Downloads: 2
Comparative Study | General Surgery | Volume 15 Issue 5, May 2026 | Pages: 1105 - 1109 | India
A Comparative Study on Knotting vs Clip Ligation of Cystic Duct in Laparoscopic Cholecystectomy
Abstract: Introduction: Laparoscopic cholecystectomy requires secure cystic duct closure to prevent bile leak. Metallic clips are standard but associated with slippage and migration, prompting interest in suture knotting. This study compares knotting versus clip ligation regarding safety, bile leak, operative time, feasibility, cost, and outcomes. Aim and objective: The aim is to identify a reliable, context-appropriate technique to optimize patient safety and surgical results across diverse clinical settings worldwide. To compare knotting versus clip ligation of the cystic duct in laparoscopic cholecystectomy regarding complications, cost, recovery, outcomes. Methodology: This was a prospective study carried out in tertiary health centre from February 2024 to January 2026 in 70 patients after taking an informed and written consent of patient having cholelithiasis. patients undergoing laparoscopic cholecystectomy were evaluated clinically and investigated. Standard four-port laparoscopic technique under general anaesthesia was used. Following Calot?s triangle dissection, patients were divided into two groups: Group A underwent intracorporeal cystic duct knotting, while Group B received titanium clip ligation. Result: Gallbladder removal, haemostasis, and standardized closure were performed in all cases. Both groups were comparable demographically and clinically. Knotting significantly reduced intraoperative bile spillage, wound infection, hospital stay, costs, and overall complications, despite longer operative time. Clip ligation showed higher intra- and postoperative complication rates. Multivariate analysis confirmed clip use and increasing age as independent predictors of postoperative complications. Conclusion: Intracorporeal knotting of the cystic duct is safer and more cost-effective than clip ligation, with fewer complications and shorter hospital stay, despite longer operative time.
Keywords: Laparoscopic, Cystic duct, Bile leak, Metallic clips, Knotting
How to Cite?: Dr. Md Saquib Khan, Dr. Amit Agarwal, Dr. Shashank Mishra, "A Comparative Study on Knotting vs Clip Ligation of Cystic Duct in Laparoscopic Cholecystectomy", Volume 15 Issue 5, May 2026, International Journal of Science and Research (IJSR), Pages: 1105-1109, https://www.ijsr.net/getabstract.php?paperid=MR26518230054, DOI: https://dx.dx.doi.org/10.21275/MR26518230054