Evaluation of Clipping Versus Bipolar Electrocautery of Cystic Artery in Laparoscopic Cholecystectomy

Background: The widespread use of surgical clips in laparoscopic cholecystectomy has been associated with various complications, including clip slippage, dislodgement, migration, ulceration, and necrosis of the cystic duct, which may lead to bile leakage. In response to these risks, clipless laparoscopic techniques, particularly the use of electrocautery, have been explored. While both monopolar and bipolar diathermy are used for tissue cauterization, monopolar systems pose a higher risk of lateral thermal injury to surrounding structures such as the common bile duct, hepatic artery, and bowel. Bipolar electrocautery, although safer, is not without drawbacks, including smoke generation that may hinder visualization during surgery.Aim: This study aimed to evaluate the efficacy and safety of bipolar electrocautery for controlling the cystic artery during laparoscopic cholecystectomy, and to determine whether it is a suitable alternative to conventional clip application.Methods: A prospective study was conducted on 100 patients undergoing laparoscopic cholecystectomy, who were divided into two groups of 50. Group A underwent surgery with clip application to control the cystic artery, while group B used bipolar electrocautery. Postoperative outcomes were assessed over a two-week follow-up period.Results: Mean operative times were 35.19 minutes in group A and 34.18 minutes in group B. Median ages were comparable between groups. One case of intraoperative bleeding occurred in group B and was successfully managed. No major complications or postoperative bleeding were noted in either group.Conclusion: Bipolar electrocautery is a safe and effective alternative to surgical clips for cystic artery control in laparoscopic cholecystectomy.