Critical view of safety faster and safer technique during laparoscopic cholecystectomy?

Objective: Incidence of Bile Duct Injuries [BDI] during Laparoscopic Cholecystectomy [LC] is reported to be higher as compared to Open Cholecystectomy. Studies have shown varying degree of success in reducing BDI by using Critical View of Safety [CVS] technique before clipping and cutting any structure. In this study, we will see whether CVS technique is faster and safer compared to conventional infundibular technique

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Methods: This comparative study was conducted on patients who presented to Surgical Out-Patient-Department [OPD] of Khyber Teaching Hospital from July 2015 to June 2016. Total of 438 patients were divided into two groups. Group-A in which LC was done using infundibular while in Group-B, CVS technique was utilized. Two groups were compared for operating time and BDI

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Results: The operative time was significantly reduced for LC using CVS technique [50 mins vs. 73 mins]. Minor leaks were comparable [0.5% vs. 0.9%] but there was a significant difference in major LEAKS between the two techniques [0.5% vs. 1.4%]

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Conclusion: Although the "critical view of safety" requires more dissection as compared to infundibular technique, but once learnt and mastered, it is faster and safer identification technique during laparoscopic cholecystectomy