{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:35:33Z","timestamp":1788924933074,"version":"build-2803163510"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>\n                  Introduction\u2003Indocyanine green (ICG) fluorescence-guided surgery (FGS) is reported extensively in adult operations, but its safety and applications in pediatric populations remain to be comprehensively understood. The dose, administration protocols, and intraoperative imaging benefits in pediatric hepatobiliary operations are not clear.<\/jats:p><jats:p>\n                  Objectives\u2003This study aimed to identify the feasibility and applications of ICG FGS in hepatobiliary surgeries (for biliary atresia, choledochal cyst, and cholelithiasis) in children.<\/jats:p><jats:p>\n                  Methods\u2003This is a prospective observational study conducted from January 2021 to December 2022. A standard ICG dose of 0.5\u2009mg\/kg\/dose was administered intravenously to children undergoing operations for biliary atresia (18\u201324\u2009hours), choledochal cyst (12\u201318\u2009hours), and cholelithiasis (2\u20136\u2009hours) before the operation. Intraoperative imaging features and adverse events were recorded.<\/jats:p><jats:p>\n                  Results\u2003ICG FGS was performed in 17 patients. In biliary atresia (n\u2009=\u20099), liver fluorescence varied in each case, the gallbladder did not show fluorescence, and there was increasing fluorescence as we reached the right depth during the excision of fibrous biliary remnants. In choledochal cyst (n\u2009=\u20096) operations and cholecystectomy (n\u2009=\u20092), real-time imaging provided anatomical details of the biliary tree and helped in safe dissection. No ICG-related adverse events occurred.<\/jats:p><jats:p>\n                  Conclusion\u2003ICG FGS appears safe, feasible, and beneficial in pediatric hepatobiliary surgeries. For conditions like biliary atresia, choledochal cysts, and cholecystectomy, ICG facilitates safer surgical navigation and may reduce intraoperative complications. Future studies with standardized protocols and quantitative fluorescence assessment are needed to further refine its use and confirm its impact on surgical outcomes.<\/jats:p>","DOI":"10.1055\/a-2509-4463","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T18:58:43Z","timestamp":1735930723000},"page":"277-285","source":"Crossref","is-referenced-by-count":4,"title":["Indocyanine Green Fluorescence-Guided Surgery in Pediatric Hepatobiliary Procedures: A Feasibility Study for Improved Intraoperative Visualization"],"prefix":"10.1055","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0264-7727","authenticated-orcid":false,"given":"Jayakumar","family":"T.K","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirtikumar Jagdish","family":"Rathod","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2835-8146","authenticated-orcid":false,"given":"Rahul","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6385-1812","authenticated-orcid":false,"given":"Manish","family":"Pathak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash S.","family":"Jadhav","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9355-8510","authenticated-orcid":false,"given":"Shubhalaxmi","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Varshney","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhash Chandra","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4103\/cmi.cmi_133_20","article-title":"Indocyanine green beyond quantitative liver function tests \u2013 An adjuvant in pediatric imaging: a review of its uses and a protocol for administration in pediatric surgical practice","volume":"19","author":"T JK Jacob","year":"2021","journal-title":"Curr Med Issues"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1007\/s00383-019-04502-4","article-title":"Application of indocyanine green in pediatric surgery","volume":"35","author":"C T Lau","year":"2019","journal-title":"Pediatr Surg Int"},{"issue":"08","key":"ref3","first-page":"594","article-title":"[Cancer arising in choledochal cyst and management]","volume":"97","author":"T Todani","year":"1996","journal-title":"Nippon Geka Gakkai Zasshi"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s005340050108","article-title":"Bile duct cancer developed after cyst excision for choledochal cyst","volume":"6","author":"Y Watanabe","year":"1999","journal-title":"J Hepatobiliary Pancreat Surg"},{"issue":"11","key":"ref5","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1001\/archsurg.136.11.1287","article-title":"Common bile duct injury during laparoscopic cholecystectomy and the use of intraoperative cholangiography: adverse outcome or preventable error?","volume":"136","author":"D R Flum","year":"2001","journal-title":"Arch Surg"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/j.jamcollsurg.2006.07.018","article-title":"Risk factors for perioperative complications in patients undergoing laparoscopic cholecystectomy: analysis of 22,953 consecutive cases from the Swiss Association of Laparoscopic and Thoracoscopic Surgery database","volume":"203","author":"U F Giger","year":"2006","journal-title":"J Am Coll Surg"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s13304-020-00888-2","article-title":"Complications in pediatric laparoscopic cholecystectomy: systematic review","volume":"73","author":"K Miura da Costa","year":"2021","journal-title":"Updates Surg"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1016\/j.crad.2011.07.045","article-title":"Tc99m-hepatobiliary iminodiacetic acid (HIDA) scintigraphy in clinical practice","volume":"66","author":"H Lambie","year":"2011","journal-title":"Clin Radiol"},{"issue":"11","key":"ref9","doi-asserted-by":"crossref","first-page":"6366","DOI":"10.1007\/s00464-021-08596-7","article-title":"Indocyanine green (ICG) fluorescent cholangiography during laparoscopic cholecystectomy using RUBINA\u2122 technology: preliminary experience in two pediatric surgery centers","volume":"35","author":"C Esposito","year":"2021","journal-title":"Surg Endosc"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1002\/jhbp.855","article-title":"Indocyanine green administration a day before surgery may increase bile duct detectability on fluorescence cholangiography during laparoscopic cholecystectomy","volume":"28","author":"M Matsumura","year":"2021","journal-title":"J Hepatobiliary Pancreat Sci"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s00383-015-3799-4","article-title":"Near-infrared fluorescence cholangiography with indocyanine green for biliary atresia. Real-time imaging during the Kasai procedure: a pilot study","volume":"31","author":"Y Hirayama","year":"2015","journal-title":"Pediatr Surg Int"},{"issue":"12","key":"ref12","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1016\/j.jpedsurg.2019.08.029","article-title":"The outcome of real-time evaluation of biliary flow using near-infrared fluorescence cholangiography with Indocyanine green in biliary atresia surgery","volume":"54","author":"Y Yanagi","year":"2019","journal-title":"J Pediatr Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"102960","DOI":"10.1016\/j.pdpdt.2022.102960","article-title":"Exploratory application of indocyanine green quantification in biliary atresia observational study","volume":"39","author":"J Zhao","year":"2022","journal-title":"Photodiagnosis Photodyn Ther"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"102129","DOI":"10.1016\/j.epsc.2021.102129","article-title":"Usefulness of indocyanine green fluorescence in laparoscopic resection of choledochal cyst in children","volume":"76","author":"C Garc\u00eda-Hern\u00e1ndez","year":"2022","journal-title":"J Pediatr Surg Case Rep"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1177\/1553350614524839","article-title":"Indocyanine green (ICG) fluorescent cholangiography during robotic cholecystectomy: results of 184 consecutive cases in a single institution","volume":"21","author":"D Daskalaki","year":"2014","journal-title":"Surg Innov"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"4369","DOI":"10.1007\/s00464-021-08784-5","article-title":"Efficacy of indocyanine green (ICG) fluorescent cholangiography to improve intra-operative visualization during laparoscopic cholecystectomy in pediatric patients: a comparative study between ICG-guided fluorescence and standard technique","volume":"36","author":"C Esposito","year":"2022","journal-title":"Surg Endosc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"314","DOI":"10.3389\/fped.2020.00314","article-title":"Image-guided pediatric surgery using indocyanine green (ICG) fluorescence in laparoscopic and robotic surgery","volume":"8","author":"C Esposito","year":"2020","journal-title":"Front Pediatr"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1005879","DOI":"10.3389\/fped.2022.1005879","article-title":"Intraoperative indocyanine green fluorescence cholangiography can rule out biliary atresia: a preliminary report","volume":"10","author":"C Shirota","year":"2022","journal-title":"Front Pediatr"},{"issue":"01","key":"ref19","first-page":"61","article-title":"Indocyanine green test is a reliable indicator of postoperative liver function in biliary atresia","volume":"16","author":"A Kubota","year":"1993","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/hep.26700","article-title":"Indocyanine green retention test as a noninvasive marker of portal hypertension and esophageal varices in compensated liver cirrhosis","volume":"59","author":"A Lisotti","year":"2014","journal-title":"Hepatology"},{"issue":"11","key":"ref21","first-page":"A4201","article-title":"Cholecystectomy in children","volume":"57","author":"A P Ainsworth","year":"2010","journal-title":"Dan Med Bull"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"115","DOI":"10.5223\/pghn.2015.18.2.115","article-title":"Pediatric cholecystectomy: clinical significance of cases unrelated to hematologic disorders","volume":"18","author":"H Y Kim","year":"2015","journal-title":"Pediatr Gastroenterol Hepatol Nutr"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.surg.2023.10.022","article-title":"Indocyanine green fluorescent cholangiography: the new standard practice to perform laparoscopic cholecystectomy in pediatric patients. A comparative study with conventional laparoscopic technique","volume":"175","author":"C Esposito","year":"2024","journal-title":"Surgery"},{"issue":"10","key":"ref24","doi-asserted-by":"crossref","first-page":"5729","DOI":"10.1007\/s00464-020-08045-x","article-title":"Fluorescent cholangiography significantly improves patient outcomes for laparoscopic cholecystectomy","volume":"35","author":"R C Broderick","year":"2021","journal-title":"Surg Endosc"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S0161-6420(94)31303-0","article-title":"Adverse reactions due to indocyanine green","volume":"101","author":"M Hope-Ross","year":"1994","journal-title":"Ophthalmology"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1016\/j.jpedsurg.2022.10.045","article-title":"Safety and feasibility of indocyanine green fluorescence angiography in pediatric gastrointestinal surgery: a systematic review","volume":"58","author":"E A Breuking","year":"2023","journal-title":"J Pediatr Surg"}],"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2509-4463.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T10:57:02Z","timestamp":1752231422000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2509-4463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":26,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,7,10]]},"published-print":{"date-parts":[[2025,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2509-4463","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1,3]]},"published":{"date-parts":[[2025,1,3]]}}}