Khalaf Mohamed H, Abdelrahman Husham, El-Menyar Ayman, Afifi Ibrahim, Kloub Ahmad, Al-Hassani Ammar, Rizoli Sandro, Al-Thani Hassan
Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar.
Front Surg. 2024 Feb 14;11:1345831. doi: 10.3389/fsurg.2024.1345831. eCollection 2024.
For decades, indocyanine green (ICG) has been available for medical and surgical use. The indications for ICG use in surgery have expanded where guided surgery directed by fluorescence and near-infrared fluorescent imaging offers numerous advantages. Recently, surgeons have reported using ICG operative navigation in the emergency setting, with fluorescent cholangiography being the most common procedure. The utility of ICG also involves real-time perfusion assessment, such as ischemic organs and limbs. The rising use of ICG in surgery can be explained by the ICG's rapid technological evolution, accuracy, ease of use, and great potential to guide precision surgical diagnosis and management. The review aims to summarize the current literature on the uses of ICG in emergency general surgery. It provides a comprehensive and practical summary of the use of ICG, including indication, route of administration, and dosages. To simplify the application of ICG, we subdivided its use into anatomical mapping and perfusion assessment. Anatomical mapping includes the biliary tree, ureters, and bowel. Perfusion assessment includes bowel, pancreas, skin and soft tissue, and gonads. This review provides a reference to emergency general surgeons to aid in implementing ICG in the emergency setting for more enhanced and safer patient care.
几十年来,吲哚菁绿(ICG)一直用于医学和外科手术。在荧光和近红外荧光成像引导的手术具有诸多优势的情况下,ICG在手术中的应用指征不断扩大。最近,外科医生报告了在急诊环境中使用ICG手术导航,其中荧光胆管造影是最常见的操作。ICG的用途还包括实时灌注评估,如对缺血器官和肢体的评估。ICG在手术中使用的增加可归因于其技术的快速发展、准确性、易用性以及在指导精准手术诊断和管理方面的巨大潜力。本综述旨在总结目前关于ICG在急诊普通外科应用的文献。它全面且实用地总结了ICG的应用,包括适应证、给药途径和剂量。为简化ICG的应用,我们将其应用细分为解剖定位和灌注评估。解剖定位包括胆管、输尿管和肠道。灌注评估包括肠道、胰腺、皮肤和软组织以及性腺。本综述为急诊普通外科医生提供参考,以帮助在急诊环境中应用ICG,从而为患者提供更优质、更安全的护理。