Abstract

The gold standard treatment for symptomatic gallstone disease is laparoscopic cholecystectomy. Common gallbladder dissection methods include monopolar electrocautery and ultrasonic harmonic scalpel. Aim: To compare harmonic scalpel and monopolar electrocautery for gallbladder dissection in laparoscopic cholecystectomy. Settings and Design: A prospective observational study was conducted at a tertiary care teaching hospital. Materials and Methods: This study comprised 120 laparoscopic cholecystectomy patients. Electrocautery (EC, n=60) and harmonic scalpel (HS, n=60) groups were evenly assigned. Demographics, operative length, intra-operative bleeding, complications, post-operative pain, nausea, and vomiting were documented and analysed. Statistical Analysis Used: Independent Student’s t-test, Chi-square and Mann– Whitney U test were used, with p <0.05 considered significant. Results: Both groups had similar demographics. The HS group had a considerably longer mean operational time (58.38 ± 4.43 minutes) compared to the EC group (45.31 ± 2.84 minutes, p < 0.001). The HS group had considerably decreased intraoperative bleeding (p < 0.001) and post- operative pain severity (p = 0.006). The EC group had greater intra-operative complications such gallbladder perforation and liver damage. No common bile duct injury was found in either group. Conclusion: The harmonic scalpel is a safe and effective alternative to electrocautery in laparoscopic cholecystectomy, with less bleeding, complications, and postoperative pain but a lengthier procedure.

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