{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:19:38Z","timestamp":1791371978494,"version":"4.3.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,7]],"date-time":"2019-04-07T00:00:00Z","timestamp":1554595200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Bile duct injuries are the most common serious complication of cholecystectomy. Avoidance of bile duct injury is a key aim of biliary surgery. The purpose of this paper is to describe laparoscopic cholecystectomy from the viewpoint of three conceptual goals. Three conceptual goals of cholecystectomy are: (1) getting secure anatomical identification of key structures; (2) making the right decision not to perform a total cholecystectomy when conditions are too dangerous to get secure identification \u2013 the \u201cinflection point\u201d; and (3) finishing the operation safely when secure anatomical identification of cystic structures is not possible. The Critical View of Safety (CVS) has been shown to be a good way of getting secure anatomical identification. Conceptually, CVS is a method of target identification, the targets being the two cystic structures. Sometimes, anatomic identification is not possible because the risk of biliary injury is judged to be too great. Then a decision is made to abandon the attempt to do a complete cholecystectomy \u2013 and instead to \u201cbail\u2010out\u201d. This \u201cinflection point\u201d is defined as the moment at which the decision is made to halt the attempt to perform a total cholecystectomy laparoscopically and to finish the operation by a different method. Currently the best bail\u2010out procedure seems to be subtotal fenestrating cholecystectomy. Application of conceptual goals of cholecystectomy can help the surgeon to avoid biliary injury.<\/jats:p>","DOI":"10.1002\/jhbp.616","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T04:05:34Z","timestamp":1551672334000},"page":"123-127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":117,"title":["A three\u2010step conceptual roadmap for avoiding bile duct injury in laparoscopic cholecystectomy: an invited perspective review"],"prefix":"10.1002","volume":"26","author":[{"given":"Steven M.","family":"Strasberg","sequence":"first","affiliation":[{"name":"Section\u00a0of Hepato\u2010Pancreato\u2010Biliary Surgery Siteman Cancer Center Barnes\u2010Jewish Hospital and Washington University School of Medicine 660 South Euclid Avenue, Box 8109 St. Louis MO 63110 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2006.01414.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-015-3365-1"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200206000-00018"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199203000-00002"},{"key":"e_1_2_5_6_1","first-page":"101","article-title":"An analysis of the problem of biliary injury during laparoscopic cholecystectomy","volume":"180","author":"Strasberg SM","year":"1995","journal-title":"J Am Coll Surg"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.02.053"},{"key":"e_1_2_5_8_1","unstructured":"SAGES.Safe Cholecystectomy Didactic Modules.2019. 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