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New Indian Journal of Surgery

Volume  3, Issue 1, Jan-Mar 2012, Pages 15-19
 

Original Article

A Prospective Randomised Comparative Study Between Clip Less Versus Conventional Laparoscopic Cholecystectomy

Choudhary Rajveer, Singh Mahendra, Gupta Ashwani, Rao ASN

All from Dept. of Surgery, VMMC & Safdarjang Hospital, New Delhi, India

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Abstract

To  evaluate  safety  and  efficacy  of  ultrasonic  scalpel  in  closure/division  of  the cystic  duct  and  artery,  and  gallbladder  dissection  in  laparoscopic  cholecystectomy  as  a single  working  instrument  compared  conventional  technique  using  clips  and  electro-cautery. Method:  This  study  included  60  patients  with  symptomatic  gallstone  disease  were  randomly  assigned  for  laparoscopic  cholecystectomy  by  either  ultrasonic  shear ( Study  Group   =  30   patients),  and   clip / cautery (Control Group=30 patients). Results: The mean operative time  was  significantly  shorter  in   study group as compare to control group  ( p value =0.002), and  postoperative  pain  scores (VAS)  were  significantly  shorter (p value = 0.001) in first 24 hours  but   no significant  difference was found  in  the  incidence  of  intra-operative & post-operative  complications. Conclusion: Ultrasonic  shear  is  as  safe  and  effective  as  clip/cautery  technique  in achieving  hemo-biliary stasis,  with  shorter  operative  time  with  decreased   pain,  especially  if  used  as  a   sole working  instrument.

Keywords: Clipless laparoscopic cholecystectomy (CLLC); Conventional laparoscopic cholecystectomy (CLC); Ultrasonic scalpel.


Corresponding Author : Choudhary Rajveer