الفهرس | Only 14 pages are availabe for public view |
Abstract The present study was carried out on 60 patients admitted with symptomatic gall bladder stones with sonographic diagnosed chronic calcular cholecystitis. They were divided into 2 group s. group A (30 patients) for those patients laparoscopic cholecystectomy was done using harmonic scalpel as the sole instrument for dissection after application of safety metallic clip on the bile duct due to defective imaging studies that are able to detect cystic duct diameter preoperatively. group B (30 patients) for these patients laparoscopic cholecystectomy was done with electrocautery and hemostatic clips. On follow-up (6-month maximum), none of the study patients suffered from postoperative biliary stricture as determined by ultrasound scan. In this study no mortality occurred. The main disadvantage of ultrasonic dissection is instrument cost which is particularly high if the surgical unit is equipped with reusable instruments. Nevertheless, some authors believe that compared with combined cost of using multiple disposable instruments (scissors, a clipper, an electrocautery hook and a grasper). |