LAUSR

Fluorescence imaging (FI) technology with indocyanine green (ICG) has become an important adjunct to multiple surgical procedures. Among other uses, FI helps surgeons visualize the biliary tree, assess perfusion to alimentary tract anastomoses, localize hepatic neoplasms, identify the ureters, and assess lymphatic drainage territories. In these cases, ICG is traditionally administered as a bolus of reconstituted solution. This is most commonly an intravenous (IV) injection, although sometimes it is injected directly into a target organ. Despite the increasingly widespread adoption of FI in abdominal surgery, there has not been a significant increase of its use in pancreatic surgery. Applications of FI for pancreatic surgeons are experimental and largely center around the use of fluorescence‐tagged particles with affinity to specific molecular targets in pancreatic cancer (e.g., near‐ infrared labeled epidermal growth factor receptor [EGFR] peptides). Other investigations focus on identifying lymphatic drainage patterns around the pancreas. Many of these applications are still in early experimental phases, and the utility of their use remains unclear. The above examples do not focus on enhancing the visualization of pancreatic parenchyma. The authors present a novel approach to using FI during pancreatic surgery, in which ICG is given as a continuous IV infusion to accentuate pancreatic parenchyma. This ongoing infusion results in steady uptake of ICG by the pancreas without significant interference from surrounding tissue. 2 | METHODS