Laparoscopic Appendectomy with Clipping versus Intra-Corporeal Ligation for Securing the Appendiceal Stump
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 2, Pages 2539-2547
AbstractBackground: Various techniques have been used for securing the appendicular stump, some of which is expensive as endoscopic linear cutting stapler (7,8); others are not available in some hospitals as preformed suture loops (endoloops).We raise the question of safety and effectiveness of securing the appendicular stump by clipping versus intra-corporeal ligation in laparoscopic appendectomy to patients with acute appendicitis.
Aim: We compare between clipping versus intra-corporeal ligation of appendiceal stump regarding safety, timing of operation and difficulty.
Patients and Methods: Forty patients presented with acute appendicitis at Damanhour Teaching Hospitaland Theodor Bilhariz Research Institute (TBRI), the diagnosis was based on clinical diagnosis,laboratory and ultrasonographic findings. They were divided randomly into two groups: Group I: Metal Clip group (MC Group), and Group II: Intra-corporeal ligation group (ICL Group).
Results: There was no statistically significant difference between patients of both groups as regarding age or gender while group II were significantly higher in operative duration. Group I is higher in the rate of conversion to open and post-operative complications. there have been no statistically significant differences regarding hospital stay.
Conclusion: The two techniques of clip application and ligature are effective in securing the appendicular stump in laparoscopic appendectomy. With increasing the skills of ligation we prefer ligation over clipping especially with large, hard and friable appendiceal stump.
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