Comparative Study of Critical View of Safety vs Infundibular Technique in Laparoscopic Cholecystectomy
DOI:
https://doi.org/10.37762/jgmds.9-2.186Keywords:
Critical View of Safety (CVS), Infundibular Technique (IT), Bile Duct Injury (BDI)Abstract
OBJECTIVES:
The purpose of this study is to compare the critical view of safety technique with the infundibular technique in laparoscopic cholecystectomy in terms of mean operative time and bile duct injuries (BDI).
METHODOLOGY:
Between 2018 and 2020, 220 patients had laparoscopic cholecystectomy in the Surgical "A" unit at Hayatabad Medical Complex in Peshawar, Pakistan. The patients were divided into two groups, with the first receiving a critical view of safety and the second receiving an infundibular procedure. Operation time and bile duct injury were compared between the two groups.
RESULTS:
The operative time was significantly reduced with the critical view of safety (CVS) approach, with a mean time of 35.07 minutes for CVS and 40.58 minutes for infundibular technique, with a significant P-value (0.013). About 17 (7.7%) cases required open cholecystectomy; the conversion rate was higher in the infundibular group, with a significant P-value (<0.001).
CONCLUSION:
Although the "critical view of safety" requires more patience during dissections than the infundibular approach, it is proven to be faster and is considered a safe procedure in laparoscopic cholecystectomy.
KEYWORDS: Critical View of Safety (CVS), Infundibular Technique (IT), Bile Duct Injury (BDI)
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Singh R, Brunt LM. Critical view of safety-its feasibility and efficacy in preventing bile duct injuries. Ann Laparosc Endosc Surg. 2018;3(2)
Daly SC, Deziel DJ, Li X, Thaqi M, Millikan KW, Myers JA, et al. Current practices in biliary surgery: do we practice what we teach?. Surg Endosc. 2016;30(8):3345-50
Chen CB, Palazzo F, Doane SM, Winter JM, Lavu H, Chojnacki KA, et al. Increasing resident utilization and recognition of the critical view of safety during laparoscopic cholecystectomy: a pilot study from an academic medical center. Surg Endosc. 2017;31(4):1627-35.
Zarin M, Khan MA, Khan MA, Shah SA. Critical view of safety faster and safer technique during laparoscopic cholecystectomy. Pak J Med Sci. 2018;34(3):574-7
Barrett M, Asbun HJ, Chien HL, Brunt LM, Telem DA. Bile duct injury and morbidity following cholecystectomy: a need for improvement. Surg Endosc. 2018;32(4):1683-8
Fong ZV, Pitt HA, Strasberg SM, Loehrer AP, Sicklick JK, Talamini MA, et al. Diminished survival in patients with bile leaks and ductal injuries: management strategy influences outcomes. J Am Coll Surg. 2018;226(4):568-76
Manatakis DK, Vitalis A, Agalianos C, Terzis I, Kyriazanos ID, Davides D. Teaching and learning the critical view of safety technique in laparoscopic cholecystectomy. HPB. 2016;18:664-5
Kaya B, Fersahoglu MM, Kilic F, Onur E, Memisoglu K. Importance of critical view of safety in laparoscopic cholecystectomy: a survey of 120 serial patients, with no incidence of complications. Ann Hepatobiliary Pancreatic Surg. 2017;21(1):17-20
Strasberg SM, Pucci MJ, Brunt LM, Deziel DJ. Subtotal cholecystectomy-"fenestrating" vs "reconstituting" subtypes and the prevention of bile duct injury: definition of the optimal procedure in difficult operative conditions. J Am Coll Surg. 2016;222(1):89-96
Ansaloni L, Pisano M, Coccolini F, Peitzmann AB, Fingerhut A, Catena F, et al. WSES guidelines on acute calculous cholecystitis. World J Emerg Surg. 2016;14(11):25
Hariharan D, Psaltis E, Scholefield JH, Lobo DN. Quality of life and medico-legal implications following iatrogenic bile duct injuries. World J Surg. 2017;41:90-9
Gupta V, Jain G. Safe laparoscopic cholecystectomy: adoption of universal culture of safety in cholecystectomy. World J Gastrointest Surg. 2019;11(2):62-84
Rystedt JM, Montgomery AK. Quality-of-life after bile duct injury: intraoperative detection is crucial: a national case-control study. HPB. 2016;18(12):1010-6
Gupta V, Jain G. Safe laparoscopic cholecystectomy: adoption of universal culture of safety in cholecystectomy. World J Gastrointest Surg. 2019;11(2):62-84
Booij KA, de Reuver PR, van Dieren S, van Delden OM, Rauws EA, Busch OR, et al. Long-term impact of bile duct injury on morbidity, mortality, quality of life, and work related limitations. Ann Surg. 2018;268(1):143-50
Pucher PH, Brunt LM, Davies N, Linsk A, Munshi A, Rodriguez HA, et al. Outcome trends and safety measures after 30 years of laparoscopic cholecystectomy: a systematic review and pooled data analysis. Surg Endosc. 2018;32:2175-83
Sutherland F, Dixon E. The importance of cognitive map placement in bile duct injuries. Can J Surg. 2017;60(6):424-5
Shang PZ. Guiding significance to ensure security of laparoscopic cholecystectomy by localization by imaginary clock for ampulla of gallbladder. Chin J Oper Proc Gen Surg. 2018;12(1):15-20
Santos BF, Brunt LM, Pucci MJ. The difficult gallbladder: a safe approach to a dangerous problem. J Laparoendosc Adv Surg Tech. 2017;27(6):571-8
Viswanathan V, Garg HP. Critical view of safety technique during laparoscopic cholecystectomy in prevention of biliary injuries. Int J Int Med Res. 2016;3(4):35-40
Honda G, Hasegawa H, Umezawa A. Universal safe procedure of laparoscopic cholecystectomy standardized by exposing the inner layer of the subserosal layer (with video). J Hepato-Biliary-Pancreatic Sci. 2016;23(9):E14-9
Anandhi PG, Alagavenkatesan VN. Anatomical variations in the extra hepatic biliary system: a cross sectional study. Int J Med Sci. 2018;6(4)
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Copyright (c) 2022 Muhammad Iftikhar, Siddique Ahmad, Khalid Aziz
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