A new bipolar feedback-controlled sealing system for closure of the cystic duct and artery.
BACKGROUND
Bile leaks are serious complications after laparoscopic cholecystectomy. The aim of this study was to evaluate the feasibility of closure of the cystic duct with a new feedback-controlled bipolar sealing system (LigaSure).


METHODS
Ten domestic pigs underwent open cholecystectomy with the cystic duct and artery dissected and sealed with the new bipolar sealing system (LigaSure). Four and 8 days postoperatively, 5 pigs each were sacrificed and the closure of the cystic duct was evaluated. The cystic stump and the common bile duct were excised for histological examination.


RESULTS
None of the pigs had a bile leak or a biliary peritonitis. There were no signs of postoperative bleeding or inflammation in Calot's triangle. Histology showed total necrosis of the cystic duct in the first two pigs due to too much energy used. The remaining specimens showed a regularly scaling zone without necrosis in 7 cases, and in one case a partial necrosis in the mucosa only was found.


CONCLUSIONS
Cystic artery and cystic duct closure with the new device may be an alternative to the clip. Further trials should evaluate the feasibility and safety of the new device in the clinical setting.
Shamiyeh
A
A
Ludwig Boltzmann Institute for Operative Laparoscopy and 2nd Surgical Department, General Hospital Linz, Krankenhausstrasse 9, 4020 Linz, Austria.
Schrenk
P
P
Tulipan
L
L
Vattay
P
P
Bogner
S
S
Wayand
W
W
D000818:Animals; D001158:Arteries / Q000601:surgery*; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods; D003135:Common Bile Duct / Q000601:surgery; D003549:Cystic Duct / Q000098:blood supply* / Q000601:surgery*; D005240:Feasibility Studies; D005246:Feedback; D005260:Female; D019106:Postoperative Hemorrhage / Q000209:etiology; D013552:Swine