Abstract
Objectives: To compare the outcome of clip-less technique by harmonic scalpel versus conventional technique by clip ligation and electrocautery in laparoscopic cholecystectomy.
Methodology: This prospective Randomized Controlled trial was carried out at Surgical Unit III, Bahawal Victoria Hospital, Bahawalpur, Pakistan from Jun 2016 to Aug 2017 and included 144 patients. They were divided into two groups of 72 each. In Group A, Harmonic Scalpel was used to perform clipless LC whereas in group B, Clip & Cautery were used. Operating time (min), intraoperative blood loss (ml), gallbladder perforation rate were noted at surgery. Postoperatively fever, ileus, collection and hospital stay (hours) were recorded. Data were analyzed by SPSS version 23.
Results: Operating time in group A was significantly shorter than in group B (28.4+5.37 vs 43.71+5.05, p<0.001). Intraoperative hemorrhage is significantly low by in group A (3.13+1.86 vs 7.14+3.56, p<0.001). Gallbladder perforation rate was significantly less in group A vs group B (6.9% vs 26.4%, p=0.002).
Conclusion: Clipless technique by harmonic scalpel during laparoscopic cholecystectomy is better than conventional technique of Clip & Cautery.

Key words: Laparoscopic cholecystectomy, Clipless, Harmonic Scalpel, Operative Time, Gallbladder perforation, Intraoperative Hemorrhage, electrocautery.