofsplenorenalshuntforextrahepaticportalvenousobstruction
AT visheshjain harnessingindocyaninegreenfluorescenceforcheckingintraoperativepatencyofsplenorenalshuntforextrahepaticportalvenousobstruction
AT devendrakumaryadav harnessingindocyaninegreenfluorescenceforcheckingintraoperativepatencyofsplenorenalshuntforextrahepaticportalvenousobstruction
AT prabudhgoel harnessingindocyaninegreenfluorescenceforcheckingintraoperativepatencyofsplenorenalshuntforextrahepaticportalvenousobstruction
AT sandeepagarwala harnessingindocyaninegreenfluorescenceforcheckingintraoperativepatencyofsplenorenalshuntforextrahepaticportalvenousobstruction