An audit of cystic duct closure in laparoscopic cholecystectomies

Rohatgi, Ashish; Widdison, Adam L.

doi:10.1007/s00464-004-2253-9

Cited by 44 publications

(44 citation statements)

References 11 publications

(13 reference statements)

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“…Significant reduction in the postoperative infection is one of the main benefits of minimally invasive surgery 7 as the rate of surgical site infection is 2% versus 8% in open surgery 19 . In another study it is reported as 1.4% in laparoscopic surgeries versus 14.8% in open cases 20 . In our study, the incidence rate of visceral injury such as bowel injury was found 0.6%.…”

Section: Discussionmentioning

confidence: 88%

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Operative and Postoperative Complications of Laparoscopic Cholecystectomy: Experience from a Tertiary Care Hospital of Bangladesh

Maitra

Ullah

Faruquzzaman

et al. 2017

Bangladesh Crit Care J

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Section: Discussionmentioning

confidence: 88%

“…11,13,14 . In another large case series, bile duct injury was minimum and occurred in only 14 (3.98%) cases 9 .…”

Section: Discussionmentioning

confidence: 99%

Operative and Postoperative Complications of Laparoscopic Cholecystectomy: Experience from a Tertiary Care Hospital of Bangladesh

Maitra

Ullah

Faruquzzaman

et al. 2017

Bangladesh Crit Care J

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“…[1][2][3][4] Metallic clip is the most commonly used method for cystic artery and duct closure all over the world. 12 However, metallic clips are not free from complications. Bile leaks has been reported in 0.2-0.27% of cases which might be due to slippage of clip, mismatch of clip arms with cystic duct lumen and pressure necrosis of duct.…”

Section: Resultsmentioning

confidence: 99%

Triple ligation technique of clipless laparoscopic cholecystectomy: a spanner especially for complicated cholecystitis

Mukesh¹,

Sangwan²,

Mohinder³

et al. 2017

Int J Adv Med

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NTRODUCTIONThe conception of laparoscopy has revolutionized the art of surgery due to its vantages over classical open technique.The lately innovated laparoscopy cholecystectomy has been drastically refined over the years by better exploration of ergonomics, instauration of new energy sources and endo suturing. The conventional four ports access technique has been modified to three ports, two ports and single incision laparoscopic surgery with corresponding results. [1][2][3] Further cystic duct closure methods like clipping, harmonic scalpel, plasma kinetic and intra corporeal ligation have been tried with gratifying results. 4Metallic clip is the most commonly used method for cystic artery and duct closure which may be due to ease of learning and its execution, short operative time and timetested safety of technique. Although it is not less than a boon for a budding surgeon but it is not free from complications. Bile leaks, migration of clip, inadvertently clipping of common bile duct and right hepatic artery have ABSTRACT Background: Although in the era of laparoscopic cholecystectomy cystic duct occlusion has been tried by clips, harmonic and plasma kinetic quite effectively but cost, availability and inadvertent injury to biliary duct are concerning factors. Intra-corporeal ligation has evolved to address these issues effectively as a boon especially for the peripheral centres where availability and cost of energy sources weighs heavier than their associated ease. Triple ligation technique is a time preserving modification without any compromise in safety and quality of surgery. The aim of our study is not only to elucidate the importance of intra-corporeal ligation in safety and cost of surgery but also to enlighten its role in safe management of even difficult cases of cholecystitis. Methods: A retrospective observational study. All cases of symptomatic gallstones operated by laparoscopic triple ligation technique were included in the study. Results: More than half (63.4%) of the cases in our study were having chronic cholecystitis was reported in 63.4% of the cases while 36.4 % cases have acute cholecystitis. Mean duration of surgery was 46.4 and 71.2 minutes in chronic and acute cases respectively. No case of bile duct or vascular injury has been reported in our study. Only 3.8% of the cases were converted to open. Gallbladder perforation was most common complication noted in 12.8% of the cases. Conclusions: Triple ligation technique of laparoscopic cholecystectomy is not only a time sparing modification but is also a veritable, safe and frugal tool with excellent results even in complicated cholecystitis without compromising its outcome and prime.

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“…However, these alternatives are technically more difficult and, therefore, were used infrequently. 2 Several reports have revealed several injuries and postoperative complications due to the current technology and technique of LC. These include deep tissue damage with possible distant tissue damage by the highfrequency electrocautery involving vascular and biliary structures in the vicinity of the cystic duct and artery, bile leakage due to slippage of the clips, and visceral and solid organ injuries due to frequent instrument exchange, which is sometimes performed without optic guidance.…”

Section: Introductionmentioning

confidence: 99%

Clipped vs Clipless Laparoscopic Cholecystectomy using the Ultrasonically Activated (Harmonic) Scalpel

Abdelhady¹,

Salama²

2017

WJOLS

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Introduction: Laparoscopic cholecystectomy (LC) is the "gold standard" in the treatment of symptomatic gallbladder lithiasis. Monopolar hook, i.e., used currently is associated with some complications, such as the risk of thermal injuries and biliary complications. The ultrasonically activated (harmonic) scalpel has been increasingly used for dissection of the gallbladder and for division of vessels and the cystic duct, because it reduces the risk of thermal injuries with encouraging results.

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An audit of cystic duct closure in laparoscopic cholecystectomies

Abstract: Locking clips are a safe and effective method for cystic duct closure. They are associated with a reduced cystic duct leak rate, as compared with that for simple clips.

Cited by 44 publications

References 11 publications

Operative and Postoperative Complications of Laparoscopic Cholecystectomy: Experience from a Tertiary Care Hospital of Bangladesh

Operative and Postoperative Complications of Laparoscopic Cholecystectomy: Experience from a Tertiary Care Hospital of Bangladesh

Triple ligation technique of clipless laparoscopic cholecystectomy: a spanner especially for complicated cholecystitis

Clipped vs Clipless Laparoscopic Cholecystectomy using the Ultrasonically Activated (Harmonic) Scalpel

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