The cause of most major bile duct injuries is misidentification of ductal structures. In the “classical” injury, the common bile duct is thought to be the cystic duct and is divided. Division of the common hepatic duct and often injury to the right hepatic artery ensue. Aberrant hepatic ducts may also be misidentified as the cystic duct or cystic arteries. The critical view of safety (CVS) is a method of target identification, the targets being the cystic duct and the cystic artery. Currently CVS is taught and used widely in laparoscopic surgery.
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