Impact of Electrocautery on the Gall Bladder Wall While Separating it From the Liver Bed During Laparoscopic Cholecystectomy

Abstract Background: Laparoscopic cholecystectomy is the gold standard for symptomatic gallstone disease. Electrocautery is widely used for gallbladder dissection from the liver bed due to its cutting and hemostatic efficiency, but its thermal effects on the gallbladder wall remain a concern. Aim: This study aimed to evaluate the impact of electrocautery on gallbladder wall histology during laparoscopic cholecystectomy compared with scissors dissection. Materials and Methods: A hospital-based prospective comparative study was conducted on 60 patients with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy at our institute. Patients were assigned to electrocautery ( n = 30) or scissors dissection ( n = 30) groups. Intraoperative findings, postoperative outcomes, and histopathological changes in the gallbladder wall were analyzed. Statistical significance was set at a P value of < 0.05. Results: Demographics and preoperative findings were comparable between groups. Intraoperative bleeding (>20 cc), gallbladder perforation, and bile spillage rates were similar in both groups ( P > 0.05). Postoperative hospital stay was significantly shorter with scissors dissection (96.7% discharged on day 1 vs. 80% in the electrocautery group; P = 0.04). Histopathology showed significant serosal thermal changes with electrocautery (60% vs 0%; P < 0.001) and more focal neural stretching in the muscularis (50% vs 3.3%). Mucosa was largely unremarkable in both groups. Conclusion: Both techniques are safe and effective for laparoscopic cholecystectomy. Electrocautery provides reliable hemostasis but is associated with greater serosal thermal changes. Scissors dissection preserves wall integrity and may support faster recovery, making it a preferred option when minimizing thermal injury is desired.