LAPAROSCOPIC CHOLECYSTECTOMY: MODERN METHODS OF CYSTIC DUCT CLOSURE AND THEIR IMPACT ON COMPLICATIONS
Keywords:
The analysis demonstrated that modern methods based on energy-driven vessel-sealing devices significantly reduce operative time; however, they may carry higher risks of specific complications and present certain technical limitations. In contrast, the ligation method (suturing) demonstrates a lower complication rate and high cost-effectiveness, although it demands advanced manual dexterity and specific surgical skills.Abstract
In recent years, laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder diseases. However, literature analysis indicates that the risk of complications, particularly bile leakage, remains significant.
This study analyzed scientific literature, including original articles, systemic reviews, and meta-analyses, focusing on cystic duct management techniques during LC. Particular attention was paid to comparing modern methods, such as vessel-sealing devices, with traditional ligation and clipping techniques.
References
1. Arezzo A, Bullano A, Cirocchi R, et al. Methods of cystic duct stump closure during laparoscopic cholecystectomy: A systematic review and meta-analysis. Surgical Endoscopy. 2022;36(11):7915-7928. doi:10.1007/s00464-022-09458-z
2. Yusupov BN, Akhmedov AT. Reducing bile leakage risks in laparoscopic cholecystectomy: An evaluation of modern sealing devices. Central Asian Journal of Surgery. 2024;3(1):22-29.
3. Guru AS, Jaiswal A, Singh S. Comparison of extra-corporeal knotting and clipping for cystic duct ligation in laparoscopic cholecystectomy: A prospective randomized study. International Journal of Surgery. 2021;9(2):104-110.
4. Bencini L, Bernini M, Farsi M. Vessel-sealing devices in laparoscopic cholecystectomy: Are they really safe for the cystic duct? Journal of Gastrointestinal Surgery. 2023;27(4):645-652. doi:10.1016/j.gassur.2022.12.008.
5. Kravchenko AY, Fedorov IV. Intraoperative complications of laparoscopic cholecystectomy: Analysis of technical errors. Endoscopic Surgery (Russia). 2020;26(3):45-51.
6. Gallagher TK, Mansour S, Jarrett P. Total laparoscopic cholecystectomy: A 10-year review of bile duct injury and the "critical view of safety". Annals of the Royal College of Surgeons of England. 2021;103(5):341-346.
7. El Nakeeb A, Ezzat H, Askar W, et al. Harmonic Scalpel versus clipping in laparoscopic cholecystectomy: A randomized controlled trial. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2020;30(3):235-241. doi:10.1097/SLE.0000000000000782.
8. Siddiqui MT, Ahmad I, Khan MA. Suture ligation of the cystic duct in laparoscopic cholecystectomy: An economical and safe alternative to metallic clips. Journal of Ayub Medical College Abbottabad. 2019;31(4):512-515.
9. European Association for Endoscopic Surgery (EAES). Clinical practice guidelines on the management of gallstone disease. Surgical Endoscopy. 2023;37(10):7421-7440.
10. Zokirov NS, Tursunov BS. Modern aspects of minimally invasive surgery in Uzbekistan: A review. Samarkand Medical Review. 2025;2(1):15-20.
