Safety of Clip-less Hook Diathermy Division Against Standard Clipped Division of Cystic Artery in Laparoscopic Cholecystectomy

Back ground: Laparoscopic Cholecystectomy is one of the most commonly performed surgery. Various methods of Cystic artery division are in practice. This study looks into the safety of clip-less hook diathermy division of cystic artery against the standard cystic artery division between clips.

Objective: To study the outcome and safety of the clip-less hook diathermy division of cystic artery in Laparoscopic Cholecystectomy.

Methods: A total of 193 patientswho underwent laparoscopic cholecystectomy between January 2007 to December2011 by the same surgeon at a single centre were analysed. 41 patients who underwent emergency cholecystectomy for acute cholecystitis, and 2 patients who had open conversion were excluded. Standard 4 port technique and calot’s dissection by flag’s technique was followed. The terminal branches  of the cystic artery was diathermised and divided using hook diathermy very close to the gall bladder wall. Rest of the procedure was completed by standard technique.

Results : Among the 150 patients who qualified for the study, 2 patients required clipping of the cystic artery after diathermy division due to bleeding. No secondary or reactionary bleeding occured. No patient required re-intervention for bleeding. Mortality was nil and no significant morbidity. Overall operating time was better.

Conclusion: The clip- less hook diathermy division of cystic artery is safe and effective technique for laparoscopic cholecystectomy in experienced hands. We believe this technique is cost effective (Clip cost / Operating time).


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