Indocyanine green fluorescence imaging in hepatobiliary surgery

Area of Science:

• Hepatobiliary Surgery
• Medical Imaging
• Fluorescence Technology

Background:

• Indocyanine green (ICG) is a vital fluorescent dye utilized in hepatobiliary surgery.
• Its intravenous injection leads to selective liver uptake and biliary secretion, enabling diverse visualization techniques.
• ICG's properties facilitate its use in various intraoperative applications.

Purpose of the Study:

• To review and characterize the applications of ICG during hepatobiliary surgery.
• To summarize the current understanding of ICG's role in improving surgical visualization and outcomes.
• To evaluate the safety, feasibility, and limitations of ICG fluorescence imaging.

Main Methods:

• Literature review summarizing current knowledge on ICG use in hepatobiliary surgery.
• Characterization of ICG applications into liver mapping, cholangiography, tumor visualization, and graft evaluation.
• Analysis of ICG's safety, efficacy, and limitations based on existing studies.

Main Results:

• ICG fluorescence imaging is a safe, simple, and feasible method for visualizing hepatobiliary anatomy and liver tumors.
• It enhances cholangiography, aids in detecting bile leaks, and helps identify hepatocellular carcinoma.
• ICG is also useful for evaluating vascular reconstruction and outflow in partial liver transplantation.

Conclusions:

• Intraoperative ICG fluorescence imaging improves surgical visualization and can reduce complications without known side effects.
• It serves as a reliable contrast agent for detecting bile leakage and visualizing tumors.
• Limitations include shallow tissue penetration (5-10mm) and potential for false positive/negative results, necessitating further research.