[Photographic documentation during safe laparoscopic cholecystectomy]

Area of Science:

• Surgical Innovation
• Patient Safety
• Minimally Invasive Surgery

Background:

• Laparoscopic cholecystectomy is a common surgical procedure.
• Biliary injury is a significant concern, necessitating strategies for its reduction.
• The critical view of safety (CVS) is a key dissection principle to enhance intraoperative safety.

Purpose of the Study:

• To evaluate the safety of dissection during laparoscopic cholecystectomy using an ambispective analysis.
• To assess the effectiveness of Doublet photography in achieving the critical view of safety (CVS).
• To determine the reproducibility and reliability of the CVS in a Mexican hospital setting.

Main Methods:

• A descriptive, ambispective, observational, and cross-sectional study.
• Inclusion of patients undergoing laparoscopic cholecystectomy between January 2015 and January 2017.
• Utilizing Doublet photography rating criteria to assess surgical dissection and CVS achievement.

Main Results:

• 321 patients were analyzed, with 77.9% females and 22.1% males, mean age 45.57 years.
• Common indications included cholelithiasis (65.4%) and acute cholecystitis (24.3%).
• The critical view of safety (CVS) was achieved in 41.4% of procedures, with significant differences noted between HPB surgeons and general surgery residents (p ≤ 0.05).

Conclusions:

• Doublet photography serves as a dependable criterion for CVS dissection during laparoscopic cholecystectomy.
• This method is easily reproducible and contributes to a stronger culture of safety.
• Improved identification of cystic structures through this technique enhances patient safety outcomes.