Abstract:
AIMS AND OBJECTIVE OF STUDY
The aims of present study are as following: To compare extracorporeal knotting
versus clips for ligating cystic duct in laparoscopic cholecystectomy in terms of:
Feasibility
Operative time (incision to closer) based on types of cholecystitis
Post-operative pain
Operative cost
Associated morbidities like Gall bladder perforation, Bile leak, Liver bed injury,
Port site infection, Migration of clips, Slipping of knot.
MATERIALS AND METHODS
It is a randomized prospective study done in patients who undergo laparoscopic
cholecystectomy in Department of Surgery, B.L.D.E. (DEEMED TO BE
UNIVERSITY) SHRI B.M. PATIL MEDICAL COLLEGE, HOSPITAL AND
RESEARCH CENTRE, VIJAYAPURA– 586103, KARNATAKA.
All the patients will be assigned by randomization into either of two groups:
Study Group: Patients in whom extracorporeal knotting will be done for ligation
of cystic duct.
Control Group: Patients in whom clips will be used for clipping of cystic duct.
DocuSign Envelope ID: 4D366DEA0B095073-F-CD1A0DD--44ED938E-B-8E4480D-0-5C26D0DA4AD4A04949480C7
X
RESULTS
Out of 60 patients, In the study group there were no intraoperative
complications noted among the 30 patients.
In the control group, 11 patients there were intraoperative complications, 7
patients had clip slippage and stone spilling in to the peritoneal cavity from the
gall bladder, 3 patients had clip slippage and bile spillage in to the peritoneal
cavity from the gall bladder and in 1 patient there was clip migration.
In the study group mean time taken for the operation was 67.37 minutes when
compared to control group of 61.83 minutes.
The average cost of the Suture material used in study group is 302 rupees and
the average cost of the Titanium clips used in control group is 500 rupees.
CONCLUSION
In laparoscopic cholecystectomy, extracorporeal knotting has the advantage
over clipping of cystic duct in terms of operative cost and lesser intraoperative
complications, with the only limitation being operative time
