Laparoscopic cholecystectomy is the most common laparoscopic

surgery performed by general surgeons. Despite increase in operative experience and new approaches in laparoscopic techniques, bile duct injuries remain twice as frequent as in the conventional open approach. The “critical view of safety” (CVS) in laparoscopic cholecystectomy serves the unequivocal identification of the cystic duct before transection as the cause of most major bile duct injuries is misidentification of ductal structures. In the “classical” injury, the common bile

duct is thought to be the cystic duct and is divided. CVS is based on a method of anatomic identification in open cholecystectomy. The critical view of safety (CVS) is a method to target identification of the cystic duct and the cystic artery. Currently CVS is taught and used widely in laparoscopic surgery. When CVS cannot be attained, there are several bailout strategies such as cholecystostomy for a case with very severe inflammation. The complication rates of bile duct injuries after laparoscopic cholecystectomy vary from 0.4% to 0.5%, depending on the underlying disease and they remain higher than in the open approach.