Use of Critical View of Safety and Proctored Preceptorship in Preventing Bile Duct Injury During Laparoscopic Cholecystectomy—Experience of 3726 Cases From a Tertiary Care Teaching Institute. Issue 1 (24th February 2023)

• Record Type: Journal Article
• Authors: Bansal, Virinder K.; Asuri, Krishna; Jain, Mayank; Prakash, Om; Bhattacharjee, Hemanga K.; Isukapati, Samrajya; Dey, Souvik; Baksi, Aditya; Khan, Washim Firoz; Subramaniam, Rajeshwari; Ramachandran, Rashmi; Garg, Pramod; Kumar, Subodh; Mishra, Mahesh C.
• Is Part Of: Surgical laparoscopy endoscopy & percutaneous techniques. Volume 33:Issue 1(2023)
• Page Start: 12
• Page End: 17
• Publication Date: 2023-02-24
• Subjects: bile duct injury -- critical view of safety -- proctored preceptorship; Endoscopic surgery -- Periodicals; Laparoscopic surgery -- Periodicals; Endoscopy -- Periodicals; Laparoscopy -- Periodicals; 617.550597
• DOI: 10.1097/SLE.0000000000001127
• Languages: English
• ISSNs: 1530-4515

Abstract

Abstract : Introduction: Bile duct injury (BDI) continues to occur despite technological advances and improvements in surgical training over the past 2 decades. This study was conducted to audit our data on laparoscopic cholecystectomies performed over the past 2 decades to determine the role of Critical View of Safety (CVS) and proctored preceptorship in preventing BDI and postoperative complications. Materials and Methods: All patients undergoing elective laparoscopic cholecystectomy were analyzed retrospectively. The data were obtained from a prospectively maintained database from January 2004 to December 2019. Proctored preceptorship was used in all cases. Intraoperative details included the number of patients where CVS was defined, number of BDI and conversions. Postoperative outcomes, including hospital stay, morbidity, and bile duct stricture, were noted. Results: Three thousand seven hundred twenty-six patients were included in the final analysis. Trainee surgeons performed 31.6% of surgeries and 9.5% of these surgeries were taken over by the senior surgeon. A CVS could be delineated in 96.6% of patients. The major BDI rate was only 0.05%. Conclusion: This study reiterates the fact that following the basic tenets of safe laparoscopic cholecystectomy, defining and confirming CVS, and following proctored preceptorship are critical in preventing major BDI.