The role of indocyanine green in fluorescence-guided pancreatic surgery: a comprehensive review

Pancreatic surgery is a complex and challenging field, with patients facing a high risk of postoperative complications. In recent years, indocyanine green (ICG) has gained prominence as a valuable tool used in various aspects of pancreatic surgery. ICG is a fluorescent dye thatoffers real-time imaging capabilities that enhance the surgeon’s ability to accurately localise tumours and critical anatomical structures, thereby improving surgical precision and potentially reducing operative time and complications. One of the most significant advantages of ICG is its ability to provide enhanced visualisation of the biliary tract and vascular structures, which is particularly beneficial in complex pancreatic resections, in which the anatomy can be highly variable and challenging to navigate. Furthermore, ICG can be instrumental in ensuring the adequate perfusion of anastomoses, thereby reducing the risk of postoperative leaks and associated morbidity. This comprehensive review aims to provide an in-depth analysis of the current applications, advantages, and limitations of ICG in pancreatic surgery.