Critical View of Safety in Laparoscopic Cholecystectomy: Prospective Evaluation Using Doublet Photography

The attainability of the CVS using the doublet photograph technique is low, with satisfactory CVS achieved in only slightly more than half of cases. Despite experienced surgeons, patient-related factors and intraoperative difficulties-particularly acute cholecystitis, empyema, and severe adhesions-significantly limited CVS attainment. These findings indicate that the doublet photograph technique alone is insufficient to reliably ensure CVS, emphasizing the need for early intervention and adjunctive safety strategies during difficult cholecystectomies.