Abstract Studies have demonstrated that the LigaSure device causes less tissue damage than bipolar electrosurgery. Increases and decreases in protein and immunoglobulin concentrations after laparoscopic cholecystectomy are expected and transient. This study aimed to compare serum values of acute-phase proteins and immunoglobulins in rabbits undergoing gallbladder dissection using bipolar electrosurgery (Maryland forceps) and vessel sealing device (VSD) LigaSure. The objective was to determine which method resulted in less inflammatory change. Twenty rabbits were divided into two groups of ten each. Group 1 underwent laparoscopic cholecystectomy with bipolar electrosurgical forceps for dissection and LigaSure for sealing the cystic duct. Group 2 underwent dissection and cystic duct sealing using VSD-LigaSure only. Acute-phase proteins and immunoglobulins were evaluated on postoperative days three, seven, and fifteen. Serum concentrations of fibrinogen, transferrin, IgG, α1-acid glycoprotein, PM 23000 Da, and C-reactive protein (CRP) did not differ significantly between groups. However, significant differences were observed between evaluation days within the same group. IgA, ceruloplasmin, and haptoglobin were not statistically analyzed for either group or day comparisons. Only albumin levels differed between groups, with group 1 showing a lower protein concentration on day 15. Both methods caused changes in acute-phase proteins, indicating no significant advantage for using the LigaSure device. transient acutephase acute phase Maryland VSD (VSD change each VSDLigaSure only Acutephase Acute three seven fifteen fibrinogen transferrin IgG α1acid αacid α1 acid α glycoprotein 2300 Da Creactive C reactive CRP (CRP However IgA ceruloplasmin comparisons 15 230 23

Resumo Estudos demonstram que o dispositivo selante de vasos DSV-LigaSure promove menor dano tecidual que o eletrocirúrgico bipolar e o aumento e diminuição das concentrações de proteínas e imunoglobulinas após a colecistectomia laparoscópica é esperado e transitório. Objetivou-se comparar os valores séricos das proteínas de fase aguda e imunoglobulinas de coelhos submetidos à dissecção da vesícula biliar utilizando eletrocirúrgico bipolar (pinça Maryland) e DSV-LigaSure para determinar qual dos dissectores apresentou menor alteração inflamatória. Vinte coelhos foram distribuídos em dois grupos com dez animais cada, sendo o Grupo 1 submetido à técnica de colecistectomia laparoscópica utilizando o eletrocirúrgico bipolar para dissecção e DSV-LigaSure para selar o ducto cístico e o Grupo 2, submetido à dissecção da vesícula biliar e selagem do ducto cístico utilizando o DSV-LigaSure. As proteínas de fase aguda e imunoglobulinas foram avaliadas nos dias três, sete e 15 do período pós-operatório. As concentrações séricas de fibrinogênio, transferrina, IgG, α1- glicoproteína ácida, PM 23000 Da e proteína C reativa não apresentaram diferenças significativas entre os grupos, apenas diferenças significativas entre os dias de avaliação no mesmo grupo. IgA, ceruloplasmina e haptoglobina não apresentaram diferenças estatísticas entre grupos e nem entre dias de avaliação. Apenas albumina apresentou diferença entre grupos, onde o Grupo 1 demonstrou menor concentração da proteína após 15 dias. Ambos dissectores apresentaram alterações nas proteínas de fase aguda, demonstrando que não houve superioridade na técnica utilizando o DSV-LigaSure. DSVLigaSure DSV LigaSure transitório Objetivouse Objetivou se pinça Maryland inflamatória cada 2 DSVLigaSure. LigaSure. três pósoperatório. pósoperatório pós operatório. operatório pós-operatório fibrinogênio transferrina IgG α1 α ácida 2300 grupo IgA 230 23

ABSTRACT Purpose: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of gallbladder (GB) disease in small animals. The aims of this study were to investigate and compare the effect of different types of dissectors during LC in rabbits; electrothermal bipolar vessel sealing device (EBVS-LigaSure) and standard electrosurgical dissection (bipolar Maryland) for dissection of the GB in LC, correlating liver function tests (LFTs) in pre and postoperative periods (days 0, 3, 7, 15); macroscopic checking 15 days after surgery through necropsy; histopathological, bacteriological through bacterial growth by culture and intraoperative complications. Methods: Twenty rabbits were used, group (n = 10) using EBVS for GB dissection and cystic duct seal (GLL), and group (n = 10) using bipolar dissecting forceps and EVBS for cystic duct seal (GLE). Results: A higher concentration of alkaline phosphatase was observed on GLL 15 days after surgery when compared to GLE. In addition, GLE resulted in a higher concentration of alanine aminotransferase at three days when compared to GLL. Conclusion: In LC no significant statistical differences were found between EBVS and bipolar Maryland; both devices are equally safe and effective in LC. Further studies are required to evaluate the effectiveness of these devices in animals with gallbladder pathologies. Therefore, clinical studies are necessary. Purpose (LC (GB EBVSLigaSure LigaSure (EBVS-LigaSure Maryland LFTs (LFTs 0 3 7 15) 1 necropsy histopathological complications Methods used n 10 GLL, , (GLL) . (GLE) Results addition Conclusion pathologies Therefore necessary (GLL (GLE

ABSTRACT Purpose: The aim of this randomized study was to compare the complications and perioperative outcome of three different techniques of laparoscopic cholecystectomy (LC). Changes in the liver function test after LC techniques were investigated. Also, we compared the degree of postoperative adhesions and histopathological changes of the liver bed. Methods: Thirty rabbits were divided into three groups: group A) Fundus-first technique by Hook dissecting instrument and Roeder Slipknot applied for cystic duct (CD) ligation; group B) conventional technique by Maryland dissecting forceps and electrothermal bipolar vessel sealing (EBVS) for CD seal; group C) conventional technique by EBVS for gallbladder (GB) dissection and CD seal. Results: Group A presented a longer GB dissection time than groups B and C. GB perforation and bleeding from tissues adjacent to GB were similar among tested groups. Gamma-glutamyl transferase and alkaline phosphatase levels increased (p ≤ 0.05) on day 3 postoperatively in group A. By the 15th postoperative day, the enzymes returned to the preoperative values. Transient elevation of hepatic transaminases occurred after LC in all groups. Group A had a higher adherence score than groups B and C and was associated with the least predictable technique. Conclusions: LC can be performed using different techniques, although the use of EBVS is highly recommended. Purpose LC. . (LC) investigated Also bed Methods Fundusfirst Fundus first (CD ligation (EBVS seal (GB Results Gammaglutamyl Gamma glutamyl p 0.05 005 0 05 th values Conclusions recommended (LC 0.0 00 0.