Ligating the cystic duct in laparoscopic cholecystectomy.
BACKGROUND
In laparoscopic cholecystectomy, bile leak from the cystic duct stump is a recognised postoperative complication. This could be due to dislodgement of the metal clips. Migration of the clip is an added problem.


METHODS
Since 1995, 70 patients were included in the study of intracorporeal cystic duct ligation in laparoscopic cholecystectomy. Construction of a ligature is a single handed procedure using a free end of the thread. It is quite different from the other two methods described in the literature.


RESULTS
There was not a single case of postoperative morbidity in these patients, but in a retrospective study, postoperative biliary dyspepsia with fatty food was evident in a few patients among those cases in which the liga-clips were applied to the cystic duct.


CONCLUSIONS
The cystic duct ligation with absorbable thread should be a gold standard in laparoscopic cholecystectomy. It reduces the risk of postoperative morbidity.
Saha
S K
SK
Department Of Surgery, West Wales Hospital, Carmarthen, Dyfed, United Kingdom.
D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery; D003549:Cystic Duct / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome