An experience with 1000 consecutive cystic duct ligation in laparoscopic cholecystectomy

Although rare, the clips are known to slip, dislodge, ulcerate, migrate, internalize, embolize, and give rise to necrosis of the cystic duct with resultant bile leak and other complications. Ligation of cystic duct has been practiced since long time with several modifications of intracorporeal and extracorporeal techniques. We have used a standard 'C' technique of intracorporeal knotting of cystic duct in 1000 consecutive patients of laparoscopic cholecystectomy. There was no case of bile leak in cystic duct ligation and no other related complications. The mean time taken for the cystic duct ligation was 3.5 minutes. This technique of total intracorporeal cystic duct and artery ligation in laparoscopic cholecystectomy is simple, secure, and economical.