CVS is a better approach for Laparoscopic CholecystectomyDownload PDF
Despite advancement in training and technology since introduction of laparoscopic surgery bile duct injuries remains a two-fold or three more common than in open surgery causing significant morbidity and mortality. Misidentification of the Common bile duct (CBD) during dissection of the Calot’s triangle can lead to such injuries. This study included 387 Iraqi patients with diagnosis of cholelithiasis underwent laparoscopic surgery from January 2010 till September 2015, Critical View of safety (CVS) approach has been adopted for all cases. CVS is achieved by creation of a “window” crossed by two structures; Cystic duct and artery. This is achieved by exposing the base of the liver bed and dissecting the upper part of Calot’s triangle free of all tissue except for the cystic duct and artery. So the Aim of our study was to evaluate CVS approach for prevention of biliary injuries during laparoscopic cholecystectomy. Our results showed that 387 patients admitted to period from January 2010 to September 2015 then CVS was achieved in 346 (89%) while the remaining 41 cases (11 %) it was difficult to achieve so undergone to complete open .There was no significant immediate or delayed complication in adopting this approach. Meantime of operation was around 57 minutes. So our findings concluded that the CVS approach appears to be safe procedure for gaining a sufficient view of calots triangle before transecting the cystic duct and artery. So we suggest to use this technique as a gold standard method for both complicated and uncomplicated cholelithiasis.
Keywords: CVS, Laparoscopic Cholecystectomy etc.