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Indocyanine Green Fluorescence Navigation in Pediatric Hepatobiliary Surgery: Systematic Review
Carlos Delgado-Miguel1,2, Javier Arredondo-Montero3, Julio César Moreno-Alfonso4
1Pediatric Surgery Department, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain.
Children (Basel, Switzerland)
|July 29, 2025
Summary
Near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG) enhances pediatric hepatobiliary surgery by improving visualization of bile ducts and liver tumors. Further prospective studies are needed to optimize ICG use.
Area of Science:
- Hepatobiliary Surgery
- Pediatric Surgery
- Medical Imaging
Background:
- Near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) is increasingly recognized for its utility in complex hepatobiliary procedures.
- Recent studies support its role in guiding surgical decisions.
Purpose of the Study:
- To systematically review the perioperative use of ICG in pediatric hepatobiliary surgeries.
- To synthesize current evidence on ICG's applications, outcomes, and limitations in this patient population.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searches conducted in PubMed, CINAHL, and EMBASE databases.
- Data extraction and analysis by two independent reviewers.
Main Results:
- 43 articles involving 930 pediatric patients were included.
- ICG is applied in bile duct surgery (39.5%), liver tumor resection (34.9%), liver transplantation (14.6%), and liver function determination (12.2%).
- Majority of studies were retrospective (51.2%) or case reports (34.9%).
Conclusions:
- ICG fluorescence navigation is a promising and safe technology for pediatric hepatobiliary surgery.
- It aids in intraoperative localization of biliary structures, liver tumor identification, and hepatic function assessment.
- Limitations include a lack of prospective studies and variability in ICG dosing and administration timing.
