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Intracorporeal vicryl ligatures reduces cost in some countries.
MedLine Citation:
PMID:  19861785     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Financial constraints and pressing priorities are major problems that delay implementation of laparoscopic cholecystectomy (LC) in some countries. This raised the need for improvisation and innovation [1],[2] . Endoclips are not available in some local markets. They cost $50 for a single set of six clips to import, in contrast to 2/0 polyglacin (Vicryl-Ethicon), which is available at a rate of $1.5 for one thread. Objective of the study: To compare the safety and cost between vicryl ligature and endoclips. Patients and Method: To secure the cystic duct, intracorporeal vicryl ligature (IVL) was applied in 64 LCs. These were divided into 32 patients presented with cystic duct, which was too wide to controlled with endoclips (group A) and 32 patients with normal diameter of cystic duct as controls (group B). Also we describe the test we used to prove the safety of IVL in the two groups. This ligature was tested with high pressure introduced and measured into the gallbladder by sphygmomanometer. Results: The gallbladder can withstand a mean (+ SD) pressure of 197 (+20.94)mmHg and 191.67 (+10.2) in group A and B respectively without statistically significant difference (P 0.1305). Total cost of vicryl was $128 compared to $3200 if endoclips were used. No complication was noted related to these ligatures in a period of two year-follow up. Conclusion: This method is easy, cost effective and suitable in some countries.
Authors:
Ahmed Mohammed Ibn Ouf; Yahia Al Arabi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association     Volume:  8     ISSN:  1998-4049     ISO Abbreviation:  Saudi J Gastroenterol     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2009-10-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9516979     Medline TA:  Saudi J Gastroenterol     Country:  Saudi Arabia    
Other Details:
Languages:  eng     Pagination:  14-6     Citation Subset:  -    
Affiliation:
Department of Medicine, Ibn Sina Hospital and Liver Diseases Centre, Khartoum, Sudan. ibnouf@sudanmail.net.
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