Impact of Monoploar Electrocautery Versus Ultrasonic Dissection On Gallbladder Perforation In Laparoscopic Cholecystectomy
DOI:
https://doi.org/10.51985/Keywords:
Cholelithiasis, Gallbladder perforation, Laparoscopic cholecystectomy, Monopolar electrocautery,Abstract
Objective: To compare the outcomes of monopolar electrocautery and ultrasonic gallbladder dissection from the gallbladder bed during laparoscopic cholecystectomy in term of gallbladder perforation.
Study design and setting: This comparative, cross-sectional study conducted in the Department of Surgery, PAF Hospital Mushaf, Sargodha, from August 2021 to December 2022 after obtaining ethical committee approval.
Methodology: A total 320 patients with cholelithiasis undergoing laparoscopic cholecystectomy were divided into two groups. In group A, the dissection of gallbladder from its bed was done with an ultrasonic device that is harmonic scalpel, while in group B, conventional monopolar electrocautery was used. Patients were assessed for gall bladder perforation. A p-value < 0.05 was considered statistically significant.
Results: Out of 320 laparoscopic cholecystectomies, gallbladder perforation occurred in 7 (4.4%) patients in Group A and 28 (17.5%) patients in Group B, a difference that was statistically significant (p < 0.001). The mean age was 29.08 ± 8.09 years in Group A and 32.49 ± 9.36 years in Group B (range 20–45 years), with no statistically significant difference between the groups (p = 0.481). The male-to-female ratio was 1:4.5 in Group A and 1:7 in Group B, with no significant difference between the groups (p = 0.792).
Conclusion: This study revealed that a significantly lower frequency of gall bladder perforation with ultrasonic dissection as compared to monopolar diathermy among patients undergoing laparoscopic cholecystectomy. This can ultimately reduce the early and long-term complications of bile spillage and stone loss in peritoneal cavity.
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