Publication:

Ligation versus clipping of the appendicular stump in laparoscopic appendectomy: an ongoing predicament

Background Appendectomy being one of the common surgical emergencies performed either laparoscopically or by open approach. As laparoscopy is replacing open appendectomies with rapid pace, closure of appendix stump base remains a debatable aspect of surgery.

Methods All the patients fulfilling inclusion criteria of acute appendicitis undergoing laparoscopic appendectomy. Stump of the appendix after appendectomy was closed either by ligation or Titanium clip.

Results Both the groups were comparable in terms of demographic details. Operating time in the clip group was much less averaging 35.62±8.3 (25-70 mins.) as compared to ligation group which was 46.32±7.8 (35-90 mins.) and which was statistically significant. Illeus being most common post operative complications observed in both the group and was non-significant. One patient in ligation group developed fistula which led to the prolonged hospital stay and readmission but was managed conservatively. Both the groups were comparable in terms of length of hospital stay.

Conclusions Closure of appendicular stump using titanium clip is an easy, cheap, readily available and reliable option.