One Thousand Laparoscopic Cholecystectomies in a Single Surgical Unit Using the “Critical View of Safety” Technique

Abstract

CVS clarifies the relations of the anatomic structures that should be divided, and therefore, it should be ideally and routinely applied in all LCs because of its highly protective role against bile duct injuries.

Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients

“…24 In a recent single centre series of over 1000 patients, the CVS was associated with a zero incidence of bile duct injury. 25 Information regarding the use of CVS in our cohort was not collected, and it is therefore not possible to comment on the aetiology of bile duct injury in this series, but it is hypothesised that bile duct injuries in low risk patients (CLOC score 6) occurred due to improper or failure to use CVS. Other strategies designed to reduce bile duct injuries, including the use of the anatomical landmark Rouvière's sulcus or a cholecystectomy checklist, have not been rigorously tested.…”

A gallbladder with the “hidden cystic duct”: A brief overview of various surgical techniques of the Calot’s triangle dissection

“…Three main risk factors have been identifi ed, which increase the risk of the biliary tree trauma, and these include surgeon's experience, an infl ammatory process, and biliary anatomical variations [1,4]. However, the vast majority of reported biliary injuries results from misidentifi cation of the CBD as the CD [2,3].…”

“…Bile duct injuries during laparoscopic cholecystectomy remain an important cause of morbidity, mortality, increased hospital stay, and litigation [1,2]. Their reported rate varies from 0.3% to 0.5% and has not changed considerably since the introduction of laparoscopic surgery in early 1990 [3].…”

“…Their reported rate varies from 0.3% to 0.5% and has not changed considerably since the introduction of laparoscopic surgery in early 1990 [3]. The common bile duct (CBD) injuries comprise a complete transection, thermal injuries, or combination of CBD and hepatic vascular injuries [1]. This case highlights that a routine laparoscopic cholecystectomy can be challenging when cystic duct is obscured.…”

Mapping the Maze of Minimally Invasive Surgery Simulators

“…Second, the trainee should participate in a theoretical course regarding steps in MIS procedures (e.g., the critical view of safety during a laparoscopic cholecystectomy). 95 Practice should here include performance of entire procedures on a box trainer, a VR system, or an AR system. Key steps are preferably trained in this way.…”