Indocyanine Green-Fluorescent Pancreatic Perfusion-Guided Resection of Distal Pancreas in Solid Pseudopapillary Neoplasm: Usefulness and Feasibility During Pancreaticobiliary Surgery

Indocyanine green (ICG) is a fluorescent dye that has been approved by the Food and Drug Administration (FDA) for clinical and research use in humans since 1956. Initially, ICG was used for quantitative measurements of hepatic and cardiac function. When ICG is injected intravenously, it binds to plasma proteins, such as albumin, and lipoproteins. It is generally excited between 750 and 800 nm, and fluorescence emission is detected near the maximum peak of 832 nm. Due to this physiologic property and the advancement of instrumental camera technology, ICG is now widely applied in realtime imaging during abdominal surgery, plastic surgery, as well as oncologic staging and treatment. However, there are few examples of clinical applications using ICG in pancreatic surgery. We recently experienced a very interesting case that supports potential application of ICG in pancreatectomy. Indocyanine Green-Fluorescent Pancreatic Perfusion-Guided Resection of Distal Pancreas in Solid Pseudopapillary Neoplasm: Usefulness and Feasibility During Pancreaticobiliary Surgery