J.Jpn. Surg. Soc.. 121(1): 11-18, 2020

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Feature topic

CURRENT STATUS OF AND FUTURE PERSPECTIVES ON FLUORESCENCE IMAGING IN HEPATOBILIARY AND PANCREATIC SURGERY

In the field of hepatobiliary and pancreatic (HBP) surgery, fluorescence imaging using indocyanine green can be used for intraoperative real-time visualization of the extrahepatic bile duct (fluorescence cholangiography), hepatic malignancies, and segmental boundaries, as well as to assess tissue blood perfusion. Recently, these techniques have become widespread, especially in minimally invasive surgery, because fluorescence imaging is easy to use and can assist in palpation and visual inspection based on white-light color imaging. On the other hand, novel target-specific fluorophores and imaging systems with higher resolution and the ability to calculate fluorescence intensity have been developed. The accumulation of fluorophores in cancer tissues can also be utilized in photodynamic treatment as well as intraoperative imaging. Active communications among surgeons, researchers, and engineers will result in the development of additional fluorescence imaging modalities specifically for intraoperative diagnosis and as essential tools for improving short- and long-term outcomes after HBP surgery.

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