title: Clipless minilaparoscopic cholecystectomy: a study of 1,096 cases.
abstract: OBJECTIVE
  Low conversion rate, high safety, and good cosmetic result with less medical cost are chased by all laparoscopic surgeons. We used general laparoscopic instruments and combined with absorbable thread trying to perform a clipless minilaparoscopic cholecystectomy for benign gallbladder patients and got all the above-mentioned results.
  
  
  METHODS
  From January 2008 to February 2011, 1096 minilaparoscopic cholecystectomies were performed for patients with uncomplicated or complicated benign gallbladder disease by our treatment team. The three-port technique with the help of an electrocautery hook, forceps, and suction was applied for laparoscopy cholecystectomy, and the cystic duct and vessels were ligated by absorbable thread rather than hemostasis clips and Harmonic(®) scalpels (Ethicon, Cincinnati, OH). The operative time, blood loss, subhepatic drain, conversion rate, drainage time, and hospital stay were reviewed and statistically analyzed.
  
  
  RESULTS
  Our conversion rate was 0.18%, which was much lower than those reported by many studies. The mean operating time was 28 minutes (range, 11-70 minutes). Mean blood loss was 12 mL (range, 5-200 mL). A subhepatic drain was placed in 63 patients, with a mean drainage time of 1.7 days (range, 1-6 days). The mean postoperative hospital stay was 2.5 days (range, 2-7 days). No postoperative bleeding, biliary leakage, intraabdominal infection, umbilical site infection, umbilical incision herniation, biliary duct or bowel injury, or mortality occurred.
  
  
  CONCLUSIONS
  Minilaparoscopic cholecystectomy using absorbable thread instead of clips and Harmonic scalpels offers a safe, effective, and economical surgical alternative for benign gallbladder patients.
authors: Department of Digestive Surgery, East Hospital, Tongji University School of Medicine , Shanghai, People's Republic of China .
authors: Guangjun
authors: G
authors: Suo
authors: Anan
authors: A
authors: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D007902:Length of Stay; D008026:Ligation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult