A Novel Approach to Complex Splenic Hilar Aneurysms: ICG-Guided Partial Spleen Preservation Combined With Distal Pancreatectomy.
Xie Song, Fangkai Du, Wentao Wang et al.
✦ AI-curated · Sources linked
Case in brief
Two patients had splenic artery aneurysms deeply embedded in the pancreatic tail at the splenic hilum. Both underwent laparoscopic aneurysm resection with distal pancreatectomy. Intraoperative indocyanine green fluorescence imaging showed sequential enhancement and fading of the splenic upper pole, indicating preserved arterial inflow and venous drainage after splenic artery ligation. The approach allowed partial splenic preservation; both patients recovered without complications and were discharged uneventfully.
What made this case unusual
ICG fluorescence was used to assess splenic perfusion during resection of complex hilar aneurysms with distal pancreatectomy, supporting partial spleen preservation despite splenic artery ligation.
Diagnostic / clinical pearl
In complex splenic hilar aneurysm surgery, intraoperative ICG perfusion imaging can help assess whether splenic tissue remains vascularized after splenic artery ligation and guide partial spleen preservation.
Why it matters
Preserving viable splenic tissue may avoid some concerns associated with splenectomy, including impaired immune function and increased thrombotic risk; this report describes a potential operative approach, not comparative evidence.