[Indocyanine green fluorescence staining in liver surgery]

Area of Science:

• Hepatobiliary Surgery
• Surgical Imaging
• Medical Diagnostics

Background:

• Indocyanine green (ICG) offers unique advantages in hepatobiliary surgery due to its exclusive hepatic excretion and near-infrared (NIR) fluorescence properties.
• ICG's characteristics enable novel applications in liver surgery, leveraging its optical capabilities.

Purpose of the Study:

• To systematically review the existing literature on the application of ICG imaging in both open and laparoscopic liver surgery.
• To summarize current scientific understanding and evidence regarding ICG's role in liver surgery.

Main Methods:

• Comprehensive literature review of recent scientific original articles and reviews.
• Synthesis and summary of findings from selected studies on ICG imaging in liver surgery.

Main Results:

• ICG fluorescence imaging is increasingly adopted in liver surgery for real-time display of liver segmental anatomy.
• It facilitates visualization of liver tumors and metastases, aids in detecting bile leaks, and potentially increases R0 resection rates.
• Effectiveness is primarily for superficial lesions due to NIR penetration limitations (8-10 mm).

Conclusions:

• ICG fluorescence staining is a valuable adjunct in contemporary liver surgery, especially in laparoscopic settings.
• It helps overcome challenges in laparoscopic surgery, such as limited tactile feedback and difficult 3D orientation.
• ICG imaging provides supplementary real-time visualization, enhancing surgical precision and decision-making.