Colecistectomía Laparoscópica: Límites en la aplicación de la Visión Crítica de Seguridad / A critical view of safety in biliary injury during Laparoscopic Cholecystectomy: the triangle of calot

ABSTRACT

Bile duct injury during laparoscopy is the most important complication of laparoscopic cholecystectomy. Bile duct injuries place an enormeous burden on the health and productivity of the population. To avoid this severe complication, it has been one of the central objectives of the biliary surgery since its beginings. Traditional teaching of surgery fails in the prevention of laparoscopic bile duct injuries, and they cannot control the problem. Assessment of biliary anatomy of the bile duct injury is mandatory for prevention of iatrogenic bile duct injuries. With a proper knowledge for identification and categorization of the triangle of Calot to avoid technical errors we will achieve system changes to improve patient safety. Finally, although medical consensus and substantial evidence exist promoting the importance of the Critical Vision on Safety, with the development of a fundamental support to the regularization, a safe operative technique will decrease the rate of severe complications of the bile duct injury