Making bile duct injuries after laparoscopic cholecystectomy a ‘near-never’ event

In this issue of the SAJS two perspectives are opined highlighting the medicolegal and tangible and intangible consequences of bile duct injury (BDI).1,2 We learn from both that, for patient and surgeon alike, a BDI is a traumatic experience that often results in significant personal, financial and medicolegal burdens. No surgeon performs a laparoscopic cholecystectomy (LC) with the intention of injuring the bile duct, but the reality is that it does happen and even though the incidence may have returned to open cholecystectomy rates, many would agree the number remains too high. With all the ramifications of laparoscopic BDI the most important question to ask ourselves is how can we prevent it? This editorial focuses on injury prevention through implementation of an operative team checklist that mandates photo documentation of the critical view of safety (CVS), assists in inculcating a culture of safety and aids in assessing competency in surgical trainees.