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Review
. 2024 Dec 1;110(12):7948-7961.
doi: 10.1097/JS9.0000000000001802.

Application of indocyanine green fluorescence imaging in hepatobiliary surgery

Jia Zhou  1   2 , Zhiguo Tan  1   2 , Bo Sun  1   3   4 , Yufang Leng  2 , Sulai Liu  1   3   4
Affiliations
Review

Application of indocyanine green fluorescence imaging in hepatobiliary surgery

Jia Zhou et al. Int J Surg. .

Abstract

Indocyanine green (ICG) is a fluorescent dye with an emission wavelength of about 840 nm, which is selectively absorbed by the liver after intravenous or bile duct injection, and then it is excreted into the intestines through the biliary system. With the rapid development of fluorescence laparoscopy, ICG fluorescence imaging is safe, feasible, and widely used in hepatobiliary surgery. ICG fluorescence imaging is of great significance in precise preoperative and intraoperative localization of liver lesions, real-time visualization of hepatic segmental anatomy, intrahepatic and extrahepatic biliary tract visualization, and liver transplantation. ICG fluorescence imaging facilitates efficient intraoperative hepatobiliary decision-making and improves the safety of minimally invasive hepatobiliary surgery. Advances in imaging systems will increase the use of fluorescence imaging as an intraoperative navigation tool, improving the safety and accuracy of open and laparoscopic/robotic hepatobiliary surgery. Herin, we have reviewed the status of ICG applications in hepatobiliary surgery, aiming to provide new insights for the development of hepatobiliary surgery.

Trial registration: ClinicalTrials.gov NCT05546619.

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Conflict of interest statement

All authors have no conflicts of interest related to this publication. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Overview of clinical applications of fluorescence-guided surgery in liver tumors, anatomical hepatectomy, biliary surgery, and liver transplantation. CRLM, colorectal cancer liver metastases; LC, laparoscopic cholecystectomy.
Figure 2
Figure 2
Clinical applications of indocyanine green (ICG) fluorescence imaging during liver resection. (A) visualization of hepatic segment VIII; (B) visualization of hepatic segment V; (C) ICG visualization during anatomical resection of hepatic segment Ⅵ; (D) liver section after hepatic segmentectomy; (E) visualization of the lesion between hepatic segments VI and VII; (F) hepatic segment VI hepatectomy with ICG; (G, H) the resected liver tumors.
Figure 3
Figure 3
A schematic representation of indocyanine green (ICG) positive staining and negative staining. (A) anatomical hepatectomy of segment VIII with ICG-positive staining; (B) anatomical hepatectomy of segment III with ICG negative staining.
Figure 4
Figure 4
Practical scheme and implementation process for applications of indocyanine green (ICG) in liver resection. This practical scheme includes the application and clinical value of ICG fluorescence imaging technology in liver tumor staining and anatomical hepatectomy.
Figure 5
Figure 5
Clinical applications of indocyanine green (ICG) fluorescence imaging during laparoscopic cholecystectomy. (A) original view of cystic duct variation; (B–D) ICG fluorescence imaging of cystic duct variation.
See this image and copyright information in PMC

References

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