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01-11-2014

Outcomes of laparoscopic cholecystectomy done with surgical energy versus done without surgical energy: a prospective-randomized control study

Authors: Brij B. Agarwal, Nayan Agarwal, Krishna A. Agarwal, Karan Goyal, Juhil D. Nanvati, Kumar Manish, Himanshu Pandey, Shruti Sharma, Kamran Ali, Sheikh T. Mustafa, Manish K. Gupta, Satish Saluja, Sneh Agarwal

Published in: Surgical Endoscopy | Issue 11/2014

Abstract

Objective

Laparoscopic cholecystectomy (LC), a gold standard procedure can be done without energized dissection (ED). We did a randomized study for the outcomes of LC done with ED or without ED, i.e., with cold dissection (CD).

Methods and Procedures

At a tertiary level institution, open-ended prospective-randomized control study was conducted between September 2008 and June 2013. Consecutive, unselected, consenting candidates for LC were enrolled following standard ethics, informed consent, anesthesia, and clinical pathway protocol. They were allocated to control group (LC with ED) or study group (LC with CD, as per our published technique with the option for rescue ED). The study points were based upon Clavien–Dindo grading of postoperative complications. They were either, peri-operative events potentially affecting, hospital stay (Grade I) or Grade II–V, e.g., peri-operative hemodynamic instability, needing intervention/blood transfusion, injury to biliary ducts/hollow viscous, postoperative biliary leak, postoperative re-intervention, re-hospitalization, mortality, and any adverse event during a 90-day follow-up period. The data were prospectively collected in an integrated “hospital information system” that could be retrieved only by independent external coordinators.

Results

Demographics, co-morbidities, and gallbladder inflammation profile of the control group (n = 361) and study group (n = 384) were comparable. There was no rescue ED usage in the study group. Hospital stay (Grade I adverse outcome dependent) was longer, i.e., 1.6 ± 1.03 in the control versus 1.35 ± 1.2 days in the study group (p < 0.001). Grade II–IV complications were significantly more (p < 0.009) in control group. There was one common bile duct (CBD) injury in each group. The index bilio-enteric anastomosis for CBD injury in control group failed and needed a revision with multiple interventions. There was one grade V adverse outcome, i.e., mortality in the control group.

Conclusion

Avoiding the use of ED in LC is associated with better outcomes.

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Title: Outcomes of laparoscopic cholecystectomy done with surgical energy versus done without surgical energy: a prospective-randomized control study
Authors: Brij B. Agarwal
Nayan Agarwal
Krishna A. Agarwal
Karan Goyal
Juhil D. Nanvati
Kumar Manish
Himanshu Pandey
Shruti Sharma
Kamran Ali
Sheikh T. Mustafa
Manish K. Gupta
Satish Saluja
Sneh Agarwal
Publication date: 01-11-2014
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 11/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3579-6

2024 ASCO Annual Meeting

Springer Medicine

Outcomes of laparoscopic cholecystectomy done with surgical energy versus done without surgical energy: a prospective-randomized control study

Abstract

Objective

Methods and Procedures

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objective

Methods and Procedures

Results

Conclusion

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