FLUORESCENCE-GUIDED LIVER RESECTIONS (ICG): MARGIN ACCURACY AND SAFETY

Abstract

Indocyanine green (ICG) fluorescence has been described as a significant innovation in hepatobiliary surgery, as it allows for better anatomical visualization and intraoperative tumor delimitation, contributing to more precise identification of surgical margins. Objective: To analyze the accuracy of surgical margins and the safety of liver resections guided by ICG fluorescence. Methodology: The methodology consisted of a literature review conducted according to the PRISMA checklist, using the PubMed, SciELO, and Web of Science databases, with the descriptors "indocyanine green," "liver resection," "fluorescence imaging," "liver neoplasms," and "surgical margins"; including studies published in the last 10 years and excluding experimental studies in animals, duplicates, or studies without access to the full text. Results: The results showed that the use of ICG fluorescence increased the rate of resections with clear margins (R0), improved intraoperative detection of additional lesions, increased the accuracy of segmental resections, reduced local recurrence, presented low rates of adverse events, and favored better anatomical orientation. In line with these findings, Itoh et al. reported that "the indocyanine green fluorescence imaging technique may offer clinical benefits in terms of a safer surgical margin" (ITOH et al., 2022, p. 2). Conclusion: It was concluded that the use of ICG in liver resections represented an effective and safe strategy, promoting greater accuracy in tumor delimitation, improving surgical safety, and contributing to more favorable clinical outcomes.