Indocyanine Green Fluorescence-Guided Surgery in Pediatric Hepatobiliary Procedures: A Feasibility Study for Improved...

Area of Science:

• Pediatric Surgery
• Surgical Navigation Technologies
• Medical Imaging

Background:

• Indocyanine green fluorescence-guided surgery (ICG FGS) is well-established in adults, but its pediatric applications and optimal dosing are not fully understood.
• Limited data exists on the safety and benefits of ICG FGS in pediatric hepatobiliary operations.

Purpose of the Study:

• To evaluate the feasibility and applications of ICG FGS in pediatric hepatobiliary surgeries.
• To assess ICG FGS in children undergoing operations for biliary atresia, choledochal cysts, and cholelithiasis.

Main Methods:

• Prospective observational study (January 2021 - December 2022).
• Standard ICG dose (0.5 mg/kg) administered intravenously prior to surgery.
• Intraoperative imaging and adverse events were recorded for 17 pediatric patients.

Main Results:

• ICG FGS was successfully performed in 17 pediatric patients.
• In biliary atresia, fluorescence aided in identifying fibrous biliary remnants.
• In choledochal cyst and cholecystectomy, ICG FGS provided real-time anatomical detail for safe dissection.
• No ICG-related adverse events were observed.

Conclusions:

• ICG FGS is a safe, feasible, and beneficial tool in pediatric hepatobiliary surgery.
• ICG FGS enhances surgical navigation and may reduce complications in conditions like biliary atresia and choledochal cysts.
• Further research with standardized protocols is recommended to optimize ICG FGS in pediatric surgery.