The difference between harmonic shear versus electrocautery in fundus-first laparoscopic cholecystectomy in acute cholecystitis: a comparative study

Abstract

Backgrounds Laparoscopic cholecystectomy (LC) may be complicated by biliary duct injury in acute cholecystitis. In this study, we compared conventional electrocautery with the harmonic scalpel in patients undergoing LC for acute cholecystitis. Patients and methods The current study was carried out as a comparative study among 148 patients with acute calculary cholecystitis who were presented to the Surgery Department in the Suez Canal University Hospitals, Ain Shams University Hospitals, and Saudi German Hospital, Jeddah. The studied patients were recruited into two groups; both were subjected to LC within the first 5 days of the attack. A total of 69 patients were allocated to fundus-first LC with a harmonic scalpel, whereas 79 were recruited to fundus-first LC using electrocautery. Results Concerning intraoperative characteristics, the operation lasted an average of 51±5 min and 63±6 min for the harmonic scalpel and electrocautery, respectively (P Conclusion The findings showed that the harmonic scalpel is a safe, feasible, and promising technique and is associated with less intraoperative and postoperative morbidities.