RESUMO
Background:Laparoscopic cholecystectomy (LC) is acceptedas the gold standart treatment of gallstones. Various methodshave been developed to close the cystic duct (CD) and cysticartery (CA), but titanium clip application is currently themost frequently used technique. High-tech electrosurgicalinstruments, such as Harmonic Scalpel (HS), have been usedboth for dissection of the cystic artery and Cystic duct. Thepresent study was conducted to observe and establish efficacyof clipless cholecystectomy, by use of harmonic scalpel as analternative, for division and sealing of cystic artery and cysticduct.Methods: This study was a hospital based, retrospectivestudy, conducted in Govt. Medical College, Srinagar, usingmedical records. A total of 114 patients included in the study,having been operated by a single surgeon over time period of5 years from February 2014 to january 2019.Results: In our study of 114 patients 82 (71.92%) werefemales and 32 (28.07%) were males with average age of41.4years (16-72 yr). No patient was converted to open withaverage operating time of 24.2 minutes (18-46 minutes). Meanhospital study was 1.42 days (1-8 days) with no mortality.Postoperative complications were found in 6 (5.2%) patientswith bile leak from duct of Lushka in 1 (0.8%) patient, portsite infection in 2 (1.7%) patients and fever in 3 (2.6%)patients.Gallbladder perforation intraoperatively was seen in7 (6.2%) patients.Conclusions:Use of harmonic scalpel is an excellent optionfor the cystic duct closure with less time consumption and lesscomplications