Clipless laparoscopic cholecystectomy is a better technique in reducing intraoperative bleeding

Abounozha, Sabry; Alshahri, Talal; Alammari, Samer; Ibrahim, Rashid

doi:10.1016/j.amsu.2021.01.039

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…23 Shabbir et al and Ali et al discovered that electrocautery had a considerably greater gallbladder perforation rate in comparison with harmonic scalpel while doing LC. 27,28 In present study drain content was significantly high in conventional (group A) as compare to ultrasonic vessel sealing device (group B). In group A, 72.3% patients required drain placement in which 68.7% containing blood and 4.3% observed with biliary context.…”

Section: Introductionmentioning

confidence: 47%

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To compare efficiency of ultrasonic vessel sealing device and convention-al method in laparoscopic cholecystectomy.

Anum Asif,

Syed Amir Shah,

Sadia paras

et al. 2023

j Muhammad Med Coll

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Objective: To compare the outcomes of ultrasonic vessel sealing device and conventional method during laparoscopic cholecystectomy.Methodology: This prospective comparative study was carried at the Department of General Surgery, LUMHS during16-06-2021 to 25-01-2022. A total of 140 Patients with symptomatic gallstones assigned in two groups on surgeon’s pref-erence after fulfilling inclusion criteria for LC. Group A, LC done by Using clips & cautery method and group B, LC done by using harmonic scalpel. All surgeries was performed by senior consultant. Data was collected via pre-structured proforma. The outcomes was measured.Results: Mean duration of procedure difference was significantly less in patients with LC was done with harmonic scal-pel in comparison with conventional method [Mean difference -6.71±1.24 min; p=0.0005]. Rate of intraoperative bleed-ing more than 100 ml was significant [A=35.7% vs. B=0; p=0.0005]. Similarly rate of postoperative bleeding was signifi-cant [A=17.14% vs. B=5.71%; p=0.034]. Rate of gallbladder perforation and lateral tissue damage was also significant [14.3% vs. 40%; p=0.001] and [0% vs. 10%; =0.013] respectively. Drain content was significant [A=72.3% vs. B=11.4%; p=0.0005]. Hospital stay more than 1 day was significantly less in patients [A=62.8% vs. B=30% p=0.0005].Conclusion:The ultrasonic vascular sealing device achieves satisfactory hemobiliary stasis in most of patients and may serve as a safer substitute to definitive cystic duct and artery clipping. Key words: laparoscopic cholecystectomy, conventional method, ultrasonic vessel sealing device, outcomes.

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Section: Introductionmentioning

confidence: 47%

“…It is worth noting that HS is only suited for occluding biliary ducts and arteries with diameter of less than 5mm 28,30. Formalized interpretation It is best suited for benign gallbladder illnesses that are not associated with a significant inflammatory state.…”

mentioning

confidence: 99%

To compare efficiency of ultrasonic vessel sealing device and convention-al method in laparoscopic cholecystectomy.

Anum Asif,

Syed Amir Shah,

Sadia paras

et al. 2023

j Muhammad Med Coll

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“…Bile leakage is also extensively reported by other studies as well. [15][16][17][18] Biliary leakage could be possibly done by various methods such as inadequate closure of the duct, slippage of the clips, necrosis of the duct or migration of the clip to the biliary tract. Clipless surgery does not involve any such hazards as it could be done through internal knotting method which minimizes the chances of biliary leakage and any such complications.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clipped Laparoscopic Cholecystectomy and Clipless Laparoscopic Cholecystectomy in Context of Biliary Leakage

Khan¹,

Shar²,

Memon³

et al. 2023

PJMHS

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Objective: To compare the outcome of clipped laparoscopic cholecystectomy and clipless laparoscopic cholecystectomy in context of biliary leakage. Study Design: Cross-sectional analytical study Place and Duration of Study: Department of Surgery Unit-II, Benazir Bhutto Hospital Rawalpindi from 1st September 2021 to 31st August 2022. Methodology: One hundred and twenty patients were included in the study and divided into two major groups. The biochemical analysis and ultrasonography was performed post 8 hours fasting. Group one had those cases which underwent clipped laparoscopic cholecystectomy while group 2 had those cases which underwent clipless laparoscopic cholecystectomy. The age of the patients was selected between 40 to 60 years and the prevalence for this sampling was considered as 20% in Pakistan. The demographic details, clinical history, signs and symptoms, clinical diagnosis based on USG, lipid profiling, and variables as post-operative time, hospital stay and ease in procedure were documented. Results: The mean age of the cases underwent clipped laparoscopic cholecystectomy was 42.3±12.11year with 40 females and 20 males who underwent those procedures. The mean age of the cases underwent clipless laparoscopic cholecystectomy was 40±11.05 years with 45 females and 15 males. The present study results evidently highlighted the fact that there were high percentage cases of biliary leakage seen in clipped cases than in the clipless cases. There were22 cases with 36.6% in clipped groups while 9 cases with biliary leakage such as 15% in clipless group. Conclusion: Clipless laparoscopic cholecystectomy is a better optional procedure with efficient usefulness in context to biliary leakage, operation time and hospital stays. Keywords: Outcome, Clipped laparoscopy cholecystectomy, Clipless laparoscopic cholecystectomy, Biliary leakage

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“…Five studies that met their inclusion criteria were included. The authors concluded that the harmonic scalpel effectively controls bleeding and can be used in patients with a high risk of intraoperative bleeding [5]. When the harmonic scalpel is used, the conversion rate is less when compared to other techniques [2,16].…”

Section: Hsc and Conversion Ratesmentioning

confidence: 98%

“…The patient outcome variables, which are essential in terms of patient wellbeing, have not been compared in literature reviews. Abounozha et al have already done studies that showed that the risk of bile leakage and intra-operative bleeding in HSC is comparatively less compared to electrocoagulation [4,5]. Ng et al have done a literature review about the titanium clip, which is usually used in electrocoagulation, acting as a nidus for stone formation for choledocholithiasis [6].…”

Section: Introductionmentioning

confidence: 99%

The Outcomes of the Patients Undergoing Harmonic Scalpel Laparoscopic Cholecystectomy

Kannan¹,

Tara²,

Quadir³

et al. 2021

Cureus

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Laparoscopic cholecystectomy has replaced conventional open cholecystectomy and has become the gold standard surgery for gall bladder pathologies. The harmonic scalpel is one of the instruments used to dissect and coagulate. Most surgeons accept the usage of the harmonic scalpel in laparoscopic cholecystectomy. The other standard method is electrocoagulation by electrocautery. The harmonic scalpel cholecystectomy has several advantages over other methods of laparoscopic cholecystectomy. Electrocoagulation by electrocautery produces smoke which can result in damage to lateral tissues, including the gall bladder. The clips are used along with electrocoagulation to seal cystic duct and cystic artery before dissection. There are various studies about bile leakage in the case of clip application. The harmonic scalpel uses ultrasonic energy to achieve hemostasis without bleeding, dissection, and gallbladder removal from the liver bed during laparoscopic surgery by causing coagulation of proteins. The patient outcome variables such as postoperative pain, duration of hospital stay, postoperative nausea and vomiting, surgical site infections, and other complications have not been compared in review articles. In this review, we collected the information from previously published studies and reviewed the outcomes of patients undergoing harmonic scalpel cholecystectomy. Harmonic scalpel cholecystectomy reduces the duration of hospital stay, duration of operation, intraoperative and postoperative complications, and postoperative pain. Thus the harmonic scalpel can be used instead of other instruments as it has better patient outcomes.

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Clipless laparoscopic cholecystectomy is a better technique in reducing intraoperative bleeding

Cited by 6 publications

References 3 publications

To compare efficiency of ultrasonic vessel sealing device and convention-al method in laparoscopic cholecystectomy.

To compare efficiency of ultrasonic vessel sealing device and convention-al method in laparoscopic cholecystectomy.

Comparison of Clipped Laparoscopic Cholecystectomy and Clipless Laparoscopic Cholecystectomy in Context of Biliary Leakage

The Outcomes of the Patients Undergoing Harmonic Scalpel Laparoscopic Cholecystectomy

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