Indocyanine Green Fluorescence-Guided Laparoscopic Subtotal Gastrectomy for Remnant Gastric Cancer after Pancreaticoduodenectomy: A Case Report

Introduction

Remnant gastric cancer (RGC) is rare after pancreaticoduodenectomy (PD). Surgical management of such cases is technically challenging because of postoperative adhesions and altered anatomy due to reconstruction. Although a completion total gastrectomy is the standard treatment for RGC, it can be highly invasive, particularly in elderly patients with significant comorbidities. While function-preserving subtotal gastrectomy or minimally invasive approaches have been considered, they remain technically demanding. Recent advances in indocyanine green (ICG) fluorescence imaging have facilitated precise tumor localization and real-time tissue perfusion assessment in complex surgical settings.