title: A meta-analysis of randomized clinical trials that compared ultrasonic energy and monopolar electrosurgical energy in laparoscopic cholecystectomy.
abstract: BACKGROUND
  Currently, monopolar electrical energy is still widely used as the main source of energy for laparoscopic cholecystectomy (LC). However, some studies have suggested that the use of ultrasonic energy is more advantageous. This meta-analysis pooled the currently published randomized controlled trials comparing the safety and efficacy of ultrasonic energy and monopolar electrical energy in LC.
  
  
  METHODS
  MEDLINE, EMBASE, Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials for relevant articles published between January 1985 to February 2012 by using the search terms "laparoscopic cholecystectomy," "electrocoagulation," "electrosurgery," "ultrasonics," "ultrasonic therapy," and "dissection." Intraoperative and postoperative measures and complications were evaluated.
  
  
  RESULTS
  Eight high-quality randomized controlled trials with 1056 patients were included. Differences in mean operation time, mean blood loss, mean hospital stay, gallbladder perforation, and postoperative abdominal pain score at 24 hours were statistically significant between the two groups, in favor of the use of ultrasonic energy. However, there were no differences in operation conversion, bile leakage, intra-abdominal collections, and postoperative nausea at 24 hours.
  
  
  CONCLUSIONS
  Ultrasonic energy is as safe and effective as electrosurgical energy and potentially might be safer in LC. However, the financial implications of this technical modality need to be established in cost-effectiveness analysis.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Xiong
authors.forename: Kiran
authors.initials: K
authors.lastname: Altaf
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Javed
authors.forename: Rajarshi
authors.initials: R
authors.lastname: Mukherjee
authors.forename: Gang
authors.initials: G
authors.lastname: Mai
authors.forename: Weiming
authors.initials: W
authors.lastname: Hu
authors.forename: Robert
authors.initials: R
authors.lastname: Sutton
authors.forename: Xubao
authors.initials: X
authors.lastname: Liu
mesh_terms: D057868:Anastomotic Leak / Q000453:epidemiology; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D004210:Dissection / Q000295:instrumentation / Q000379:methods*; D004564:Electrocoagulation / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D010149:Postoperative Pain / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D014465:Ultrasonics