title: Efficacy of absorbable clips compared with metal clips for cystic duct ligation in laparoscopic cholecystectomy.
abstract: OBJECTIVE
  This study was conducted to examine the usefulness and safety of absorbable clips in laparoscopic cholecystectomy (LC).
  
  
  METHODS
  We retrospectively compared the clinical data of 328 patients who underwent LC using absorbable clips for cystic duct ligation and 444 patients who underwent LC using metal clips for cystic duct ligation.
  
  
  RESULTS
  The mean operative time in the absorbable clip group was significantly shorter than that in the metal clip group. The mean intraoperative blood loss and hospital stay were not significantly different between the two groups. The rate of conversion to open laparotomy in the absorbable clip group was significantly higher than that in the metal clip group, at 6.7% vs 2.3%, respectively. The most common reason for conversion was difficult adhesions and inflammation around the gallbladder. The morbidity of the metal clip group was significantly higher than that of the absorbable clip group, at 8.4% vs 4.0%, respectively. The incidence of major postoperative complications requiring laparotomy did not differ between the two groups. There were no deaths in the absorbable clip group, but 1 of the 444 patients (0.23%) in the metal clip group died from disseminated intravascular coagulation on postoperative day 3.
  
  
  CONCLUSIONS
  The results of this study suggest that absorbable clips are as safe and effective as standard metal clips for vessel and duct ligation in LC.
authors.affiliation: Department of Surgery, NTT West Osaka Hospital, 2-6-40 Karasugatsuji, Tennoji-ku, Osaka 543-8922, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yano
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Okada
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Kinuta
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Nakano
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tono
authors.forename: Shigeo
authors.initials: S
authors.lastname: Matsui
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwazawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kanoh
authors.forename: Takushi
authors.initials: T
authors.lastname: Monden
mesh_terms: D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D007813:Laparotomy; D008026:Ligation / Q000295:instrumentation; D008297:Male; D008670:Metals; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000009:adverse effects; D013997:Time Factors
chemical_list: D001672:Biocompatible Materials; D008670:Metals