Clipless harmonic scalpel assisted cholecystectomy versus conventional laproscopic cholecystectomy

Abstract

Introduction: Laproscopic cholecystectomy is gold standard in the management of symptomatic gallstone disease. Ultrasonically activated scalpel has come up as alternative to traditional electrocautery for haemostatic dissection of tissues. Little research has been done to compare effectiveness of conventional laproscopic cholecystectomy and harmonic cholecystectomy. Aim and objective: To compare conventional laproscopic cholecystectomy versus clipless harmonic scalpel assisted cholecystectomy among the patients undergoing laproscopic cholecystectomy for symptomatic cholelithiasis at IGMC Shimla. Materials and method: Prospective study involved 400 patients operated for symptomatic cholelithiasis. Patients were divided into two groups of 200 patients each.Group A was control group who underwent conventional laproscopic cholecystectomy and Group B who underwent laproscopic cholecystectomy with harmonic scalpel. Results: In group A mean duration of surgery was 43 min and 20 seconds while in group B it was 30 min and 40 sec. In terms of intraoperative complications in group A gallbladder perforation was seen in 48 patients while in group B in 8 patients, while spillage of gall stones was seen in 48 patients in Group A it was seen in 8 patients in group B. Mean blood loss in group A was 19.72 cc while in group B it was 13.18 cc. Mean time interval of rescue with analgesic for post operative pain in group A was 7.64 while in group B was 8.72. Conclusion: Present study clearly establishes that harmonic laproscopic cholecystectomy is a safe alternative to conventional laproscopic cholecystectomy with short hospital stay, less postoperative pain, early recovery and comparable complication rate.