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Cholecystectomy is the most common operation performed worldwide by general surgeons; Several recent large have found major BDI rates of 0.15-0.36% and an overall biliary complication rate of 1.5% if bile leaks are included.
In this context, the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) formed the Safe Cholecystectomy program with the mission of creating a universal culture of safety around this operation and reducing biliary injuries; The topics included anatomic identification techniques, disease factors, surgical techniques, surgeon education, and intraoperative management of injury to reduce the risk of BDI, and improve associated morbidity, cost, and quality of life, highlighting implementation of critical view of safety, the use of Intraoperative cholangiogram, subtotal cholecystectomy as an alternative option and referral to specialized center for management of the CBD injuries by hepatobiliary surgeons.