Indocyanine green fluorescence-guided surgery in the emergency setting: the WSES international consensus position paper

作者：B. de Simone, F. Abu-Zidan, L. Boni, A. Castillo, E. Cassinotti, Francesco Corradi, Francesco Di Maggio, Hajra Ashraf, G. Baiocchi, A. Tarasconi, M. Bonafede, Hùng Trường, N. De’angelis, Michele Diana, R. Coimbra, Z. Balogh, E. Chouillard, F. Coccolini, M. D. Kelly, S. Di Saverio, G. Di Meo, A. Isik, A. Leppäniemi, A. Litvin, Ernest E Moore, A. Pasculli, M. Sartelli, M. Podda, M. Testini, I. Wani, B. Sakakushev, V. Shelat, Dieter G. Weber, Joseph M. Galante, L. Ansaloni, V. Agnoletti, J. Régimbeau, G. Garulli, Andrew Kirkpatrick, W. Biffl, Carlo Alberto Desire Francesco Ahmad M. Yifat Fainzilber Schena Pantalone Marchegiani Zarour Goldman Hayes , C. Schena, Desiré Pantalone, F. Marchegiani, A. Zarour, Yifat Fainzilber Goldman, Alastair Hayes, D. Perini, F. Cammelli, G. Alemanno, L. Barberis, Eugenio Cucinotta, Justin Davies, A. Di Bella, Riccardo Bertelli, A. Toro, Isidoro Di Carlo, Andrea Hacker, Yunfeng Cui, E. Picetti, A. La Greca, F. Catena · 发表于：World Journal of Emergency Surgery · 年份：2025 · DOI：10.1186/s13017-025-00575-w · 被引用次数：41 · 研究领域：Medicine

Decision-making in emergency settings is inherently complex, requiring surgeons to rapidly evaluate various clinical, diagnostic, and environmental factors. The primary objective is to assess a patient’s risk for adverse outcomes while balancing diagnoses, management strategies, and available resources. Recently, indocyanine green (ICG) fluorescence imaging has emerged as a valuable tool to enhance surgical vision, demonstrating proven benefits in elective surgeries. This consensus paper provides evidence-based and expert opinion-based recommendations for the standardized use of ICG fluorescence imaging in emergency settings. Using the PICO framework, the consensus coordinator identified key research areas, topics, and questions regarding the implementation of ICG fluorescence-guided surgery in emergencies. A systematic literature review was conducted, and evidence was evaluated using the GRADE criteria. A panel of expert surgeons reviewed and refined statements and recommendations through a Delphi consensus process, culminating in final approval. ICG fluorescence imaging, including angiography and cholangiography, improves intraoperative decision-making in emergency surgeries, potentially reducing procedure duration, complications, and hospital stays. Optimal use requires careful consideration of dosage and timing due to limited tissue penetration (5–10 mm) and variable performance in patients with significant inflammation, scarring, or obesity. ICG is contraindicated in pat...