Background: Every year, worldwide, the celebration for patient safety is carried out; since about 2.6 million people are documented who die each year from events that can potentially be avoided during their medical care, it is even estimated that around 15% of hospital costs can be attributed to treatment resulting in patient safety. As an important part of its dissemination in the medical-surgical community, we present the following article in relation to the critical vision of safety in the bile duct, promoted and published initially by Dr Steven Strasberg, which aims to reduce the number of complications during laparoscopic cholecystectomies.
Materials And Methods: A bibliographic search was carried out in PubMed, Medline, Clinical Key, and Index Medicus. From May 2020 to July 2021 in Spanish and English with the following.
Conclusions: Strasberg's critical view is a proposed strategy to minimize the risk to zero during laparoscopic gallbladder surgery. It consists of obtaining a plane in which the surgeon can visualize the anatomical structures that make up the bile duct, as well as its irrigation and drainage. Being able to clearly observe these structures allows the surgeon to cut freely and safely to avoid bile duct injuries which are not so uncommon during this procedure.
How To Cite This Article: Montalvo-Javé EE, Contreras-Flores EH, Ayala-Moreno EA, Strasberg's Critical View: Strategy for a Safe Laparoscopic Cholecystectomy. Euroasian J Hepato-Gastroenterol 2022;12(1):40-44.
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http://dx.doi.org/10.5005/jp-journals-10018-1353 | DOI Listing |
Surg Endosc
December 2024
Department of Minimal Invasive and Bariatric, Surgery University Hospital of Indianapolis, Indianapolis, USA.
Background: The protective impact of the Critical View of Safety (CVS) approach on the vasculo-biliary injuries during laparoscopic cholecystectomy (LC) depends largely upon the understanding of the normal and variant anatomy. Structures exposed during the acquisition of the CVS can deviate from the typical dual configuration of the cystic duct and artery (gallbladder pedicle) representing either a third (supernumerary) or atypical in course (heterotopic) element. The aim of this study was to determine the identity and the frequency of these anatomical elements and to propose anatomic schemata that can guide the achievement of CVS by surgeons.
View Article and Find Full Text PDFJ Surg Res
December 2024
Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
Arq Bras Cir Dig
October 2024
Universidade Federal do Paraná, Department of Surgery - Curitiba (PR), Brazil.
Background: The incidence of biliary duct injuries remains higher in laparoscopic cholecystectomy (LC) in comparison to open surgery. The Critical View of Safety (CVS) was introduced by Strasberg as a strategy for reducing this catastrophic complication. AIM: The aim of this study was to evaluate how often an adequate CVS is achieved during LC, the determining factors for its success, and the associated surgical outcomes.
View Article and Find Full Text PDFSurg Clin North Am
December 2024
Division of Surgical Oncology and Hepatobiliary Surgery, William N. Pennington Cancer Institute, Renown Health, 1500 East 2nd Street, Suite 300, Reno, NV 89502, USA.
Injury to the biliary system can be a major problem leading to significant morbidity for the patient. This most commonly occurs due to iatrogenic causes and identification as early as possible is critical to maximizing the patient outcome. The timing of identification will dictate the optimal time for repair, and this should be undertaken at a facility with hepatobiliary surgery expertise as well as advanced gastroenterology and interventional radiology services.
View Article and Find Full Text PDFSurg Endosc
December 2024
Department of Surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, USA.
Introduction: Laparoscopic cholecystectomy is one of the most frequently performed procedures by general surgeons. Strategies for minimizing bile duct injuries including use of the critical view of safety method, as outlined by the SAGES Safe Cholecystectomy Program, are not always possible. Subtotal cholecystectomy has emerged as a safe "bail-out" maneuver to avoid iatrogenic bile duct injury in these difficult cases.
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