Safety and Feasibility of Indocyanine Green Fluorescence Angiography in Pediatric Gastrointestinal Surgery: A Systematic Review

•ICG-FA is used to determine anastomotic perfusion rates, thereby reducing surgical complications and aiding in intraoperative decision-making in adults, but not yet extensively described in pediatric surgery.•This systematic review analyzes the current knowledge on usefulness of ICG for intestinal perfusion assessment in pediatric gastrointestinal surgery and its safety in neonates.•ICG might be useful for intraoperative intestinal perfusion assessment, perhaps even more than conventional clinical assessment.•The safety profile of ICG looks promising in neonates. Larger prospective studies are necessary to confirm these assumptions and seem warranted given the safety profile. Although ICG-FA may be valuable in assessing anastomotic perfusion, reliable data on its use in pediatric gastrointestinal surgery is lacking. This systematic review analyzes whether ICG is useful for intestinal perfusion assessment in pediatric gastrointestinal surgery and safe to use in neonates. Systematic searches of PubMed, EMBASE & MEDLINE and CENTRAL were performed (last conducted December 6, 2021). The main inclusion criteria were (1) use of ICG for intestinal perfusion assessment and (2) use of ICG in young infants. Exclusion criteria were lack of an English or Dutch full-text and MINORS quality score