With the widespread introduction of laparoscopic cholecystectomy, the incidence of iatrogenic main bile duct lesions has significantly increased, with incidences ranging from 0.2 to 1.5% according to current studies. Although there are studies regarding the use of indocyanine green (ICG) for improved visualization of the biliary anatomy, there is no consensus on the dose, timing and optimal mode of administration, or the indications in which ICG provides a real benefit through increased safety in laparoscopic cholecystectomy (LC). A systematic review was performed on articles in English published until March 2021, which were identified on PubMed, Springer Nature, Elsevier and Scopus via specific mesh terms: ‘Indocyanine green’/‘near‑infrared fluorescence’ and ‘laparoscopic cholecystitis’. The most used method of administration of ICG was intravenously, only one study evaluated the efficiency of a near‑infrared cholangiogram (NIRC) when ICG was administered directly in the gallbladder. The majority of the studies included in the review used 2.5 mg of ICG administered within 1 h before imaging. The intensity of the NIRC fluorescence signal was revealed to depend on several factors, with obesity and inflammation as the most clinically significant. NIRC was reported to be a simple, feasible, safe and cost‑effective procedure, which may improve safety in difficult cases of LC. NIRC use in combination with white light has been demonstrated to be superior to white light alone in identifying extrahepatic biliary anatomy, thus decreasing the risk of intraoperative bile duct injuries (BDI). For its large‑scale use, data on a higher number of patients to confirm its clinical value and specific indications is required.

Biomarkers in colorectal cancer (CRC) are of great interest in the current literature due to improvements in techniques such as liquid biopsy and next-generation sequencing (NGS). However, screening methods vary globally, with multi-target stool DNA (mt-sDNA) predominantly used in the USA and, more recently, the Cologuard Plus; biomarkers such as the Galectins family and septins show promise in early detection. Gut microbiome assessments, such as Fusobacterium nucleatum, are under intense exploration. Diagnostic tests, such as circulating DNA analysis via NGS, exhibit effectiveness and are being increasingly adopted. Circulating tumor cells emerge as potential alternatives to traditional methods in terms of diagnosis and prognosis. Predictive biomarkers are well established in guidelines; nonetheless, with the aid of machine learning and artificial intelligence, these biomarkers may be improved. This review critically explores the actual dynamic landscape of CRC biomarkers and future, promising biomarkers involved in screening, diagnosis, and prognosis.

Background: Fluorescence-guided surgery based on near-infrared imaging, most often using indocyanine green (ICG), is increasingly used in colorectal cancer (CRC) surgery. This narrative review integrates current evidence across four clinically relevant domains-anastomotic perfusion, lymphatic mapping, tumor localization, and metastasis detection and emphasizes the technical and translational factors that will determine broader implementation. Methods: We performed a structured narrative review of clinical and translational studies identified through PubMed and citation tracking, with emphasis on ICG-based workflows and emerging targeted tracers. Because the literature spans heterogeneous interventions, imaging platforms, and endpoints, no de novo meta-analysis or formal risk-of-bias assessment was undertaken. Results: ICG fluorescence angiography is the most mature application and can refine transection-line selection, although its effect on anastomotic leak appears protocol dependent. In lymphatic mapping, ICG improves visualization of drainage pathways and nodal basins but does not reliably distinguish benign from metastatic nodes. For tumor localization, ICG supports lesion marking and dynamic tissue characterization, while targeted probes and contrast-free adjuncts may improve oncologic specificity. For metastatic disease, ICG is most useful for liver margin guidance and for excluding residual disease, whereas CEA-targeted and multimodal approaches appear particularly promising for peritoneal metastases. Conclusions: The added value of this review lies in linking current clinical maturity to the translational steps still required for routine adoption. In CRC surgery, fluorescence imaging is already useful in selected settings, but broader implementation will depend on standardized protocols, objective real-time quantification, and multicenter validation of targeted tracers against clinically meaningful outcomes.

Background Near-infrared fluorescence–guided surgery (FGS), predominantly using indocyanine green (ICG), is increasingly adopted to support intraoperative decision-making in colorectal cancer (CRC). This narrative review synthesizes current evidence across four major clinical applications—assessment of anastomotic perfusion, lymphatic mapping, tumor localization, and metastasis detection—and outlines translational directions (targeted probes, multimodality, quantitative analytics/AI). Methods: We conducted a narrative, non-systematic review of clinical and translational studies on intraoperative fluorescence imaging in CRC, with a primary focus on ICG-based techniques and emerging targeted agents. Representative studies were selected to illustrate benefits, technical constraints (dose, timing, optics), and methodological limitations; formal risk-of-bias assessment and meta-analysis were not performed given the heterogeneity of designs. Results: (1) Anastomotic perfusion: ICG fluorescence angiography reduces uncertainty regarding transection lines and tissue viability; impact on anastomotic leak appears protocol-dependent and is likely enhanced by standardized acquisition parameters and objective, real-time quantification. (2) Lymphatic mapping: ICG improves visualization of drainage pathways and nodal basins but does not discriminate benign from metastatic involvement; the utility is primarily anatomic/functional. (3) Tumor localization: FGS facilitates identification of lesions and margins in selected scenarios; non-contrast adjuncts (e.g., hyperspectral imaging) may complement perfusion assessment. (4) Metastases: In the liver, FGS is useful as a rule-out tool and for margin guidance; in peritoneal disease, targeted anti-CEA approaches integrated with multimodality workflows (NIR + SPECT/CT + gamma-probe) demonstrate feasibility and clinical promise. Conclusions: ICG-based FGS is sufficiently mature for selective use in CRC—most notably for anastomotic perfusion assessment and resection guidance. Broader adoption will require protocol standardization, robust real-time quantification, and multicenter validation of targeted probes with clinically meaningful endpoints.