Clipless Laparoscopic Cholecystectomy: Our Experience

Abstract

Background:Laparoscopic cholecystectomy (LC) is accepted as the gold standart treatment of gallstones. Various methods have been developed to close the cystic duct (CD) and cystic artery (CA), but titanium clip application is currently the most frequently used technique. High-tech electrosurgical instruments, such as Harmonic Scalpel (HS), have been used both for dissection of the cystic artery and Cystic duct. The present study was conducted to observe and establish efficacy of clipless cholecystectomy, by use of harmonic scalpel as an alternative, for division and sealing of cystic artery and cystic duct. Methods:This study was a hospital based, retrospective study, conducted in Govt. Medical College, Srinagar, using medical records. A total of 114 patients included in the study, having been operated by a single surgeon over time period of 5 years from February 2014 to january 2019. Results:In our study of 114 patients 82 (71.92%) were females and 32 (28.07%) were males with average age of 41.4years (16-72 yr). No patient was converted to open with average operating time of 24.2 minutes (18-46 minutes). Mean hospital study was 1.42 days (1-8 days) with no mortality. Postoperative complications were found in 6 (5.2%) patients with bile leak from duct of Lushka in 1 (0.8%) patient, port site infection in 2 (1.7%) patients and fever in 3 (2.6%) patients.Gallbladder perforation intraoperatively was seen in 7 (6.2%) patients.Conclusions:Use of harmonic scalpel is an excellent option for the cystic duct closure with less time consumption and less complications.

Clippless Laparoscopic Cholecystectomy Using Ultrasonic Dissection

“…Attri and his colleagues, [15] , found 6.2% gall bladder perforation intraoperatively which disagree with our results.…”

“…Attri and his colleagues, [15] , found in their study that the mean age was 41.4 years with a female predominance which was in agree with what we found in our results.…”

“…Attri and his colleagues, [15] , found bile leak in 0.8% of their patients, 1.7% of patients had port site infection which run in lines with what we found in our results.…”