THE CRITICAL VIEW OF SAFETY: WHY LAPAROSCOPIC CHOLECYSTECTOMY STANDARD OF CARE DOES NOT REQUIRE IT AS THE ONLY DUCTAL IDENTIFICATION METHOD

Around 1990, laparoscopic cholecystectomy became widely used and has since been shown to be beneficial to patients. But it was linked to a dramatic rise in serious bile duct injuries. Biliary injuries are unpleasant, expensive, and the subject of lawsuits. Although they are mostly iatrogenic and not the result of neglect, they lessen the benefits of laparoscopic cholecystectomy. Misidentification is the leading cause of serious bile duct damage. The common bile duct is believed to be the cystic duct and is separated in the "classical damage." Additionally, the cavernous conduit or cystic artery may be misinterpreted for abnormal hepatic ducts. The cystic duct and the cystic artery are the targets of the Critical View of Safety (CVS), a technique for target identification. Today, CVS is extensively taught and used. Its usage complies with the established standards of care and is recognized as a reliable method of identifying cystic formations. The goal of this surgical viewpoint is to assess if CVS has become the sole procedure recognized for identifying structures during laparoscopic cholecystectomy.

Keywords: Critical View, Safety, Laparoscopic Cholecystectomy Standard, Care, Ductal Identification Method.