Can cystic artery cauterization be safely practiced in laparoscopic cholecystectomy?

Abstract EN

This study aimed to evaluate the safety and efficacy of cystic artery cauterization in laparoscopic cholecystectomy (Lap.Chole.) and to outline possible complications and limitations that might arise from adoption of such approach. Cauterization of the cystic artery was adopted as the principal mean of securing the cystic artery in the course of standard lap.chole.

The technique was applied on 46 cases of laparoscopic cholecystectomy.

Patients with adhesions in the triangle of Calot and /or very short cystic arteries were excluded from the study.

All patients were followed up for 2-3 weeks. We didn't get any serious complication in form of : major bile duct injury, right hepatic artery injury, post operative hematoma. Mean operative time was 35 minutes.

Out of the 46 patients who had cystic artery cauterization we had the following complications: one patient developed intra-operative bleeding from the cystic artery in the course of its skeletonization which was controlled by prompt clipping, another patient developed rather severe bleeding from a torn cystic artery and we converted him to open cholecystectomy. Forty one patients were females (age range 18-48 years) and 5 were males (age range 33-49 years).

Complications occurred exclusively in females. Apart from conversion due to other causes, the incidence rate of conversion due to bleeding from cystic artery during clipping and cauterization was 1.5%, 2% respectively