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Isolation and Clipping of Cystic Artery outside Versus inside Calot?s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy

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Background: Laparoscopic cholecystectomy (LC) is the “Gold Standard“ for the treatment of cholelithiasis and acute cholecystitis, and is the commonest operation performed laparoscopically worldwide. In spite of this fact ,… Click to show full abstract

Background: Laparoscopic cholecystectomy (LC) is the “Gold Standard“ for the treatment of cholelithiasis and acute cholecystitis, and is the commonest operation performed laparoscopically worldwide. In spite of this fact , still the most serious complications like extrahepatic bile duct injury (BDI) & vascular injury, are more common in LC than OC(open cholecystectomy).Objectives: to compare between the isolation & clipping of cystic artery outside & inside Calot’s triangle in regard of minimizing the intraoperative complications in LC. Patients and methods: This is a prospective( therapeutic controlled trial ) study of 508 patients with symptomatic gallstones (456/508=90% females & 52/508=10% males) who were admitted to Al-Diwaniya teaching hospital to undergo LC from April 2015 to April 2018.Group–A-: consists of 272 patients (246/272=90.4% F & 26/272=9.6% M) selected to undergo a LC with standard conventional technique of dissection of cystic pedicle. Group –B-: consists of 236 patients (210/236=89% F & 26/236=11% M) selected to undergo LC with isolation & clipping of cystic artery outside the Calot’s triangle. Results: Cystic artery injury: In group-A-(29/272=10.7%) vs (8/236=3.4%) in group–B-. The control of bleeding in group-A-(34%=10/29) vs (100%=8/8) in group-B. Clipping was used to control bleeding in group-A-(5/29=17%) vs (8/8=100%) in group-B-, while electrocoagulation used in group-A-(5/29=17%) vs (0/8=0%) in group-B-. The conversion done in group-A- in (19/272=7%) vs (0/8=0%) group-B- A sizable posterior branch was identified in group-A-(6/272=2.2%) vs (62/236=26.3%) in group–B-.In group–A- the clear identification of the anatomy achieved in (202/272=74%) vs (236/236=100%) in group-B-. The conversion rate due to poor identification of the anatomy or complex anomalies in group-A-(4.4%=12/272) vs (0%) in group-B-.Conversion from LC to OC: The total conversion rate in group–A-(36/272=13.24%) vs (0%) in group-B-.. No mortality reported in our study. Conclusion: This technique significantly minimizes the overall conversion rate in LC.   How to Cite this Article Pubmed Style Adel Mosa Al-Rekabi. Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy. SRP. 2020; 11(10): 123-127. doi:10.31838/srp.2020.10.21 Web Style Adel Mosa Al-Rekabi. Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy. http://www.sysrevpharm.org/?mno=10512 [Access: March 29, 2021]. doi:10.31838/srp.2020.10.21 AMA (American Medical Association) Style Adel Mosa Al-Rekabi. Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy. SRP. 2020; 11(10): 123-127. doi:10.31838/srp.2020.10.21 Vancouver/ICMJE Style Adel Mosa Al-Rekabi. Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy. SRP. (2020), [cited March 29, 2021]; 11(10): 123-127. doi:10.31838/srp.2020.10.21 Harvard Style Adel Mosa Al-Rekabi (2020) Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy. SRP, 11 (10), 123-127. doi:10.31838/srp.2020.10.21 Turabian Style Adel Mosa Al-Rekabi. 2020. Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy. Systematic Reviews in Pharmacy, 11 (10), 123-127. doi:10.31838/srp.2020.10.21 Chicago Style Adel Mosa Al-Rekabi. "Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy." Systematic Reviews in Pharmacy 11 (2020), 123-127. doi:10.31838/srp.2020.10.21 MLA (The Modern Language Association) Style Adel Mosa Al-Rekabi. "Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy." Systematic Reviews in Pharmacy 11.10 (2020), 123-127. Print. doi:10.31838/srp.2020.10.21 APA (American Psychological Association) Style Adel Mosa Al-Rekabi (2020) Isolation & Clipping of Cystic Artery outside Versus inside Calot’s Triangle Minimizes the Intraoperative Complications in Laparoscopic Cholecystectomy. Systematic Reviews in Pharmacy, 11 (10), 123-127. doi:10.31838/srp.2020.10.21

Keywords: isolation clipping; cystic artery; artery outside; calot triangle; group; clipping cystic

Journal Title: Systematic Reviews in Pharmacy
Year Published: 2020

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