Laparoscopic Cholecystectomy Using Harmonic Scalpel Versus Conventional Laparoscopic Cholecystectomy

Abstract

Background: laparoscopic cholecystectomy is the worldwide gold standard treatment of symptomatic gallbladder lithiasis. During the conventional LC, we used usually clips for closure of cystic duct and artery and dissector, electrosurgical hook, spatula and/or scissor for dissection of cystic duct and artery and sealing of gall bladder from liver bed. Now, single instrument called harmonic scalpel is introduced as a potential replacement for all of these instruments. Objective: To evaluate the safety, efficacy and clinical outcome of LC using harmonic scalpel compared with conventional LC. Patients and Methods: Our prospective randomized study was carried out during the period from February 2018 to August 2018 at Azhar Assuit University Hospital, and included 60 adult patients presented with chronic calcular cholecystitis divided randomly into 2 groups. All patients of both groups were signed the informed consent and assessed preoperative (history, clinical examination, CBC, LFTs, RFTs, virology and Pelvi-abdominal ultrasound), intraoperative (time, incidence of gall bladder perforation, bleeding and conversion to open procedure) and postoperative (pain, analgesia, drain, bile leakage, hospital stay and wound infection). Results: No statistically significant difference was found age, sex, BMI and associated diseases between both groups but there is significant difference in operative time, incidence of gall bladder perforation, blood loss, postoperative pain, drain and hospital stay. No significant difference in wound infection. No incidence of bile leakage or conversion to open procedure in both groups. Conclusion: Harmonic scalpel in general is an efficient tool for complete hemobiliary sealing with high safety profile.