title: Laparascopic cholecystectomy: cystic duct occlusion with titanium clips or ligature? A prospective randomized study.
abstract: During laparoscopic cholecystectomy (LC), cystic duct occlusion can be done with titanium clips or laparoscopically tied knots. However, till date, there is no randomized, controlled study reported in the literature that has prospectively compared the outcome using either of these methods. In the present study, 105 patients who were to undergo LC were randomly assigned to two groups. Group I comprised patients undergoing cystic duct occlusion with clips while group II comprised those undergoing cystic duct occlusion with knots. Our aim was to compare the postoperative outcome in both the cases. The incidence of overall bile leak following LC was 4 out of 105 (3.8%) while the leak rate following cystic duct occlusion with clips was 2 out 52 (3.9%), and that following ligature was 2 out of 53 (3.8%). The procedure using ligature took slightly longer time than that using clips. There was no significant difference in the postoperative outcome in either group. The use of ligature is a feasible, safe and cost-effective alternative to the use of titanium clips for cystic duct occlusion during LC.
authors.affiliation: Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029.
authors.forename: Vuthaluru
authors.initials: V
authors.lastname: Seenu
authors.forename: Dhronamraju
authors.initials: D
authors.lastname: Shridhar
authors.forename: Chandrashekar
authors.initials: C
authors.lastname: Bal
authors.forename: Rajinder
authors.initials: R
authors.lastname: Parshad
authors.forename: Arvind
authors.initials: A
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013525:Surgical Instruments; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium