Systematic review of cystic duct closure techniques in relation to prevention of bile duct leakage after laparoscopic cholecystectomy

Table 1 Characteristics of included comparative studies, descending in year of publication

Study, year, country	Study design	Intervention	Control	Aim study
Jain[27], 2011, India	RCT	Ultrasonic shears	Electrocautery	To test the benefit of ultrasonic shears in LC
Redwan[13], 2010, Egypt	RCT	Harmonic shear (Olympus Keymed Sono surg version G2 220–240V 3A)	Titanium clips	To demonstrate the efficiency and safety of the harmonic scalpel
Kandil[14], 2010, Egypt	RCT	Harmonic scalpel (Harmonic ACE, Ethicon Endo-Surgery)	Metal clips	To compare metal clips vs the harmonic scalpel on safety and efficacy in LC
Bessa[15], 2008, Egypt	RCT	Harmonic scalpel (Harmonic ACE, Ethicon Endo-Surgery)	Clip and cautery	To compare the safety and efficacy of the harmonic scalpel vs clip and cautery in LC
Seenu[16], 2004, India	RCT	Absorbable ligature (Vicryl1, Ethicon)	Titanium clips (Ligaclip, Ethicon)	To compare postoperative outcomes after occlusion of the cystic duct with tied knots vs titanium clips
Singal[19], 2018, India	PS	Non-absorbable ligature (Filasilk, Meril)	Titanium clips (Ligaclip, Ethicon)	To study safety and efficacy of silk ligatures compared to clips of closure of the cystic duct
Schulze[17], 2010, Denmark	PS	LigaSure (ForceTriad system, Valleylab)	Titanium clips	To evaluate the safety of the LigaSure system in cholecystectomy
Hüscher[18], 2003, Italy	PS	Harmonic shears (Ultracision, Ethicon Endo-Surgery)	Harmonic shears and absorbable endo-loop	To verify the advantages if ultrasonic dissection
Yang[21], 2014, China	RS	One absorbable clip	Titanium clips	The effectiveness and safety of electrocoagulation after occlusion of the cystic duct and artery with an absorbable clip
Wills[22], 2013, USA	RS	Harmonic scalpel (Harmonic ACE, Ethicon Endo-Surgery) in pts with a cystic duct > 5 mm	Single surgical clip in pts with cystic duct < 5 mm	The comparison of the Harmonic scalpel vs surgical clips in the occlusion of the cystic duct
Matsui[20], 2012, Japan	RS	Locking absorbable clips (Laproclip 8 mm, 12mm, Tyco Healthcare) Locking non-absorbable clip (Hem-o-lok XL, Teleflex Medical)	Endo-loop (SURGITIE, Tyco Healthcare) Suture Metallic clip (ENDO CLIP III, Tyco Healthcare)	To evaluate the effect of locking clips on the leakage from the cystic duct in cholecystectomy
Wu[26], 2011, China	RS	Ultrasonic shears (Harmonic ACE, Ethicon Endo-Surgery)	Clips	To compare conventional LC to SILC
Gelmini[23], 2010, Italy	RS	Harmonic scalpel (Harmonic- Ethicon Endo Surgery)	Clips	To demonstrate that the harmonic scalpel is safe in LC
Rohatgi[24], 2006, United Kingdom	RS	Absorbable locking clips (Laproclip, USS-DG, Tyco)	Titanium clips (Ligaclip, Ethicon)	To compare the efficacy of the locking absorbable clip vs clips in LC
Yano, 2003, Japan[25]	RS	Locking absorbable clips (Laproclip, Davis and Geck)	Ligaclip (metal clip, Ethicon)	To assess if locking clips are safer and less invasive than metal Ligaclips

RS: Retrospective studydesign; RCT: Randomized controlled trial; PS: Prospective study design; LC: Laparoscopic cholecystectomy.