RESUMO
Objective: to determine the efficacy of ultrasound shear in laparoscopic cholecystectomy in terms of total operative time, postoperative bile leaks, gall bladder perforation rate, and postoperative bleeding from cystic artery and collateral injury to bowel and duodenum
Study Design: comparative study
Place and Duration of Study: Mayo Hospital, Lahore, from June 2013 to May 2014
Methodology: 150 cases [75 in each group] were randomized into two groups, i.e. harmonic scalpel clipless group [HSG] versus conventional laparoscopic cholecystectomy [CLC] with electrocautery group. The above stated variables were documented. The data for age, blood loss, and drain output were positively skewed as calculated using the Shapiro-Wilk test. The histograms, Q-Q plots and box plots were analyzed for all the dependent variables. Skewed qualitative continuous data was analyzed using the Mann-Whitney U-Test
Results: operative time was significantly lower in HSG as compared to CLC. Median operative times were 30 minutes [IQR 10] versus 35 minutes [IQR 10] [p<0.001]. HSG group had perforation rate of 5/75 [6.67%] as compated to 16/75 [21.33%] in CLC [p=0.010]. Intraoperative blood loss in group A was significantly lower than in group B [p=0.001]. Postoperative median pain score was 3 [IQR 2] versus 3 [IQR 3] in HSG versus CLC, respectively
Conclusion: all the primary outcomes showed improved results in the ultrasound shear group as compared to the group for conventional electrocautery