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Updated: Jun 19, 2026

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Published on: February 10, 2023

Comparative study between clipless laparoscopic cholecystectomy by harmonic scalpel versus conventional method: a

Tharwat Kandil¹, Ayman El Nakeeb, Emad El Hefnawy

¹Gastroenterology Surgical Center, Faculty of Medicine, Mansoura University, Jihan St., Mansoura, Egypt. tharwat@mans.edu.eg

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract

|November 3, 2009

Summary

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The harmonic scalpel (HS) significantly reduces operative time and postoperative pain in laparoscopic cholecystectomy compared to traditional methods. This advanced technique offers a safer, more effective approach for gallbladder removal, minimizing complications.

Area of Science:

Surgical Innovation
Minimally Invasive Surgery
Gastrointestinal Surgery

Background:

Laparoscopic cholecystectomy (LC) is a standard procedure for gallbladder removal.
Traditional methods involve clipping and diathermy for dissection.
Evaluating newer technologies like the harmonic scalpel is crucial for improving patient outcomes.

Purpose of the Study:

To compare the safety and efficacy of traditional laparoscopic cholecystectomy (LC) with LC using the harmonic scalpel (HS).
To assess intraoperative and postoperative parameters, including operative duration, pain, and complications.

Main Methods:

A comparative study involving 140 patients divided into two groups: traditional method (TM) and harmonic scalpel (HS).
Group A (70 patients) underwent LC using TM (clipping and diathermy).

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Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Published on: February 10, 2023

Group B (70 patients) underwent LC using HS for vessel and duct closure and dissection.

Main Results:

HS resulted in significantly shorter operative duration (33.21 min vs. 51.7 min) and less postoperative drainage (29 mL vs. 47.7 mL).
Gallbladder perforation incidence was significantly lower with HS (7.1% vs. 18.6%).
Postoperative pain scores (VAS) at 12 and 24 hours were significantly lower with HS, and no bile leaks occurred with HS compared to 2.9% with TM.

Conclusions:

The harmonic scalpel (HS) is a safe and effective alternative to traditional clipping for cystic duct and artery in LC.
HS offers advantages including shorter operative time, reduced gallbladder perforation, less postoperative pain, and a lower conversion rate to open surgery.