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Saudi Journal of Medicine (SJM)
Volume-4 | Issue-01 | 18-22
Original Research Article
Critical View of Safety is a Safe Approach for Laparoscopic Cholecystectomy
Ala Wafa, Ali Ghellai, Khalid Garib
Published : Jan. 25, 2019
DOI : 10.36348/sjm.2019.v04i01.004
Abstract
Background: Laparoscopic cholecystectomy has morbidity due to bile duct injuries about 0.3% to 0.5% [1]. The main technique used for gallbladder dissection is infundibulum technique. Critical view of safety method is identification of the cystic duct and cystic artery during laparoscopic cholecystectomy and it is used to minimize risk of bile duct injury. Several studies confirm the routine use of critical view of safety technique eliminate the chance of bile duct injury. First introduced by Steven Strasberg 1992 [1]. Materials and Methods: A retrospective study compared the critical view of safety with infundibular technique regarding operative time, and bile duct injuries. We had 487 patients with critical view of safety and 534 with infundibular technique done at Misurata cancer center between January 2012 and December 2015. Indication of surgery were acute cholecystitis and biliary colic. All operations done by both young and experienced surgeons. Results: There were 1021 laparoscopic cholecystectomy, 483 with critical view of safety technique, 538 patients with infundibular technique. The mean operative time in critical view of safety is 57 minutes while in infundibulum technique is 43 minute. Risk of cystic duct stump leak in critical view of safety is 0.4%, while in infundibulum technique is 0.6%. The risk of major bile duct injuries in critical view of safety in our study is 0%, while in infundibulum technique is 0.4%. Conclusion: The risk of bile duct injuries is the main concern in laparoscopic cholecystectomy. Critical view of safety technique in compared to infundibulum technique has a little increase in the operative time and less bile duct injuries
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