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Use the Critical View of Safety (CVS) method of identification of the cystic duct and cystic artery during laparoscopic cholecystectomy. 7 Three criteria are required to achieve the CVS: The hepatocystic triangle is cleared of fat and fibrous tissue.
Laparoscopic cholecystectomy is considered the "gold standard" for the surgical treatment of gallstone disease. This procedure results in less postoperative pain, better cosmesis, and shorter hospital stays and disability from work than open cholecystectomy .
In this article, a technique of achieving critical view of safety during laparoscopic cholecystectomy is described with the aim to enhance its understanding among general surgery trainees and practicing general surgeons.
Major vasculobiliary injuries during laparoscopic cholecystectomy continue to occur at 0.2 to 0.6% and the vast majority (up to 85%) are related to misidentification of anatomical structures. 1 The Critical View of Safety (CVS) was described in 1995 as a target identification method and has the following three requirements: (1) clearance of the ...
The critical view of safety: why it is not the only method of ductal identification within the standard of care in laparoscopic cholecystectomy. Ann Surg. 2017;265(3):464–465. doi: 10.1097/SLA.0000000000002054.
The Critical View of Safety (CVS) has been increasingly recognised as the standard method for identification of the cystic structures, to prevent vasculobiliary injuries during laparoscopic cholecystectomy, however, its adoption has been anything but universal.
Background The Critical View of Safety (CVS) has been increasingly recognised as the standard method for identification of the cystic structures, to prevent vasculobiliary injuries during laparoscopic cholecystectomy, however, its adoption has been anything but universal.
Laparoscopic cholecystectomy is considered the gold standard for the treatment of gallbladder lithiasis; nevertheless, the incidence of bile duct injuries (BDI) is still high (0.3–0.8%) compared to open cholecystectomy (0.2%).
The critical view of safety in laparoscopic cholecystectomy: towards a national consensus. Ir Med J. 2015 Jan;108 (1):26. Authors. J A O'Kelly , J A De Marchi , W P Joyce. PMID: 25702354. No abstract available. Publication types. Letter. MeSH terms. Bile Ducts, Extrahepatic / anatomy & histology. Bile Ducts, Extrahepatic / surgery.
The rationale of CVS is based on a 2-step method for ductal identification that was and continues to be used in open cholecystectomy. First, by dissection in the triangle of Calot, the cystic duct and artery are putatively identified and looped with ligatures.