Advances in Indocyanine Green Fluorescence Imaging for Laparoscopic Hepatectomy

Vollständiger Abstract

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Indocyanine green (ICG) near-infrared fluorescence imaging enables real-time, repeatable, and radiation-free navigation during laparoscopic hepatectomy. Its applications have expanded from tumor localization to segmental staining, delineation of anatomical resection planes, margin assessment, biliary visualization, and evaluation of parenchymal perfusion. Current evidence indicates that ICG-guided surgery is associated with improved detection of small or superficial lesions, higher R0 resection rates, and improvements in selected perioperative outcomes. Nevertheless, performance is affected by liver function, dose and timing, lesion depth, staining strategy, and imaging-system characteristics. Evidence from robust randomized trials and long-term oncological follow-up remains limited. This narrative review summarizes the principles, clinical applications, evidence, limitations, and future directions of ICG fluorescence imaging in laparoscopic hepatectomy, with emphasis on Chinese- and English-language literature published from 2021 to 2025.