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

Table 3 Clinical outcomes of included comparative studies

Study, year, country	No. of patients	Leakage of the cystic duct	Bile duct injury	Biloma	Intra-abdominal abcess
Harmonic scalpel/shears vs metal clips
Wills[22], 2013, United States	57 vs 148	1 vs 1	1 (D) vs 0	1 vs 0	0 vs 0
Wu[26], 2011, China	100 vs 100	0 vs 1	0 vs 0	0 vs 0	0 vs 0
Redwan[13], 2010, Egypt	80 vs 80	0 vs 1	0 vs 0	0 vs 0	0 vs 0
Kandil[14], 2010, Egypt	70 vs 70	0 vs 1	0 vs 0	NR	NR
Gelmini[23], 2010, Italy	95 vs 90	0 vs 0	0 vs 0	NR	2 vs 0
Bessa[15], 2008, Egypt	60 vs 60	0 vs 0	0 vs 0	NR	NR
Locking absorbable vs locking non-absorbable clips
Yang[21], 2014, China	635 vs 728	0 vs 7	NR	NR	1 vs 2
Locking vs non-locking clips
Matsui[20], 2012, Japan	907 vs 110	0 vs 0	NR	NR	NR
Rohatgi[24], 2006, United Kingdom	344 vs 146	0 vs 3	NR	2 vs 2	NR
Yano[25], 2003, Japan	328 vs 444	1 vs 2	2 vs 4 (severity not reported)	NR	NR
Other
Singal[19], 2018, India	70 silk ligature vs 70 titanium clips	0 vs 0	NR	NR	NR
Schulze[17], 2010, Denmark	101 Ligasure vs 113 titanium clips	0 vs 0	0 vs 0	NR	NR
Seenu[16], 2004, India	53 absorbable ligature vs 52 titanium clips	2 vs 2	NR	NR	NR
Hüscher[18], 2003, Italy	331 harmonic shears vs 130 harmonic shears + endoloop	7 vs 3	1 (D) vs 0	NR	0 vs 1

Amsterdam classification was used to identify the severity of the bile duct injuries: B: Major bile duct leaks with or without concomitant biliary strictures; C: Bile duct strictures without bile leakage; D: Complete transection of the duct with or without excision of some portion of the biliary tree.