SynthesisMedicine2018
A comparative study of ultrasonic scalpel (US) versus conventional metal clips for closure of the cystic duct in laparoscopic cholecystectomy (LC): A meta-analysis.
Synthesis in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Bile leak after elective laparoscopic cholecystectomy: association with transcystic instrumentation and cystic duct closure method.Surgical endoscopy · 2026Article
- Review
- Are We Overtesting? Rethinking Routine Blood Work After Low-Risk Laparoscopic Cholecystectomy: A Retrospective Study.Medicina (Kaunas, Lithuania) · 2025Article
- Impact of metal vs non-absorbable, polymer clips during laparoscopic cholecystectomy.Surgical endoscopy · 2025Article
- Ultrasonic Technique for Femoral Tunnel Creation in Anterior Cruciate Ligament Reconstruction.Arthroscopy techniques · 2023Article
- High rate of stone-related complications after stapling the cystic duct during laparoscopic cholecystectomy-an underrecognized risk.Surgical endoscopy · 2023Article
- Harmonic Scalpel Versus Clips for Ligation of Cystic Duct in Laparoscopic Cholecystectomy: A Systematic Review.Cureus · 2022Review
- Review
- Technical note: rectangular femoral tunnel for anterior cruciate ligament reconstruction using a new ultrasonic device: a feasibility study.Journal of experimental orthopaedics · 2021Article
- Ultrasonic scalpel combined with internal oxygen assisted sodium nitroprusside in laparoscopic cholecystectomy for elderly patients with acute cholecystitis.American journal of translational research · 2021Article
- Characteristics of ultrasound device: a new technology for bone curettage and excavation.Journal of experimental orthopaedics · 2019Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundlaparoscopic cholecystectomy (LC) has become the gold standard surgery for benign gallbladder diseases. Metal clips are conventionally used to secure the cystic duct and artery, while monopolar electrocautery (ME) predominates during laparoscopic dissection. ultrasonic scalpel (US) has already been explored for sealing the cystic duct and artery as a sole instrument, which has been regarded as a reasonable alternative to clips. The aim of this study was to investigate the safety and effectiveness of US versus clips for securing the cystic duct during LC.
methodsWe identified eligible studies in PubMed, Medline, Cochrane Library, Embase, and SpringerLink up to 1st May 2018, together with the reference lists of original studies. Meta-analysis was conducted using STATA 14.0. Q-based chi-square test and the I statistics were utilized to assess heterogeneity among the included studies. A P-value below .05 was set for statistical significance. Forest plots of combined Hazard ratios (HRs) with 95% confidence intervals (CIs) were also generated.
resultsEight studies met eligibility criteria in this meta-analysis eventually. A total of 1131 patients were included, of whom 529 were contained in the US group, compared to 602 in the clips group, which showed a significant difference (P = .025) without substantial statistical heterogeneity (I = 0.0%). No statistical significance was revealed regarding age (I = 0.0%, P = .957), and sex (I = 0.0%, P = .578) between both groups. The operative time and hospital stay in the US group were significantly shorter than that in the clips group, with I = 95.0%, P = .000 and I = 72.8%, P = .005, respectively. Concerning conversion (I = 48.6%, P = .084), perforation (I = 12.0%, P = .338), along with bile leakage (I = 0.0% P = .594), and overall morbidity (I = 19.1%, P = .289), comparison between both groups exhibited no statistical significance.
conclusionsUS enabled shorter operative time and hospital stay during LC, compared with clips. Additionally, US was comparable to clips regarding conversion, perforation, along with bile leakage and overall morbidity. Therefore, our meta-analysis concluded that US is clinically superior to the conventional clips in some aspects, or is at least as safe and effective as them, concerning closure of the cystic duct and artery.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.