Clinical Studies of Laparoscopic Cholecystectomy with Absorbable Surgical Ligating Clips -Compared with Metal Clips-

Kazuyuki Okada, Takeshi Tono, Hiroshi Yano, Shoichiro Fujita, Toshiyuki Kano, Takashi Iwazawa, Shigeo Matsui, Yoshiaki Nakano, Masakatsu Kinuta and Takushi Monden

Department of Surgery, NTT West Osaka Hospital

Recent reports of choledocholithiasis related to migrated metal clips (MCs) following laparoscopic cholecystectomy (LC) have warned physicians to consider the benefits of absorbable surgical ligating clips (ACs). We evaluated the efficacy of ACs in LC at our facility. We analyzed 304 cases of LC in the last 3 years. The clinical outcome of 209 patients receiving ACs was compared to that of 72 receiving MCs. We also studied details in 23 patients suffering complications due to ACs. No significant difference was seen in disease classification, intraoperative blood loss, operating time, or hospitalization between groups. The number of clips used on the cystic duct and cystic artery in the ACs group was significantly lower than that in the MCs group, and the ACs group suffered fewer complications. We could not use ACs in 23 cases because the exposed cystic duct or cystic artery waas not long enough. ACs seem superior in holding strength and in their shorter existence in the abdominal cavity as a froeign body. The ACs is laterally longer than the MCs, and ligation is somewhat complicated, making difficult to use ACs in cases with short cystic duct or cystic arter exposure. In most patients, we used ACs safely and easily, and clinical outcomes were very satisfactory. The ACs is beneficial because it preventis late postoperative complications related to remaining clips.

Key words
laparoscopic cholecystectomy, absorbable clip, metal clip

Reprint requests
Kazuyuki Okada Department of surgery, NTT west Osaka Hospital 2-6-40 Karasugatsuji, Tennoji-ku, Osaka, 543-8922 JAPAN

Accepted
May 29, 2002

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