• Mohammad Zarin, Muhammad Asim Khan, Maryam Alam Khan, and Syed Asad Maroof Shah.
• Mohammad Zarin, FCPS. Department of Surgery, MTI, Khyber Teaching Hospital, Peshawar, Pakistan.
• Pak J Med Sci. 2018 May 1; 34 (3): 574-577.

ObjectiveIncidence of Bile Duct Injuries (BDI) during Laparoscopic Cholecystectomy (LC) is reported to be higher as compared to Open Cholecystectomy. Studies have shown varying degree of success in reducing BDI by using Critical View of Safety (CVS) technique before clipping and cutting any structure. In this study, we will see whether CVS technique is faster and safer compared to conventional infundibular technique.MethodsThis comparative study was conducted on patients who presented to Surgical Out-Patient-Department (OPD) of Khyber Teaching Hospital from July 2015 to June 2016. Total of 438 patients were divided into two groups. Group-A in which LC was done using infundibular while in Group-B, CVS technique was utilized. Two groups were compared for operating time and BDI.ResultsThe operative time was significantly reduced for LC using CVS technique (50 mins vs. 73 mins). Minor leaks were comparable (0.5% vs. 0.9%) but there was a significant difference in major LEAKS between the two techniques (0.5% vs. 1.4%).ConclusionAlthough the "critical view of safety" requires more dissection as compared to infundibular technique, but once learnt and mastered, it is faster and safer identification technique during laparoscopic cholecystectomy.

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