Description 

Indocyanine green (ICG) is a water-soluble, non-toxic tricarbocyanine dye extracted exclusively from the hepatic parenchyma. Measurement of ICG clearance using pulse spectrophotometry is a simple, reproducible and non-invasive test, easily performed in the operating room. ICG plasma disappearance rate (PDR) and the retention rate at 15 min (R15) produce real-time metrics to aid assessment and decision-making before, during and after complex liver surgery. ICG clearance has also been used to suggest the presence of postoperative complications, including thrombosis of the hepatic artery and graft dysfunction following liver transplantation. We present a case of 65-year-old Caucasian man, with Child-Pugh A liver cirrhosis undergoing complex right hepatectomy for metastatic colorectal liver cancer where ICG clearance impacted on the extent of surgical resection.

Given the concerns about marginal postoperative liver function of the residual left hepatic lobe, we used pulse spectrometry intraoperatively to predict the risk of postoperative liver dysfunction. Immediately preoperatively, a dose of 20 mg (0.25 mg/kg) ICG …