ArticleSurgical endoscopy2017
How often do surgeons obtain the critical view of safety during laparoscopic cholecystectomy?
Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Critical view of safety approach vs. infundibular technique in laparoscopic cholecystectomy, which one is safer? A systematic review and meta-analysis.Updates in surgery · 2025Pooled it
- Safe cholecystectomy multi-society practice guideline and state-of-the-art consensus conference on prevention of bile duct injury during cholecystectomy.Surgical endoscopy · 2020Guideline
- SAGES safe cholecystectomy modules improve practicing surgeons' judgment: results of a randomized, controlled trial.Surgical endoscopy · 2023Trial
- Critical view of safety in laparoscopic cholecystectomy: a nationwide video-based benchmark of resident-performed cases.Surgical endoscopy · 2026Article
- TempoSafe-CVS: A Temporal Multi-scale Deep Learning Framework for Automated Assessment of the Critical View of Safety in Laparoscopic Cholecystectomy.Journal of imaging informatics in medicine · 2026Article
- AI-based computer vision as an adjunct tool for CVS documentation in laparoscopic cholecystectomy.Surgical endoscopy · 2026Article
- Article
- A novel biliary-specific near-infrared fluorescent dye (BL-760) enhances visualization of the biliary tree in a swine inflammatory model of bile duct obstruction.Surgical endoscopy · 2025Article
- How low can you go? Intraoperative microdosing of indocyanine green for fluorescence cholangiography during laparoscopic cholecystectomy.Surgical endoscopy · 2025Article
- Article
- Article
- Selective vs Routine Cholangiography Across a Health Care Enterprise.JAMA surgery · 2025Article
- Patient and surgeon predictors of achieving the critical view of safety in laparoscopic cholecystectomy: a prospective cohort study.Frontiers in surgery · 2025Article
- Article
- Artificial intelligence applied to laparoscopic cholecystectomy: what is the next step? A narrative review.Updates in surgery · 2024Review
- The Role of Artificial Intelligence on Tumor Boards: Perspectives from Surgeons, Medical Oncologists and Radiation Oncologists.Current oncology (Toronto, Ont.) · 2024Review
- Observational
- Automated segmentation of phases, steps, and tasks in laparoscopic cholecystectomy using deep learning.Surgical endoscopy · 2024Article
- Development of an artificial intelligence system for real-time intraoperative assessment of the Critical View of Safety in laparoscopic cholecystectomy.Surgical endoscopy · 2023Article
- Challenging Orthodoxy: Beyond the Critical View of Safety.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe reported incidence (0.16-1.5 %) of bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is higher than during open cholecystectomy and has not decreased over time despite increasing experience with the procedure. The "critical view of safety" (CVS) technique may help to prevent BDI when certain criteria are met prior to division of any structures. This study aimed to evaluate the adherence of practicing surgeons to the CVS criteria during LC and the impact of a training intervention on CVS identification.
methodsLC procedures of general surgeons were video-recorded. De-identified recordings were reviewed by a blinded observer and rated on a 6-point scale using the previously published CVS criteria. A coaching program was conducted, and participating surgeons were re-assessed in the same manner.
resultsThe observer assessed ten LC videos, each involving a different surgeon. The CVS was adequately achieved by two surgeons (20 %). The remaining eight surgeons (80 %) did not obtain adequate CVS prior to division of any structures, despite two surgeons dictating that they did; the mean score of this group was 1.75. After training, five participating surgeons (50 %) scored > 4, and the mean increased from 1.75 (baseline) to 3.75 (p < 0.05).
conclusionsThe CVS criteria were not routinely used by the majority of participating surgeons. Further, one-fourth of those who claimed to obtain the CVS did so inadequately. All surgeons who participated in training showed improvement during their post-assessment. Our findings suggest that education of practicing surgeons in the application of the CVS during LC can result in increased implementation and quality of the CVS. Pending studies with larger samples, our findings may partly explain the sustained BDI incidence despite increased experience with LC. Our study also supports the value of direct observation of surgical practices and subsequent training for quality improvement.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.