ASSOCIATION OF IATROGENIC GALL BLADDER PERFORATION IN LAPAROSCOPIC CHOLECYSTECTOMY WITH HARMONIC SCALPEL AND ELECTROSURGICAL CAUTERY

Laparoscopic Cholecystectomy

Abstract

Objective: To compare the operative time and incidence of iatrogenic gallbladder perforation in laparoscopic cholecystectomies while using harmonic scalpel and electrosurgical cautery hook to raise the gall bladder from its bed, in all age groups in both genders.
Study Design: Randomized controlled trial.
Place and Duration of Study: Combined Military Hospital Rawalpindi, Six months with effect from Feb 2008.
Patients and Methods: Patients undergoing elective laparoscopic cholecystectomy meeting the inclusion criteria were included in the study, after taking written informed consent and approval of ethics committee. They were divided into two groups “A" and "B" of fifty five each. In Group "A", patients underwent laparoscopic cholecystectomies by using harmonic scalpel for dissection of gallbladder from its bed. In Group "B", patients underwent laparoscopic cholecystectomy by using electrosurgical cautery for dissection of gallbladder from its bed.
Results: There is an increased risk of iatrogenic gallbladder perforation, and an increased operative time in laparoscopic cholecystectomies by using electrosurgical cautery as compared to harmonic scalpel.
Conclusion: Use of harmonic scalpel is more feasible and safe in laparoscopic cholecystectomies for avoiding iatrogenic gallbladder perforation and to complete the procedure in lesser time.