Comparison Between Critical View of Safety and Infundibular Technique in Laparoscopic Cholecystectomy

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.

Avoidance of bile duct injury in laparoscopic cholecystectomy with feasible intraoperative resources: A cohort study

“…According to a systematic review and meta-analysis in China, the incidence rate of BDI was 1.12% (16). In a large study in India (17), it was 0.05%, and in a local study (Sulaimani, Kurdistan region, Iraq) (18), it was 0.4%. However, a study by Buddingh et al (4) from the Netherlands showed a significantly lower rate of major BDI after the implementation of routine IOC (1.9 vs. 0%).…”