Journal of AdvancedMedical and Dental Sciences Research

Background: Laparoscopic surgery has induced a tremendous revolution in the treatment of gallbladder disease. Direction of traction on gall bladder can lead to misidentification of common bile duct (CBD) as cystic duct contributing to CBD injury. Over the past few decades, surgeons have spent considerable amount of time developing a safe way of Calot’s triangle dissection and cystic duct identification. The present study was carried out on the patient planned for laparoscopic cholecystectomy with CVS approach. Materials & methods: 100 consecutive patients of gallbladder disease was included in the study. Patients were admitted a day prior to surgery in case of elective cholecystectomy from outpatient department (OPD) after complete investigations. Some patients were admitted from emergency with acute cholecystitis. Standard four port method of performing lap cholecystectomy was used. Dissection of calot’s triangle from both its dorsal and ventral aspects was performed using both blunt and electrocautry dissection. All of the above procedures for the dissection were maintained above the line between the epigastric port and Rouviere’s sulcus. Data was analysed statistically. Results: Aberrant anatomy was found to be present in 1 percent of the patients. Spillage was found to be present in 22 percent of the patients, while it was absent in 78 percent of the patients. Critical view of safety was achieved in 100 percent of the patients of the present study. Conclusion: The critical view of safety method of ductal identification is an effective approach according to the best evidence that exists to minimize the risk of bile duct injury (BDI) during LC. Key words: Bile duct injury, Critical view of safety