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Updated: Jun 30, 2026
The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
Published on: January 31, 2025
Indocyanine green disappearance rate is the most useful marker for liver resection
Stefan Scheingraber1, Sven Richter, Dorian Igna
1Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Saarland, D-66421 Homburg, Germany. stefan.scheingraber@kkh-vilsbiburg.de
Background/Aims:
Non-invasive measurement of indocyanine green plasma disappearance rate (PDR(ICG)) is supposed to be an accurate liver function parameter. However, its value compared to conventional markers like bilirubin and prothrombin time (PT) is unclear. The authors therefore prospectively determined PDR(ICG) and bilirubin and PT and recorded the clinical course after liver resection.
Methodology:
Ninety-six patients underwent liver resection. Three patients died due to liver failure. Twenty patients (21%) developed signs of liver dysfunction. Receiver operating curve (ROC) analysis was performed to assess the value of each parameter to detect postoperative liver failure and dysfunction.
Results:
PDR(ICG) and PT but not bilirubin preoperatively differentiated between patients with and without cirrhosis. In cirrhosis, PDR(ICG) patients did not recover to preoperative baseline values. ROC analysis revealed that PDR(ICG) [area under the curve (AUC): 0.867] did significantly better indicate postoperative liver dysfunction than bilirubin (AUC: 0.633) and PT (AUC: 0.570).
Conclusions:
PDR(ICG) should be measured preoperatively and daily after liver resection in patients at risk (underlying liver disease, resections > 30% standard liver volume).
