Comparative Analysis of Direct Pressure and Electrocauterization Techniques for Hemorrhage Control in the Liver Bed during Laparoscopic Cholecystectomy

Abstract

Background: Gallstones affect a significant percentage of the population, and the gold standard treatment is laparoscopic cholecystectomy. Hemorrhage, however, is a frequent complication, and bleeding from the liver bed is difficult to control. This study compares two hemostatic methods—direct pressure with a hot sponge and electrocauterization—to control hemorrhage from laparoscopic cholecystectomy. Direct pressure is 83% effective and electrocauterization is 65% effective according to previous studies. Objective: To compare and evaluate the effectiveness of electrocauterization and direct pressure in managing intraoperative bleeding and postoperative pain. Study Design: A descriptive study Duration and place of study: This study was conducted in Gulam Muhammad Mahar Medical College Hospital Sukkur from December 2023 to December 2024 Methodology: 100 patients with ultrasound-proven cholelithiasis, ranging from 12 to 70 years, underwent laparoscopic cholecystectomy. Patients were randomly allocated in two groups: Group B received monopolar electrocauterization, while Group A received direct gauze compression to manage liver bed hemorrhage. Gallbladder fossa intraoperative bleeding was the primary outcome, and postoperative bleeding and pain were measured using the visual analogue scale at 6, 12, and 24 hours. Results: There were a total of 100 participants of this study. All the people in this study were equally divided into 2 groups (50 in each group). The average age calculated was 40.39 for Group A and 42.22 for Group B. There were a total of 22 males and 78 females overall in this study. Bleeding during surgery was secured in 86% cases (n=43). Conclusion: In laparoscopic cholecystectomy, electrocauterization is more effective than direct pressure in achieving haemostasis in the presence of liver bed.