Comparative Study between Ligation versus Clipping Methods of Appendicular Base in Laparoscopic Appendectomy

Document Type : Original Article


The Department of General Surgery, Faculty of Medicine, Al-Azhar University


Abstract Background: Nowadays Laparoscopic approach for ap-pendectomies more used rather open approachfor cases of acute appendicitis. Most surgeons preferred laparoscopic appendectomy as minimal access surgery. There are many methods for closing of appendicular stump as stapling, ligation and clipping. Aim of Study: This study was aimed to compare between two ligation and clipping techniques regardingits safety, operative time, postoperative outcome and complications. Patients and Methods: A randomized prospective clinical trial study included 150 patients with acute appendicitis. The patients were randomly distributed into 2 main groups (A, B): In 75 patients we secured the base of the appendix by ligation method (group A) and in 75 patients by clip Application (group B). Results: There was no significant statistical difference between the two groups as regard drain insertion or conversion to open appendectomy. Four patients within ligation group (A) had been converted to open due to presence of base gangrene while six patients within clipping group (B) had been converted to open due to gangrenous base and intra-operative bleeding. Two cases in clipping group (B) had been converted to ligation techniques due to wide base which can't be secured by clip application. Conclusion: Both methods were effective, safe, and almost same in complicationsrates. Clip application consumed less operative time cause of easy application soit doesn't require more experience or training.