World Journal of Laparoscopic Surgery

Register      Login

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

RESEARCH ARTICLE

A Clinical Comparative Study of Bipolar Electrocautery vs Clips for Cystic Artery during Laparoscopic Cholecystectomy

Shaileshkumar M Emmi, DS Suhas

Keywords : Bipolar electrocautery, Clips, Cystic artery, Laparoscopic cholecystectomy

Citation Information : Emmi SM, Suhas D. A Clinical Comparative Study of Bipolar Electrocautery vs Clips for Cystic Artery during Laparoscopic Cholecystectomy. World J Lap Surg 2022; 15 (1):74-76.

DOI: 10.5005/jp-journals-10033-1500

License: CC BY-NC 4.0

Published Online: 13-06-2022

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


Abstract

Introduction: Since 1987, laparoscopic cholecystectomy has been regarded as the gold standard treatment for cholelithiasis. Surgical clips, harmonic scalpel and ligature, or bipolar cautery can be used to control the cystic artery during this treatment. In this paper, we examine the use of bipolar electrocautery vs clip ligation to control the cystic artery during laparoscopic cholecystectomy. Method: This is a clinical comparative study that was carried out in total of 60 patients who underwent laparoscopic cholecystectomy conducted for 3 year duration (2016–2019). The patients were monitored for postoperative hemorrhage and bile leak, as well as differences in hospital stay length and postoperative sequelae. Results: In our study, the cystic artery was controlled using bipolar electrocautery in 30 patients (group B) and by surgical clips in 30 patients (group A). In both groups, the length of stay in the hospital and the duration of surgery were similar. In Group A, no incidences of intraoperative hemorrhage or bile leak were documented, but Group B had two cases of bile leak and four cases of intraoperative cystic artery bleed. Conclusion: We conclude that, especially in developing countries, bipolar diathermy and clip application are equally effective strategies for hemostatic control of the cystic artery during laparoscopic cholecystectomy.


HTML PDF Share
  1. Conference NC. Gallstones and laparoscopic cholecystectomy. Journal of the American Medical Association 1992;269(8):1018–1024. PMID: 8429583.
  2. Jain SK, Tanwar R, Kaza RC, et al. A prospective, randomized study of comparison of clipless cholecystectomy with conventional laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech A 2011;21(3):203–208. DOI: 10.1089/lap.2010.0455.
  3. Ayyaz M, Fatima T, Ahmed G. Arterial anatomy in Calot's triangle as viewed through the laparoscope. Ann K E Med Coll 2001;7:183–185. DOI: 10.7860/jcdr/2015/13089.6156.
  4. Wasserberg N, Gal E, Fuko Z. Surgical clip found in duodenal ulcer after laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2003;13(6):387–388. DOI: 10.1097/00129689-200312000-00008.
  5. Strasberg SM. Avoidance of biliary injury during laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg 2002;9(5):543–547. DOI: 10.1007/s005340200071.
  6. Mühe E. Long-term follow-up after laparoscopic cholecystectomy. Endoscopy 1992;24(9):754–758. DOI: 10.1055/s-2007-1009119.
  7. Larobina M, Nottle PD. Extrahepatic biliary anatomy at laparoscopic cholecystectomy: is aberrant anatomy important? ANZ J Surg 2005;75(6):392–395. DOI: 10.1111/j.1445-2197.2005.03396.x.
  8. Hugh TB, Kelly MD, Li B. Laparoscopic anatomy of the cystic artery. Am J Surg 1992;163(6):593–595. DOI: 10.1016/0002-9610(92)90564-8.
  9. Das RS, Talukdar M, Shaan AR. Monopolar electrocautery vs surgical clips in control of cystic artery in laparoscopic cholecystectomy:a comparative study. J Evol Med Den Sci 2016;5(33):1790–1793. DOI: 10.14260/jemds/2016/422.
  10. Katri KM, Bessa SS, Elnagah GA, et al. Is monopolar electrocautery safe and effective for control of the cystic artery during laparoscopic cholecystectomy. Laparoendosc Adv Surg Tech A 2012;22(6):557–560. DOI: 10.1089/lap.2011.0507.
  11. Chauhan A, Gangji A, Singhal A. Control of cystic artery using monopolar electrocautery in laparoscopic cholecystectomy: our experience. Sch J Appl Med Sci 2014;2(4D):1381–1382.
  12. Redwan AA. Single-working-instrument, double-trocar, clipless cholecystectomy using harmonic scalpel: a feasible, safe and less invasive technique. J Laparoendosc Adv Surg Tech A 2010;20(7):597–603. DOI: 10.1089/lap.2009.0375.
  13. Ramirez-Flores R. A new anatomic guide for safe ligation of the cystic artery. Surg Gynecol Obstet 1955;100(5):633–635. PMID: 14373369.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.