A Study of Laparoscopic Cholecystectomy in Haryana

There is no doubt that laparoscopic cholecystectomy (LC) has become the gold standard for the management of symptomatic gallstones disease. There are many techniques of cystic artery and duct ligation, the standard method being application of clips but there are still many complications due to failure of this ligation. With the view to avoid these complications and to make LC cost effective, the present study of intracorporeal ligation of cystic artery and duct (ILAD) with 1–0 free silk suture was taken up.

In this retrospective study, 80 patients of symptomatic gallstone disease during January 2013-December 2013 were taken up. Laparoscopic cholecystectomy (LC) with ILAD technique was performed in all these patients by a single laparoscopic surgeon (the author). The following parameters were analyzed: age, sex, weight, underlying diseases, previous surgery, diagnosis, anatomy of hepatobiliary system, operation time, length of stay (LOS), the numbers of intracorporeal knots,time taken for each knot and complications.

LC was successfully performed in all 80 patients without any conversion to open. The most common diagnosis was symptomatic gallstones without cholecystitis (42.5%). The average operative time was 44 minutes (32–58.5). The average LOS was 2 days and the average number of intracorporeal knots was 3 for each patient. There were 7 patients who had complications in which the most common was bleeding which was well controlled. There was no common biliary duct injury and mortality.

The intracorporeal ligation of the cystic artery and duct (ILAD) during LC is feasible, practical, safe and very economical technique. It can manage all kinds of cystic ducts. It should be mastered by surgeons willing to perform more advanced and complex laparoscopic procedures.