ArticleWorld journal of surgery2019
Ten-year Audit of Safe Bail-Out Alternatives to the Critical View of Safety in Laparoscopic Cholecystectomy.
Article in World journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Risk factors and mitigating measures associated with bile duct injury during cholecystectomy: meta-analysis.BJS open · 2025Pooled it
- Morphology of the sulcus of the caudate process (Rouviere's sulcus) in a Greek population and a systematic review with meta-analysis.Anatomical science international · 2022Pooled it
- Intraoperative Variations of Cystic Artery and Duct in Laparoscopic Cholecystectomy: A Systematic Review With Meta-Analysis.ANZ journal of surgeryPooled it
- Prevention of bile duct injury - A bird's eye view.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Review
- Article
- Reconstituting, Fenestrating, and Cholecystostomy-our approach and surgical technique for difficult gallbladders using three bailout procedures.Journal of visualized surgery · 2026Article
- Patient and surgeon predictors of achieving the critical view of safety in laparoscopic cholecystectomy: a prospective cohort study.Frontiers in surgery · 2025Article
- Subtotal laparoscopic cholecystectomy versus conversion to open as a bailout procedure: a cohort study.Surgical endoscopy · 2024Observational
- Patient and surgeon factors contributing to bailout cholecystectomies: a single-institutional retrospective analysis.Surgical endoscopy · 2022Article
- Critical View of Safety in Laparoscopic Cholecystectomy: A Word of Caution in Cases of Aberrant Anatomy.Surgery journal (New York, N.Y.) · 2022Article
- [Measures for preventing bile duct injuries during difficult cholecystectomies-Bail-out procedures].Chirurgie (Heidelberg, Germany) · 2022Review
- Routine extensive dissection of the cystic duct during laparoscopic cholecystectomy to reduce the risk of residual choledocholithiasis: an unnecessary step and a potentially hazardous concept.Przeglad gastroenterologiczny · 2022Article
- Are YouTube Videos a Reliable Training Method for Safe Laparoscopic Cholecystectomy? A Simulated Decision-Making Exercise to Assess the Critical View of Safety.Surgery journal (New York, N.Y.) · 2021Article
- What are the risk factors of conversion from total cholecystectomy to bailout surgery?Surgical endoscopy · 2021Article
- Peri-operative Mortality Following Cholecystectomy in Australia: Potential Preventability of Adverse Events.World journal of surgery · 2021Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo prevent vasculobiliary injuries according to the Tokyo Guidelines, Critical View of Safety (CVS) is the recommended method for the identification of the cystic duct and cystic artery. Our aim was to audit laparoscopic cholecystectomies, in order to determine the rate of CVS feasibility and to explore safe bail-out alternatives, when CVS cannot be obtained.
methodsPatients who underwent either elective or emergent laparoscopic cholecystectomy, between January 2009 and December 2018, in whom the CVS was attempted, were retrospectively identified from the institutional electronic database. Dissection technique was documented in the operative notes. Bile duct injuries (BDI) were classified by the Strasberg classification, and their management and outcome were reported in the patient files.
resultsIn total, 1226 cases were included in the final analysis. CVS was feasible in 1128 cases (92.0%), whereas 65 patients (5.3%) were managed laparoscopically by a bail-out technique. Of those, 52 (4.3%) underwent a subtotal cholecystectomy, 12 (0.9%) a fundus-first cholecystectomy, and in one patient (0.1%) the operation was concluded by a tube cholecystostomy. Overall conversion rate was 2.7% (33/1226 cases). Male gender, older age, junior surgeons, and acute cholecystitis were significantly associated with higher conversion rates. Post-operatively, 10 patients (0.82%) developed a type A bile leakage. No major BDI (types B-E) were observed, either with CVS or the bail-out techniques.
conclusionsOur study showed that CVS and the bail-out alternatives complement each other in preventing major BDI and should belong to the armamentarium of every modern surgeon.
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