World Journal of Laparoscopic Surgery

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VOLUME 15 , ISSUE 1 ( January-April, 2022 ) > List of Articles

Original Article

A Comparative Study of Extracorporeal Knotting vs Clips for Ligating Cystic Duct in Laparoscopic Cholecystectomy

Hebbatam Vishnu Teja, Deepak R Chavan, Girish Kullolli

Keywords : Clipping, Cystic duct, Extracorporeal knotting, Laparoscopic cholecystectomy

Citation Information : Teja HV, Chavan DR, Kullolli G. A Comparative Study of Extracorporeal Knotting vs Clips for Ligating Cystic Duct in Laparoscopic Cholecystectomy. World J Lap Surg 2022; 15 (1):14-17.

DOI: 10.5005/jp-journals-10033-1494

License: CC BY-NC 4.0

Published Online: 13-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


The aims of present study were as following: To compare extracorporeal knotting vs clips for ligating cystic duct in laparoscopic cholecystectomy in terms of feasibility operative time (incision to closer) based on types of cholecystitis postoperative pain, operative cost, and associated morbidities like gallbladder perforation, bile leak, liver bed injury, port site infection, migration of clips, and slipping of knot. Methodology: All the patients were assigned by randomization into either of two groups: study group—patients in whom extracorporeal knotting was done for ligation of cystic duct, and control group—patients in whom clips were used for clipping of cystic duct. Period of study was from November 2018 to June 2020. Results: This was a case series analysis conducted from November 2018 to June 2020; i.e., for a period of 20 months, 60 cases were subjected to laparoscopic cholecystectomy. In the control group, 11 patients had intraoperative complications, and no complications in the study group. In the study group, mean time taken for the operation was 67.37 minutes when compared to control group of 61.83 minutes. The cost of the suture material used in study group was 302 rupees, and the average cost of the titanium clips used in control group was 500 rupees. Conclusion: In laparoscopic cholecystectomy, extracorporeal knotting has the advantages over clipping of cystic duct in operative cost and lesser intraoperative complications with the only limitation being operative time.

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