Comparison of Single Clip Laparoscopic Cholecystectomy (SCLC) and Two Clip Laparoscopic Cholecystectomy (TCLC): A randomized control study

Abstract

<jats:p>Background: Advanced energy sources, such as the harmonic scalpel,
though expensive, may provide the advantage of shorter operating time by
reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from
the cystic artery due to secure vessel sealing, and avoiding the use of a larger
number of titanium clips. This study was undertaken to compare the advantages of
Single clip laparoscopic cholecystectomy (SCLC) and Two Clip Laparoscopic
Cholecystectomy (TCLC). Material and Methods: This prospective randomized
study was conducted in the Department of Surgery IGMC, Shimla over a period
of 1 year starting from 1st july 2019 to 30th june 2020. In this study 100
consecutive patients of symptomatic cholelithiasis confirmed by USG reporting
were participated and randomized into 2 groups of 50 each. Group 1 patients
underwent SCLC and Group 2 patients underwent TCLC. Outcomes were
measured in terms of operative time, intra operative stone spillage, intra operative
blood loss, amount of CO2 used , post operative pain , conversion into open
cholecystectomy and post operative complications. Results: Among the total 100
patients, 24 were males and 76 were females. Among them, 10 males and 40
females underwent single clip laparoscopic cholecystectomy (SCLC) while 14
males and 36 females underwent Two Clips laparoscopic cholecystectomy
(TCLC). Mean age of males were 48.50 ± 14.49 and females were 46.73 ± 16.16
in SCLC group while mean age of males were 45.36 ± 14.53 and females were
45.25 ± 15.97 in two clips laparoscopic cholecystectomy group. Present study
showed that there was more Operative Time, more Mean CO2 used, more
Approx. Blood Loss, more Intra Op. Stone spillage and more Use of Drain but less
Average pain score at 6 and 24 hours and less Average Length of hospital stay in
DCLC group as compared to SCLC group but this difference was not statistically
significant. Similarly in both group equal number of patients Convered to Open
Cholecystectomy and there was no Post op. Complications in both groups.
Conclusion: Study concluded that there was no statistically significant difference
among both SCLC and DCLC groups in terms of operative time , intra operative
stone spillage , Use of Drain, intra operative blood loss , amount of CO2 used ,
post operative pain, Conversion to Open Cholecystectomy and post operative
complications.</jats:p>