Application of intraoperative vascular and biliary tract imaging in laparoscopic duodenum-preserving pancreatic head resection

Indocyanine green (ICG) fluorescence imaging, which visualizes the biliary tract and blood vessels, is a valuable intraoperative tool during laparoscopic duodenum-preserving pancreatic head resection (LDPPHR).This study aimed to evaluate the clinical application value of fluorescence laparoscopy-assisted duodenum-preserving pancreatic head resection (FLDPPHR) for benign pancreatic head tumors at our institution. The data of patients who underwent LDPPHR from January 2020 to December 2025 were retrospectively collected. Patients using fluorescence laparoscopy were assigned to the fluorescence laparoscopy group (ICG group), while those using conventional laparoscopy were assigned to the traditional group (non-ICG group). Baseline and perioperative data were compared and analyzed between the two groups. A total of 34 patients were included in the analysis, with 18 patients in the ICG group and 16 patients in the non-ICG group. There were no statistically significant differences between the two groups in terms of preoperative examinations and other baseline indicators. The ICG group had lower operation time, a lower incidence of postoperative bile leakage, and a shorter postoperative hospital stay compared to the non-ICG group. Indocyanine green fluorescence imaging enables real-time visualization of the common bile duct, which helps reduce bile duct injury and the incidence of postoperative bile leakage. It also clearly delineates the pancreaticoduodenal arterial arcade, minimizing injury to the mesenteric vessels of the duodenum and reducing intraoperative blood loss. This technique has good clinical application value and is worthy of widespread adoption.