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167916

Ligation versus Clipping of the Appendicular Stump in Laparoscopic Appendectomy

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Last updated: 22 Jan 2023

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Abstract

Abstract Background: Appendectomy is the most common surgical procedure performed in general surgery. For almost a century, open appendectomy, first described by Charles McBurney in 1889, has remained the gold standard treatment for acute appendicitis. The introduction of laparoscopic surgery has dramatically changed the field of surgery and laparoscopic surgery has been widely used as a minimally invasive surgery. Aim of Study: Comparative evaluation of intra-corporeal ligation versus titanium clip application as methods of securing the appendicular stump. As regard safety, simplicity, compe-tence, surgical technique, operative time, hospital stay and post-operative morbidity. Patients and Methods: This study was conducted to evaluate the results of the Intracorporeal ligation versus Titanium clips application in securing the appendicular stump in regarding operative time, operative findings, post-operative complications, hospital stay and return of the patients to their normal daily activities. Results: The overall post-operative complications were different in the 2 group. The incidence of wound infection was less in clips group (0% versus 10%). The mean hospital stay was shorter in clips group patients than ligation group patients (13.45 versus 18.95 hours). The mean time to return to normal activities was shorter in titanium clips patients (5.45 days versus 6.30 days). The use of laparoscope in suspected appendicitis is better than the open method especially in equivocal cases to reach an exact diagnosis. We must not hesitate to convert laparoscopic appendectomy to open appen-dectomy for the sake and safety of the patient. Conclusion: Both methods of intracorporeal ligation and clip application are cost effective in securing the appendicular stump. Titanium clip application is more easy to the surgeon, more time saving during the operation and less post-operative stay in the hospital. The only limitation of the clip application is the wider diameter of the base of the appendix beyond the large titanium clip in these cases intra-corporeal ligation is a safe and cheap alternative.

DOI

10.21608/mjcu.2021.167916

Keywords

Laparoscopic appendectomy, ulcerative colitis, ligation, clipping

Authors

First Name

AHMED A. DARWISH, M.D.;

Last Name

IBRAHIM M. ABDEL MAKSOUD, M.D.

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First Name

MOHAMED S.F.

Last Name

ZAEMA, M.Sc.

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Affiliation

The Department of General Surgery, Faculty of Medicine, Ain Shams University

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Volume

89

Article Issue

June

Related Issue

22430

Issue Date

2021-06-01

Receive Date

2021-01-30

Publish Date

2021-06-01

Page Start

715

Page End

722

Print ISSN

0045-3803

Online ISSN

2536-9806

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https://mjcu.journals.ekb.eg/article_167916.html

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https://mjcu.journals.ekb.eg/service?article_code=167916

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32

Publication Type

Journal

Publication Title

The Medical Journal of Cairo University

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https://mjcu.journals.ekb.eg/

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Article

Created At

22 Jan 2023