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Fluorescence-guided pancreatic surgery: A scoping review.
Thomas B Piper1, Gustav H Schaebel2, Charlotte Egeland3
1Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Fluorescence guidance using fluorophores, particularly indocyanine green, shows promise in pancreatic surgery for improving organ perfusion, detecting tumors, and identifying metastases. Further research is needed due to study heterogeneity.
Area of Science:
- Surgical Oncology
- Medical Imaging
- Gastroenterology
Background:
- Fluorescence guidance is established in surgery, but its application in pancreatic surgery is novel.
- Fluorophore use in pancreatic surgery requires further clinical description and investigation.
Purpose of the Study:
- To systematically review and illuminate the clinical applications of fluorophores in pancreatic surgery.
- To assess the current evidence on fluorescence-guided pancreatic surgery.
Main Methods:
- A systematic scoping review adhering to PRISMA and PRISMA-ScR guidelines.
- Searched PubMed, Embase, Scopus, Cochrane Library, and Web of Science for human original articles and case reports.
- Assessed bias using the Newcastle-Ottawa Scale and surgical innovation with the IDEAL framework.
Main Results:
- 23 original articles and 24 case reports (754 patients) met inclusion criteria.
- Indocyanine green was the most prominent fluorophore, aiding in organ perfusion, neuroendocrine tumor detection, and hepatic micrometastasis identification.
Conclusions:
- Indocyanine green demonstrates potential clinical value in various pancreatic surgery settings.
- Included studies were heterogeneous and exploratory; further research is warranted.
- Tumor-targeted probes represent a promising future direction in fluorescence-guided pancreatic surgery.
