The Critical View of Safety

Laparoscopic cholecystectomy was introduced into wide practice about 1990, with demonstrated benefit to patients. However, it was associated with a sharp increase in major bile duct injuries. Biliary injuries are morbid, costly, and the source of litigation. Although not usually due to negligence, they are iatrogenic and detract from the value of laparoscopic cholecystectomy. Most major bile duct injuries are due to misidentification. In the...