Clipless laparoscopic cholecystectomy: 3 Port access.

Hassan, Ghulam; Gulzar, Saad; Iqbal, Tariq; Haque, Mohammad Imranul

doi:10.29309/tpmj/2020.27.06.3549

Cited by 3 publications

(5 citation statements)

References 15 publications

(19 reference statements)

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“…9 similarly, inconsistent results were reported by another study conducted in Rawalpindi in which it was seen that the frequency of gall bladder perforation was same in both groups (2 [3.4%] vs. 2 [3.6] respectively with P-value=0.972). 8 These variations in the literature makes the evidence based use of harmonic scalpel a controversy during laproscopic surgery. A study by Roberta Gelmini et al presented that the mean operative time was significantly shorter in patients treated with the Harmonic scalpel.…”

Section: Discussionmentioning

confidence: 99%

Clipped or Clipless Cholecystectomy

Akhtar¹,

Farooq

Rathore

et al. 2018

TPMJ

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… Background: Cholecystectomy is the surgical removal of the inflamed gallbladder. Advancement in technology has led to many treatment options and methods of cholecystectomy but the selection of right method depends upon severity of disease along with available resources and expertise. Objective: To compare the frequency of biliary leakage with clipless versus clipped laparoscopic cholecystectomy for management of cholecystitis. Material & Methods: Study design: Randomized control trial. Setting: Unit 1, Department of Surgery, Jinnah hospital, Lahore. Duration: It was conducted for a period of six months from July 2016 to January 2017. Data collection: A total of 130 patients were included in the study using nonprobability consecutive sampling and were randomly divided in two groups by using lottery method. In group A, clip-less Harmonic scalpel was used along with Ultrasonic shear. In group B, the conventional instruments were used with the application of clips. Patients were called for follow-up in OPD after 1 week to assess biliary leakage through MRCP. All the data was collected through a pre-designed proforma. The data was entered and analyzed in SPSS version 20. Results: The mean age of patients was 42.97±10.77 years with 68 (52.31%) patients were male and 62 (47.69%) patients were females. The biliary leakage was noted in 29 cases i.e. 9 from clipless group and 20 were from clipped group and the difference was statistically significant (p-value=0.020) Conclusion: It can be concluded from this study that the frequency of biliary leakage is significantly higher in the clipped LC for management of Cholecystitis. Thus it is encouraging to use clipless method to avoid such complication and improve surgical outcomes.

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Section: Discussionmentioning

confidence: 99%

Clipped or Clipless Cholecystectomy

Akhtar¹,

Farooq

Rathore

et al. 2018

TPMJ

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show abstract

Section: Discussionmentioning

confidence: 99%

“…7 Similarly, another study conducted in Rawalpindi also reported same frequency of biliary leakage in both groups (2 [3.4%] vs. 2 [3.6] respectively with P-value=0.972). 8 the results of the study conducted by Hassan et al also endorsed these findings by reporting the rate of biliary as 1.7% with clipless method and 3.3% with clipped method which was not statistically significant (p = 0.45). 9 The aim of this study was to compare the frequency of biliary leakage with clipless versus clipped Laparoscopic Cholecystectomy for management of Cholecystitis.…”

Section: Introductionmentioning

confidence: 87%

Clipped or Clipless Cholecystectomy

Akhtar¹,

Farooq

Rathore

et al. 2018

TPMJ

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Background: Cholecystectomy is the surgical removal of the inflamedgallbladder. Advancement in technology has led to many treatment options and methods ofcholecystectomy but the selection of right method depends upon severity of disease alongwith available resources and expertise. Objective: To compare the frequency of biliary leakagewith clipless versus clipped laparoscopic cholecystectomy for management of cholecystitis.Material & Methods: Study design: Randomized control trial. Setting: Unit 1, Departmentof Surgery, Jinnah hospital, Lahore. Duration: It was conducted for a period of six monthsfrom July 2016 to January 2017. Data collection: A total of 130 patients were included in thestudy using nonprobability consecutive sampling and were randomly divided in two groups byusing lottery method. In group A, clip-less Harmonic scalpel was used along with Ultrasonicshear. In group B, the conventional instruments were used with the application of clips. Patientswere called for follow-up in OPD after 1 week to assess biliary leakage through MRCP. All thedata was collected through a pre-designed proforma. The data was entered and analyzed inSPSS version 20. Results: The mean age of patients was 42.97±10.77 years with 68 (52.31%)patients were male and 62 (47.69%) patients were females. The biliary leakage was noted in29 cases i.e. 9 from clipless group and 20 were from clipped group and the difference wasstatistically significant (p-value=0.020) Conclusion: It can be concluded from this study thatthe frequency of biliary leakage is significantly higher in the clipped LC for management ofCholecystitis. Thus it is encouraging to use clipless method to avoid such complication andimprove surgical outcomes.

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“…All these prolong the hospital stay of the patient, thus increasing the financial burden on the patient, his family and the health facility and most of all increase the morbidity and mortality. 3 Harmonic scalpel is an option for the clipless surgery and has been considered as a better choice for securing the cystic artery and cystic duct in order to prevent the risk of biliary leakage following clipped laparoscopic cholecystectomy. 4,5 Multiple studies have reported that the incidence of biliary leakage was more in clipped as compared to clipless surgeries, respectively.…”

Section: Original Articlementioning

confidence: 99%

“…8 Others have also observed that the clipped procedures resulted in higher incidence of biliary leakage. 3,9 The purpose of this study was to compare the efficacy of clipped and clipless cholecystectomy in the management of gallstone-related cholecystitis. Local data regarding newer techniques is very limited.…”

Section: Original Articlementioning

confidence: 99%

Comparison of Clipless and Clipped Laparoscopic Cholecystectomy at Nishtar Hospital Multan, Pakistan

Manan

Khan²,

Ahmad

et al. 2020

J Islamabad Med Dental Coll

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Objective: To compare the efficacy of clipless cholecystectomy using harmonic scalpel and clipped conventional laparoscopic cholecystectomy. Study design: A randomized control trial. Place and duration of study: Department of general surgery at Nishtar Hospital Multan, from October 1st 2019 to March 31st 2020. Methodology: Total 188 patients of gallstone related cholecystitis were enrolled in the study and were selected using non-probability consecutive sampling technique. All the patients were randomly divided into two equal groups. One group was designated for clipless and the other for conventional clipped laparoscopic cholecystectomy. Age, gender, duration of cholecystitis, duration of Procedure, hospital stay, usefulness in difficult procedures and biliary leakage were recorded for all the patients. Data was entered in SPSS version 23 and analyzed. Results: Operation time was 28.35±7.92 minutes and 21.15±4.47 minutes in clipped and unclipped surgery, respectively (p<0.001). Hospital stay was 2.37±0.60 days in clipped surgery group and 1.71±0.74 days in clipless surgery group (p<0.001). Biliary leakage was reported in 2(2.1 %) patients of the clipped group and 1(1.1%) patients of the unclipped group (p = 0.561). Usefulness of the procedure in difficult cases was documented in 0 (0.0%) of the clipped procedures and in 8 (8.5%) of the clipless procedures (p=0.004). Conclusion: As witnessed from this study, it can be concluded that clipless surgery is a better option as compared to the clipped conventional laparoscopic Cholecystectomy as former is associated with shorter operation time, shorter hospital stay and better usefulness in difficult cases.

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Clipless laparoscopic cholecystectomy: 3 Port access.

Cited by 3 publications

References 15 publications

Clipped or Clipless Cholecystectomy

Clipped or Clipless Cholecystectomy

Clipped or Clipless Cholecystectomy

Comparison of Clipless and Clipped Laparoscopic Cholecystectomy at Nishtar Hospital Multan, Pakistan

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