Results of laparoscopic cholecystectomy without energized dissection: a prospective study.
BACKGROUND
Laparoscopic cholecystectomy (LC) a gold standard treatment of symptomatic gall stone disease has yet to become as safe as open cholecystectomy. The concerns of safety for both surgeon as well as patient are present even after the passage of "learning curve" phase. Emphasis on experience and technique have helped but for the morbidity associated with the use of energy sources. The purpose of this study was to evaluate the possibility of avoiding this morbidity by not using energy sources in LC.


METHODS
Prospective case series, with a minimum follow up of 1 year. Consecutive, unselected patients of symptomatic gall stone disease operated by an experienced laparoscopic surgeon from July 2003-June 2005. Operative, early and late postoperative outcomes were evaluated.


METHODS
LC was performed by dissecting in avascular Holy planes without using any energy source.


RESULTS
LC could be performed safely in all 135 patients. The technique was uniformly applicable irrespective of gender, age, time of presentation, grade of inflammation, adhesions or any comorbidity. There was no hemodynamic instability, conversion, injury manifesting early or late or any mortality.


CONCLUSIONS
The potential injury from use of energy sources in LC can be avoided as it can be safely performed without using any energy source.
Agarwal
Brij B
BB
Dr. Agarwal's Surgery & Yoga, F-81&82, Street 4, Virender Nagar, New Delhi - 110058, India. endosurgeon@gmail.com
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D004210:Dissection / Q000009:adverse effects / Q000379:methods; D011211:Electric Power Supplies / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control*; D020706:Laparoscopes; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D018570:Risk Assessment; D017751:Safety Management; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult