EP-190 Comparative Study of Single Clip Laparoscopic Cholecystectomy (SCLC), Two Clips Laparoscopic Cholecystectomy (TCLC) and Clipless Laparoscopic Cholecystectomy (CLLC) Vs Conventional Laparoscopic Cholecystectomy (CLC)

Abstract

Abstract Introduction Laparoscopic cholecystectomy has been accepted as the “gold standard” for the treatment of symptomatic gallstone disease. Conventionally 6 titanium clips are used for laparoscopic cholecystectomy (LC). Cost of 6 titanium clips are high and have been associated with complications in form of migration. Material and Methods 200 patients of proven gallstones were randomly divided into four groups of 50 patients each, undergoing dissection of gall bladder by harmonic scalpel with application of one titanium clip, two titanium clips and absorbable Vikyl suture on cystic duct in Group 1 (SCLC), 2(TCLC) and 3(CLLC) respectively before division of duct and artery with harmonic ace. Group 4(CLC) patients underwent conventional LC with electrocautery and application of 6 clips. Results Mean operative time was statistically significant when CLC was compared with SCLC, TCLC and CLLC (CLC 43.10 ± 9.68 min vs 26.80 ± 8.44 in SCLC, 28.76 ± 8.23 IN TCLC, 37.30 ± 8.22min in CLLC group). Approximate blood loss in the CLC group was 28.90 ± 11.71ml as compared to 7.8 ± 3.06 in SCLC, 8.10 ± 3.18 ml in TCLC and 8.40 ± 3.70 ml in the CLLC group. Pain score was significantly better in the SCLC, TCLC and CLLC group. Conversion to open cholecystectomy was comparable in all the groups. Post operative hematoma formation and overall cost was significantly high in the CLC group. Conclusion SCLC, TCLC and CLLC are comparable to standard 6 clip laparoscopic cholecystectomy in all aspects. SCLC and TCLC have a clear advantage of decreased operative time, blood loss and low cost.