title: Safety measures during cholecystectomy: results of a nationwide survey.
abstract: BACKGROUND
  This study aimed to identify safety measures practiced by Dutch surgeons during laparoscopic cholecystectomy.
  
  
  METHODS
  An electronic questionnaire was sent to all members of the Dutch Society of Surgery with a registered e-mail address.
  
  
  RESULTS
  The response rate was 40.4% and 453 responses were analyzed. The distribution of the respondents with regard to type of hospital was similar to that in the general population of Dutch surgeons. The critical view of safety (CVS) technique is used by 97.6% of the surgeons. It is documented by 92.6%, mostly in the operation report (80.0%), but often augmented by photography (42.7%) or video (30.2%). If the CVS is not obtained, 50.9% of surgeons convert to the open approach, 39.1% continue laparoscopically, and 10.0% perform additional imaging studies. Of Dutch surgeons, 53.2% never perform intraoperative cholangiography (IOC), 41.3% perform it incidentally, and only 2.6% perform it routinely. A total of 105 bile duct injuries (BDIs) were reported in 14,387 cholecystectomies (0.73%). The self-reported major BDI rate (involving the common bile duct) was 0.13%, but these figures need to be confirmed in other studies.
  
  
  CONCLUSIONS
  The CVS approach in laparoscopic cholecystectomy is embraced by virtually all Dutch surgeons. The course of action when CVS is not obtained varies. IOC seems to be an endangered skill as over half the Dutch surgeons never perform it and the rest perform it only incidentally.
authors: Department of Surgery, University Medical Centre Groningen, P. O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors: K T
authors: KT
authors: Buddingh
authors: H S
authors: HS
authors: Hofker
authors: H O
authors: HO
authors: ten Cate Hoedemaker
authors: G M
authors: GM
authors: van Dam
authors: R J
authors: RJ
authors: Ploeg
authors: V B
authors: VB
authors: Nieuwenhuijs
mesh_terms: D002758:Cholangiography / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002983:Clinical Competence; D003135:Common Bile Duct / Q000293:injuries*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D017751:Safety Management; D011795:Surveys and Questionnaires; D016896:Treatment Outcome