Control of cystic artery during laparoscopic cholecystectomy: clips versus ultrasonic energy devices which is better?

Abstract

Background: This study was undertaken to know whether clip usage or ultrasonic energy application, obtains better haemostasis of cystic artery during laparoscopic cholecystectomy.Methods: About 80 patients undergoing laparoscopic cholecystectomy were selected on a prospective basis and divided into two equal groups- A and B. a comparative study was done between the two group. Clips were used to control cystic artery in group A patients and ultrasonic energy device was used for the same in group B.Results: In group A, 2 patients had clip slippage intraoperatively which was dealt by reapplication of clips.in group B,1 patient had intraoperative bleeding from cystic artery few minutes after application of ultrasonic energy which was dealt by bipolar cauterization. In both the groups no, postoperative bleeding was encountered.Conclusions: During laparoscopic cholecystectomy, clip usage and ultrasonic energy application are equally competent in achieving haemostasis of cystic artery.

Harmonic scalpel versus monopolar electrocauterization in laparoscopic cholecystectomy

“…Regarding gender distribution, our study observed a higher number of females compared to males in both the Monopolar (50 females, 20 males) and Harmonic groups (62 females, 15 males), with a p-value greater than 0.05. This finding aligns with the results reported by Venkatapuram and Sateesh [18] . Similarly, no statistically significant difference was found in the mean age of patients between the two groups, as supported by Venkatapuram and Sateesh [18] .…”

“…This finding aligns with the results reported by Venkatapuram and Sateesh [18] . Similarly, no statistically significant difference was found in the mean age of patients between the two groups, as supported by Venkatapuram and Sateesh [18] . The operative time was also similar between the groups (p=0.82), with mean times of 52.20 ± 4.60 minutes in the Monopolar group and 52.31 ± 4.62 minutes in the Harmonic group.…”

“…The operative time was also similar between the groups (p=0.82), with mean times of 52.20 ± 4.60 minutes in the Monopolar group and 52.31 ± 4.62 minutes in the Harmonic group. This outcome is consistent with the findings of Venkatapuram and Sateesh [18] and Mohamed Samir et al [19] , who also reported no statistically significant differences (p> 0.05). In contrast, Safdar Hussain et al [20] (n=86) found a significant difference (p=0.002), which could be attributed to their smaller sample size and the use of the harmonic scalpel in dissecting the gallbladder from the hepatic bed.…”

“…The primary failure rate in controlling the cystic artery was one patient in the Monopolar group and three patients in the Harmonic group (p=0.354). Similar results were reported by Venkatapuram and Sateesh [18] . However, Al-Aubiadi T et al [21] found a significant difference between the groups, possibly ~ 13 ~ due to the use of the harmonic scalpel in gallbladder dissection and cystic artery control.…”