Abstract
Background. ‘Critical view of safety’ (CVS) technique was introduced to avoid
bile duct injury (BDI) due to misidentification of anatomy during laparoscopic
cholecystectomy (LC). This study aimed at assessing the feasibility and comparing
the outcome of LC through CVS with those performed by ‘infundibular technique’
(INT).
Patients and Methods. A prospective randomized study included patients who
had LC as an elective procedure from January 2009 to December 2011, at Sohag
University Hospital. Patients were classified into 2 groups; the first included patients
underwent LC with CVS and the second included patients underwent LC with INT.
The study analyzed the outcome of both techniques.
Results. The study included 441 patients underwent LC of them 282 patients with
CVS, and 159 patients with INT. We reported zero BDI with both techniques.
Significant differences were found in the operative times in favor of CVS technique
(P=0.003) and conversion rate was found more significant in favor of group I
(P=0.047). No differences were found regarding minor complication rates, time for
re-feeding, time to first passage of stool, or discharge. No operative mortality
occurred.
Conclusion. Meticulous application of CVS defines the anatomic structures whish
should be divided, so has a protective role in avoidance of BDI and should be
adopted in LC.