Clipping Vs Suture ligation of cystic duct and artery in laparoscopic cholecystectomy: A tertiary care based observational study

Abstract

Introduction: Surgical removal of gall bladder is called cholecystectomy. The most commonly operation done in the case of symptomatic gall stone diseases and other gall bladder related pathologies. Cholecystectomy can be performed using two techniques either ‘open cholecystectomy’ and laparoscopic Cholecystectomy. Methods and material: This was a tertiary hospital based observational study carried in the department of general surgery government medical college srinagar kashmir, over a period of three years from august 2017 to august 2020 including 100 patients who underwent elective laparoscopic cholecystectomy for symptomatic gall bladder stones. In this study we divided patients into two categories where group a which includes first 50 patients who underwent ligation of cystic artery and duct by titanium clipping and group b included those with separate suture ligation of cystic duct and artery. Results: most of these patients were belonging to age group of 19-28 and 29-38 with mean age of 31.3. pre-operative usg was showing mostly stones. the body mass index was mostly between 18.5-24.5. mean operative time in clipping group 41.2 and in suture ligation group was 46.8 and in according to bmi, higher bmi took less operative time in suture ligation 38.1 min than clipping 41.7. One patient (clipping) was having post operative bile leak which was managed by ercp and one patient among 50 developed clip migration. Conclusion: From this study we concluded that suture ligation of cystic duct and artery by either silk or vicryl 2/0 is safe, effective and low cost alternative to clips especially in developing countries.