Background: Cholecystectomy is the most common abdominal procedure performed for removal of gall bladder in cholelithiasis. Various advances have been made in the laparoscopic cholecystectomy procedures.

Objective: To compare safety and efficacy of clipless laparoscopic cholecystectomy by bipolar cautery versus traditional method using titanium clips.

Material and Methods: This was Prospective Randomized study conducted on 100 patients undergoing elective cholecystectomy. Patients were recruited with study to treat after satisfying inclusion and exclusion criteria and divided into two groups of 50 each. Both Groups undergoes elective laparoscopic cholecystectomy, in group titanium clips were used to reseal and ligate cystic duct and artery and in group B bipolar cautery was used. The preoperative, intraoperative and postoperative parameters were collected and analysed using statistical methods.

Results: The mean age in group A was 41.7±4.2 years and in group B was 41.6±4.0 years. There were 36 females in group A and 38 in group B. Duration of surgery was 30.9±7.3 and 37.0±7.5 in group A and Group B respectively. Intraoperative blood loss was 9.3±2.9 ml in group A and 6.9±1.6 ml in group B. There was significant difference between two groups in relation to duration of surgery and intraoperative blood loss. Number of clips applied varies from 45 in group A and no clip was applied in group B. Amount of post operative drainage in Group A was 22.4±13.6 ml and in group B was 3.6±3.9 ml and there was significant difference between the two. 

Conclusion: Bipolar cautery is a safe alternative to standard clips to ligate and seal cystic duct and artery. It provides less cost and amount of intraoperative blood loss is less.