Ligating the cystic duct in laparoscopic cholecystectomy.

Background: In laparoscopic cholecystectomy, bile leak from the cystic duct stump is a recognised postoperative complication. This could be due to dislodgement of the metal clips. Migration of the clip is an added problem.

Methods: Since 1995, 70 patients were included in the study of intracorporeal cystic duct ligation in laparoscopic cholecystectomy. Construction of a ligature is a single handed procedure using a free end of the thread. It is quite different from the other two methods described in the literature.

Results: There was not a single case of postoperative morbidity in these patients, but in a retrospective study, postoperative biliary dyspepsia with fatty food was evident in a few patients among those cases in which the liga-clips were applied to the cystic duct.

Conclusions: The cystic duct ligation with absorbable thread should be a gold standard in laparoscopic cholecystectomy. It reduces the risk of postoperative morbidity.