Cystic duct identification in laparoscopic cholecystectomy review articles

Abstract

Postcholecystectomy bile duct injury (BDI) is a life-threatening complication; it associated with increased morbidity and mortality in addition to the medicolegal consequences. The most common cause of serious biliary injury is misidentification of cystic duct-common bile duct relationship. Many techniques had been tested by surgeons to avoid the misidentification injury, this include infundibular technique, critical view of safety, retrograde laparoscopic cholecystectomy, operative cholangiography, fluorescence cholangiography, and biliary navigation surgery using endoscopic nasobiliary drainage. Among these methods, critical view of safety (CVS) has been found most reliable and safe method for cystic duct identification. Moreover, it is easy applicable, fast to learn, and not required special equipment. If the CVS cannot be achieved safely, there are others alternative methods to avoid BDI according to SAGES recommendations.