Day-care laparoscopic cholecystectomy with diathermy hook versus fundus-first ultrasonic dissection : a randomized study

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http://hdl.handle.net/10138/225349

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Mattila , A , Mrena , J , Kautiainen , H , Nevantaus , J & Kellokumpu , I 2016 , ' Day-care laparoscopic cholecystectomy with diathermy hook versus fundus-first ultrasonic dissection : a randomized study ' , Surgical Endoscopy , vol. 30 , no. 9 , pp. 3867-3872 . https://doi.org/10.1007/s00464-015-4691-y

Title: Day-care laparoscopic cholecystectomy with diathermy hook versus fundus-first ultrasonic dissection : a randomized study
Author: Mattila, Anne; Mrena, Johanna; Kautiainen, Hannu; Nevantaus, Juha; Kellokumpu, Ilmo
Contributor: University of Helsinki, Department of General Practice and Primary Health Care
Date: 2016-09
Language: eng
Number of pages: 6
Belongs to series: Surgical Endoscopy
ISSN: 0930-2794
URI: http://hdl.handle.net/10138/225349
Abstract: To examine the impact of day-care laparoscopic cholecystectomy (LC) with ultrasonic scissors dissection versus diathermy hook dissection method in a randomized setting. From April 2012 to September 2014, a total of 169 elective day-care patients were randomized to undergo either laparoscopic cholecystectomy with ultrasonic scissors using fundus-first approach (n = 88) or diathermy hook dissection starting from the triangle of Calot (n = 79). Main measures of outcome were operative time, same-day discharge and intraoperative complications. Secondary outcome measures were postoperative pain (numeric rating scale), postoperative nausea and vomiting (PONV), readmissions and 30-day morbidity. Median operative time was similar in the ultrasonic dissection and diathermy hook dissection groups (45 vs 45 min, p = 0.95). Same-day discharge was possible in 77 patients (87 %) in the ultrasonic dissection group and in 69 patients (87 %) in the diathermy group, p = 0.98. Intraoperative gallbladder perforations, mean intraoperative bleeding, postoperative pain and PONV at 1, 2 and 4 h (p = 0.78) did not differ significantly between the study groups. Day-care LC using either diathermy hook or ultrasonic dissection resulted in excellent same-day discharge in both groups (87 %). LC with ultrasonic dissection does not offer any clinical advantages compared to diathermy dissection.
Subject: Laparoscopy
Day surgery
Cholecystectomy
Ultrasonic dissection
BILE-DUCT INJURY
CLINICAL-TRIAL
ELECTROCAUTERY
GALLBLADDER
PERFORATION
REGISTRY
STAY
3126 Surgery, anesthesiology, intensive care, radiology
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