Is monopolar electrocautery safe and effective for control of the cystic artery during laparoscopic cholecystectomy?
BACKGROUND
Laparoscopic cholecystectomy is one of the most common surgical procedures. Here we report our experience with the use of monopolar electrocautery to control the cystic artery during laparoscopic cholecystectomy.


METHODS
Data regarding the site, number, size, and method of control of the cystic artery during laparoscopic cholecystectomy were prospectively collected. Other data collected included the operative time, intraoperative difficulties, and postoperative complications.


RESULTS
The study included 158 laparoscopic cholecystectomies. Two arteries were controlled in 25 patients (15.8%) and one artery in 122 patients (77.2%), while the cystic artery was not identified in 11 patients (7%). The artery was graded as small, medium, and large in 43, 72, and 32 patients, respectively. Patients with unidentified cystic artery were excluded from our data analysis. The artery was controlled using monopolar electrocautery in 114 patients (77.5%) and by metal clips in 33 patients (22.5%). The cystic artery was controlled lateral to the cystic lymph node in the majority of patients (68%). Neither bleeding nor bile duct injury was encountered throughout the study period.


CONCLUSIONS
Electrocautery is safe and effective for control of the cystic artery during laparoscopic cholecystectomy. A future randomized study is needed to confirm the findings of the present study.
Department of General Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt. kkatry@hotmail.com
Khaled M
KM
Katri
Samer S
SS
Bessa
Galal Abou
GA
Elnagah
El-Saed A
el-SA
El-Kayal
D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies