Jsmc-10233

COMPARISON BETWEEN CRITICAL VIEW OF SAFETY AND INFUNDIBULAR TECHNIQUE IN LAPAROSCOPIC CHOLECYSTECTOMY 

Deari Ahmed Ismaeil a, Barham M. M. Salih a, Karzan Seerwan Abdulla a, Shahow Abdulrehman Ezzaddin b, Sarmad Hiwa Arif a, and Dlshad Hama Saeed c 

a Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 

b Department of Community Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq

c Department of Surgery, Shar hospital, Ministry of Health, Kurdistan Region, Iraq.

Submitted: 12/3/2019; Accepted: 6/11/2019; Published: 21/12/2019

DOI Link: https://doi.org/10.17656/jsmc.10233 

ABSTRACT

Background 

Laparoscopic cholecystectomy is a one of main surgical procedures that used widely for the treatment of symptomatic gallstones throughout the world. Although laparoscopic cholecystectomy has its own advantages, but bile duct injuries occur more frequently compared to the open cholecystectomy. In this study, critical view of safety (CVS) technique is compared to conventional infundibular technique (IT).

Objectives 

The aim is to compare critical view of safety with infundibular technique in laparoscopic cholecystectomy, in term of duration of the surgery and bile duct injuries (BDI).

Methods

Laparoscopic cholecystectomy was performed for 245 patients at Sulaimani city within a period from April 13th 2015 to April 13th 2016. The patients were divided into two groups; critical view of safety was used for the first group and infundibular technique for the second. Comparison performed between the both groups for operation time and bile duct injury.

Results

The operative time was significantly reduced in CVS technique as the mean time of the operations was (33.04 min) for CVS, and (38.58 min) for IT, with significant P-value (0.013). Seventeen cases (6.93%) converted to open cholecystectomy; the conversion found more in IT group, with significant P-value (< 0.001).

Conclusion

The “critical view of safety” although needs more patience in dissections with comparison to infundibular technique, but it is found to be faster and regard as a safe technique in laparoscopic cholecystectomy.

KEYWORDS

Critical View of Safety (CVS), Infundibular technique, Bile Duct Injury, Laparoscopic cholecystectomy.

References 

1. Hurley V, Brownlee S. Cholecystectomy in California:  A Close-Up of Geographic Variation. California Healthcare Foundation 2011.

2. Karadeniz E, Özogul B, Yildirgan MI, Kisaoglu A, Atamanalp S. Determination of eligibility for laparoscopic cholecystectomy of elective patients. J. Exp. Clin. Med. 2013; 30: 331-334.

3. Buddingh KT, Weersma RK, Savenije RA, van Dam GM, Nieuwenhuijs VB. Lower rate of major bile duct injury and increased intraoperative management of common bile duct stones after implementation of routine intraoperative cholangiography. Journal of the American College of Surgeons 2011; 213:267-74.

4. Kern KA. Malpractice litigation involving laparoscopic cholecystectomy: cost, cause, and consequences. Archives of Surgery. 1997 Apr 1;132(4):392-8.

5. Flum DR, Flowers C, Veenstra DL. A cost-effectiveness analysis of intraoperative cholangiography in the prevention of bile duct injury during laparoscopic cholecystectomy. Journal of the American College of Surgeons 2003; 196:385-93.

6. Strasberg SM, Brunt LM. Rationale and use of the critical view of safety in laparoscopic cholecystectomy.Journal of the American College of Surgeons. 2010 Jul 1;211(1):132-8.

7. Club SS. A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl j Med. 1991;324:1075-8.

8. Machi J, Johnson JO, Deziel DJ, et al. The routine use of laparoscopic ultrasound decreases bile duct injury: a multicenter study. Surgical endoscopy. 2009 Feb 1;23(2):384.SurgEndosc 2009;23:384-8.

9. Machi J, Oishi AJ, Tajiri T, et al. Routine laparoscopic ultrasound can significantly reduce the need for selective intraoperative cholangiography during cholecystectomy. SurgEndosc 2007;21:270-4.

10. Buddingh KT, Nieuwenhuijs VB, van Buuren L, Hulscher JB, de Jong JS, van Dam GM. Intraoperative assessment of biliary anatomy for prevention of bile duct injury: a review of current and future patient safety interventions. Surgical endoscopy. 2011 Aug 1;25(8):2449-61.

11. Strasberg SM. Error traps and vasculo-biliary injury in laparoscopic and open cholecystectomy. J HepatobiliaryPancreatSurg 2008;15:284-92.

12. Strasberg SM, Eagon CJ, Drebin J. The “Hidden Cystic Duct” syndrome and the infundibular technique of laparoscopic cholecystectomy—the danger of the false infundibulum. J Am CollSurg 2000;191:661-7.

13. Strasberg SM. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180:101-25.

14. Eikermann M, Siegel R, Broeders I, et al. Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surgical endoscopy. 2012 Nov 1;26(11):3003-39.

15. Singh R, Brunt LM. Critical view of safety—its feasibility and efficacy in preventing bile duct injuries. Annals of Laparoscopic and Endoscopic Surgery. 2018 Aug 1;3(1).

16. Daly SC, Deziel DJ, Li X, Thaqi M, Millikan KW, Myers JA, Bonomo S, Luu MB. Current practices in biliary surgery: Do we practice what we teach?. Surgical endoscopy. 2016 Aug 1;30(8):3345-50.

17. Chen CB, Palazzo F, Doane SM, et al. Increasing resident utilization and recognition of the critical view of safety during laparoscopic cholecystectomy: a pilot study from an academic medical center. Surgical endoscopy. 2017 Apr 1;31(4):1627-35

18. Avgerinos C, Kelgiorgi D, Touloumis Z, Baltatzi L, Dervenis C. One thousand laparoscopic cholecystectomies in a single surgical unit using the “critical view of safety” technique. Journal of Gastrointestinal Surgery. 2009 Mar 1;13(3):498-503.

19. Sanjay P, Fulke JL, Exon DJ. ‘Critical view of safety’as an alternative to routine intraoperative cholangiography during laparoscopic cholecystectomy for acute biliary pathology. Journal of Gastrointestinal Surgery. 2010 Aug 1;14(8):1280-4.

20. Russell JC, Walsh SJ, Reed-Fourquet L, Mattie A, Lynch J. Symptomatic cholelithiasis: a different disease in men? Connecticut Laparoscopic Cholesystectomy Registry. Annals of surgery. 1998 Feb;227(2):195.

21. Lein HH, Huang CS. Male gender: risk factor for severe symptomatic cholelithiasis. World journal of surgery. 2002 May 1;26(5):598-601.

22. Schrenk P, Woisetschlager R, Reiger R, et al. Preoperative ultrasonography and prediction of difficulties in laparoscopic cholecystectomy. World J Surg. 1998; 22:75–77.

23. Fried GM, Barkun JS, Sigman HH, Joseph L, Uas D, Garzon J, Hinchey EJ, Meakins JL. Factors determining conversion to laparotomy in patient undergoing laparoscopic cholecystectomy.Am J Surg. 1994; 167:35–41.

24. Zarin M, Khan MA, Khan MA, Shah SA. Critical view of safety faster and safer technique during laparoscopic cholecystectomy?. Pakistan journal of medical sciences. 2018 May;34(3):574.

25. Vettoretto N, Saronni C, Harbi A, Balestra L, Taglietti L, Giovanetti M. Critical view of safety during laparoscopic cholecystectomy. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2011 Jul;15(3):322.

26. 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.

27. Lam T, Usatoff V, Chan ST. Are we getting the critical view? A prospective study of photographic documentation during laparoscopic cholecystectomy.HPB. 2014 Sep;16(9):859-63.

28. Takada T, Strasberg SM, Solomkin JS, Pitt HA, Gomi H, Yoshida M, , et al. TG13: Updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences. 2013 Jan;20(1):1-7.

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