The Critical View of Safety in Laparoscopic Cholecystectomy: User Trends Among Residents and Consultants.

ABSTRACT

BACKGROUND: The Critical View of Safety (CVS) aims at preventing bile duct injuries (BDIs) in laparoscopic cholecystectomy (LCC). This study investigated CVS utilization among surgeons. METHODS: Photos from LCCs were scored for satisfactory CVS. Rates of satisfactory CVS, BDIs, and postoperative complications among residents and consultants were compared. A lecture on CVS was given halfway through the study. RESULTS: The study comprised 1532 patients. Residents had higher rates of satisfactory CVS in elective LCCs compared with consultants (34.9% vs. 23.0%, P <0.001), but not in emergency LCCs (18.4% vs. 15.0%, P =0.252). No significant differences in BDIs or postoperative complications emerged between residents and consultants. After the lecture, elective LCCs were photographed more frequently (80.3% vs. 74.0%, P =0.032), but rates of satisfactory CVS, BDIs, and postoperative complications remained unchanged. CONCLUSIONS: Utilization of CVS can be affected by a single lecture but affecting rates of satisfactory CVS may require stronger interventions.