The Critical View of Safety Prevents the Appearance of Biliary Injuries? Analysis of a Survey

Abstract

Background: The risk of bile duct injury (BDI) during cholecystectomy remains a concern, despite efforts proposed for increasing safety. The Critical View of Safety (CVS) has been adopted promoting to reduce its risk. Aim: To perform a survey to assess the awareness of the CVS, estimating the proportion of surgeons that correctly identified its elements and its relationship with BDI. Methods: An anonymous online survey was sent to 2096 surgeons inquiring on their common practices during cholecystectomy and their knowledge of the CVS. Results: A total of 446 surgeons responded the survey (21%). The percentage of surgeons that correctly identified the elements of CVS was 21.8% and 24.8% among surgeons claiming to know the CVS. The percentage of surgeons that reported BDI was higher among those that incorrectly identified the elements of the CVS (p=0.03). In the multivariate analysis, career length was the most significant factor related to BDI (p=0.002). Conclusions: The percentage of surgeons that correctly identified the Critical View of Safety was low, even among those who claimed to know the CVS. The percentage of surgeons that reported BDI was higher among those that incorrectly identified the elements of the CVS.

Critical View of Safety in Laparoscopic Cholecystectomy: A Systematic Review of Current Evidence and Future Perspectives

“…Indeed, in the Netherlands the CVS is included in the national guidelines for LC [8]. However, despite accepting the core CVS principles, a significant proportion of surgeons still has difficulty in correctly recognising all three criteria (17% in the Netherlands, 25% in Latin America) [9, 52].…”

Critical view of safety in laparoscopic cholecystectomy: A prospective investigation from both cognitive and executive aspects

“…In this study, most surgeons (88.3%) reported that they knew about CVS but only 11.5% knew about it correctly ( 38 ). A survey conducted in South America comprising 446 surgeons showed that the percentage of surgeons who correctly identified all three criteria of CVS was 21.8% ( 39 ). A large-sample survey conducted in the Netherlands, where CVS is routinely required during LC, indicated that although 98.2% of the surgeons claimed that they incorporated the CVS technique into daily practice, only 16.9% of the surgeons correctly selected all three criteria of CVS ( 40 ).…”