IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-8-4-18879 Original Research Paper A Comparative Study Between Clip Less Laparoscopic Cholecystectomy And Conventional Titanium Clip Laparoscopic Cholecystectomy Vijay Kumar Gupta Dr. April 2019 8 4 01 02 ABSTRACT

Introduction: To study safety and efficacy of ultrasonic scalpel in closure and division of the cystic duct and artery, and gallbladder dissection in laparoscopic cholecystectomy as a single working instrument compared to conventional technique using titanium clips and electro–cautery. Method: This study included 50 patients with symptomatic gallstone disease were randomly assigned for laparoscopic cholecystectomy by either ultrasonic shear ( Study Group = 25 patients), and titanium clip and electro–cautery (Control Group=25 patients). Results: The mean operative time was significantly shorter in study group as compare to control group ( p value =0.002), and postoperative pain scores (VAS) were significantly shorter (p value = 0.001) in first 24 hours but no significant difference was found in the incidence of intra–operative & post–operative complications. Conclusion: Ultrasonic shear is as safe and effective as clip and electro–cautery technique in achieving hemobiliary stasis, with shorter operative time with decreased pain, especially if used as a sole working instrument.