Laparoscopic Cholecystectomy Using Harmonic Scalpel Versus Conventional Laparoscopic Cholecystectomy

Background: laparoscopic cholecystectomy is the worldwide gold standard treatment of symptomatic 
gallbladder lithiasis. During the conventional LC, we used usually clips for closure of cystic duct and 
artery and dissector, electrosurgical hook, spatula and/or scissor for dissection of cystic duct and 
artery and sealing of gall bladder from liver bed. Now, single instrument called harmonic scalpel is 
introduced as a potential replacement for all of these instruments. Objective: To evaluate the safety, 
efficacy and clinical outcome of LC using harmonic scalpel compared with conventional LC. Patients 
and Methods: Our prospective randomized study was carried out during the period from February 2018 to 
August 2018 at Azhar Assuit University Hospital, and included 60 adult patients presented with chronic 
calcular cholecystitis divided randomly into 2 groups. All patients of both groups were signed the informed 
consent and assessed preoperative (history, clinical examination, CBC, LFTs, RFTs, virology and Pelviabdominal ultrasound), intraoperative (time, incidence of gall bladder perforation, bleeding and conversion 
to open procedure) and postoperative (pain, analgesia, drain, bile leakage, hospital stay and wound 
infection). Results: No statistically significant difference was found age, sex, BMI and associated 
diseases between both groups but there is significant difference in operative time, incidence of gall 
bladder perforation, blood loss, postoperative pain, drain and hospital stay. No significant difference 
in wound infection. No incidence of bile leakage or conversion to open procedure in both groups.
Conclusion: Harmonic scalpel in general is an efficient tool for complete hemobiliary sealing with 
high safety profile.