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A single-institution review of the absorbable clips used in laparoscopic colorectal and gallbladder surgery: feasibility, safety, and effectiveness

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Abstract

This retrospective study was conducted to examine the safety and effectiveness of polymeric absorbable clips in laparoscopic gallbladder and colorectal surgery. The prospectively maintained database review included all patients undergoing elective laparoscopic cholecystectomy and colorectal resection at the institution between November 2004 and December 2009. In each patient, absorbable clips were used as the only system of vascular and cystic duct ligation. Of the 911 patients who satisfied the inclusion criteria, 664 underwent laparoscopic cholecystectomy and 247 underwent laparoscopic colonic resection. No intra-operative or post-operative bleeding related to absorbable clip use occurred in either procedure. No bile duct injuries or cystic duct leakages were observed. There were no peri-operative deaths with either procedure. In this experience, absorbable clips demonstrated easy handling and high reliability. They provided safe hemostasis and permitted complete and adequate oncologic resection.

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References

  1. Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev 18(4):CD006231

    Google Scholar 

  2. Schlinkert RT (1991) Laparoscopic-assisted right hemicolectomy. Dis Colon Rectum 34:1030–1031

    Article  PubMed  CAS  Google Scholar 

  3. Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350(20):2050–2059

    Article  Google Scholar 

  4. Guillou PierreJ, Quirke Philip, Thorpe Helen, Walker Joanne, Jayne DavidG, Smith AdrianMH, Heath RichardM, Brown JuliaM, for the MRC CLASICC trial group (2005) Short-term endpoints of conventional versus laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726

    Article  PubMed  Google Scholar 

  5. Lacy AM, Garcia-Valdecasas JC, Delgado S et al (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet 359:2224–2229

    Article  PubMed  Google Scholar 

  6. Hazebroek EJ (2002) COLOR: a randomized clinical trial comparing laparoscopic and open resection for colon cancer (The Color Study Group). Surg Endosc 16:949–953

    Article  PubMed  CAS  Google Scholar 

  7. Lindemann F, Geissler B, Hausser L, Witte J (1997) Laparoscopically placed clips on the human cystic duct-an experimental comparison of dislocation between resorbable and titanium clips. Chirurg 68(3):244–246

    Article  PubMed  CAS  Google Scholar 

  8. Klein RD, Jessup G, Ahari F, Connolly RJ, Schwaitzberg SD (1994) Comparison of titanium and absorbable polymeric surgical clips for use in laparoscopic cholecystectomy. Surg Endosc 8(7):753–758

    Article  PubMed  CAS  Google Scholar 

  9. Woods MS, Shellito JL, Santoscoy GS et al (1994) Cystic duct leaks in laparoscopic cholecystectomy. Am J Surg 168:560–565

    Article  PubMed  CAS  Google Scholar 

  10. Kennedy RJ, Clements WDB, Diamond T (1995) Cystic duct laceration by metallic clips: a cautionary note. Br J Surg 82:1540–1543

    Article  Google Scholar 

  11. Adams DB, Borowicz MR, Woolton FT III, Cunningham JT (1993) Bile duct complications after laparoscopic cholecystectomy. Surg Endosc 7:70–88

    Article  Google Scholar 

  12. Ng WT, Kong CK, Lee WM (1999) Migration of three endoclips following laparoscopic cholecystectomy. J R Coll Surg Edinb 44:200–202

    PubMed  CAS  Google Scholar 

  13. Cetta F, Lombardo F, Baldi C, Cariati A (1997) Clip migration within the common bile duct after laparoscopic cholecystectomy: a case of transient acute pancreatitis in the absence of associated stones. Endoscopy 29:S59

    Article  PubMed  CAS  Google Scholar 

  14. Matsuura T, Kanisawa Y, Sato T, Hirata K (1992) Migration of endoclips into common bile duct after laparoscopic cholecystectomy. Lancet 340:306

    Article  PubMed  CAS  Google Scholar 

  15. Lombardo F, Cetta F, Cappelli A (1994) The long term fate of metallic clips used for cystic duct and artery ligation during laparoscopic cholecystectomy. Gastroenterology 106:A347

    Google Scholar 

  16. Yoshizumi T, Ikeda T, Shimizu T, Ohta S, Nagata S, Sonoda T, Sugimachi K (2000) Clip migration causes choledocholithiasis after laparoscopic cholecystectomy. Surg Endosc 14(12):1188

    PubMed  CAS  Google Scholar 

  17. Herline AJ, Fisk JM, Debelak JP, Shull HJ Jr, Chapman WC (1998) Surgical clips: a cause of late recurrent gallstones. Am Surg 64(9):845–848

    PubMed  CAS  Google Scholar 

  18. Yano H, Okada K, Kinuta M, Nakano Y, Tono T, Matsui S, Iwazawa T, Kanoh T, Monden T (2003) Efficacy of absorbable clips compared with metal clips for cystic duct ligation in laparoscopic cholecystectomy. Surg Today 33(1):18–23

    Article  PubMed  Google Scholar 

  19. Saha SK (2000) Ligating the cystic duct in laparoscopic cholecystectomy. Am J Surg 179(6):494–496

    Article  PubMed  CAS  Google Scholar 

  20. Rohr S (1997) Value of absorbable clips in laparoscopic cholecystectomy. A randomized prospective study. J Chir (Paris) 134(4):180–184

    CAS  Google Scholar 

  21. Leung KL (1996) Absorbable clips for cystic duct ligation in laparoscopic cholecystectomy. Surg Endosc 10(1):49–51

    Article  PubMed  CAS  Google Scholar 

  22. Seenu V (2004) Laparascopic cholecystectomy: cystic duct occlusion with titanium clips or ligature? A prospective randomized study. Trop Gastroenterol 25(4):180–183

    PubMed  Google Scholar 

  23. Rohatgi A (2006) An audit of cystic duct closure in laparoscopic cholecystectomies. Surg Endosc 20(6):875–877

    Article  PubMed  CAS  Google Scholar 

  24. Kandil T (2010) Comparative study between clipless laparoscopic cholecystectomy by harmonic scalpel versus conventional method: a prospective randomized study. J Gastrointest Surg 14(2):323–328

    Article  PubMed  Google Scholar 

  25. Marcello PW, Roberts PL, Rusin LC, Holubkov R, Schoetz DJ (2006) Vascular pedicle ligation techniques during laparoscopic colectomy. A prospective randomized trial. Surg Endosc 20:263–269

    Article  PubMed  CAS  Google Scholar 

  26. Casillas S, Delaney CP, Senagore AJ, Brady K, Fazio VW (2004) Does conversion of a laparoscopic colectomy adversely affect patient outcome? Dis Colon Rectum 47:1680–1685

    Article  PubMed  Google Scholar 

  27. Bencini L, Boffi B, Farsi M, Sanchez LJ, Scatizzi M, Moretti R (2003) Laparoscopic cholecystectomy: retrospective comparative evaluation of titanium versus absorbable clips. J Laparoendosc Adv Surg Tech A 13(2):93–98

    Article  PubMed  Google Scholar 

  28. Bennett CL, Stryker SJ, Ferreira MR, Rosario M, Adams J, Beart R (1997) The learning curve for laparoscopic colorectal surgery: preliminary results from a prospective analysis of 1, 194 laparoscopic-assisted colectomies. Arch Surg 132:41–44

    PubMed  CAS  Google Scholar 

  29. Larach SW, Patankar SK, Ferrara A, Williamson PR, Perozo SE, Lord AS (1997) Complications of laparoscopic colorectal surgery: analysis and comparison of early vs. latter experience. Dis Colon Rectum 40:592–596

    Article  PubMed  CAS  Google Scholar 

  30. Gunatillake PA, Adhikari R (2003) Biodegradable synthetic polymers for tissue engineering. Eur Cell Mater 5:1–16

    PubMed  CAS  Google Scholar 

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Correspondence to Francesco Feroci.

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Feroci, F., Lenzi, E., Kröning, K.C. et al. A single-institution review of the absorbable clips used in laparoscopic colorectal and gallbladder surgery: feasibility, safety, and effectiveness. Updates Surg 63, 103–107 (2011). https://doi.org/10.1007/s13304-011-0059-6

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  • DOI: https://doi.org/10.1007/s13304-011-0059-6

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