Critical view of safety in laparoscopic cholecystectomy

The critical view of safety is a "window" crossed by two structures: the cystic duct and artery. This is achieved by exposing the base of the liver bed and dissecting Calot's triangle free of all tissue except for the cystic duct and artery. The two structures emanating from the gallbladder (cystic duct and cystic artery) and the interface with the liver at the base of the gallbladder fossa should be definitively identified. The critical view of safety should be achieved prior to clipping or dividing any tubular structures in a laparoscopic cholecystectomy. Difficulty with identification of the critical view should lead the surgeon to consider performing cholangiography or converting the laparoscopic cholecystectomy into an open procedure.