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Is laparoscopic cholecystectomy more challenging in male patients?
Peter Ambe1, Babak Janghorban Esfahani, Ibrahim Tasci
1Department of Surgery, St. Elisabeth-Kreiskrankenhaus Grevenbroich, Akademisches Lehrkrankenhaus der RWTH Aachen, Von-Werth-Straße 5, 41515, Grevenbroich, Germany. peter.ambe@kkh-ne.de
Insights
Laparoscopic cholecystectomy (LC) is more challenging in males, with longer surgery times and higher conversion rates to open surgery compared to females. This study confirms LC is more difficult for male patients.
Area of Science:
- Surgical Outcomes
- Minimally Invasive Surgery
- Comparative Effectiveness
Background:
- Laparoscopic cholecystectomy (LC) is a common procedure for gallbladder disease.
- Clinical observations suggest LC may be more challenging in male patients.
- Previous beliefs indicate longer operative times and higher conversion rates in males.
Purpose of the Study:
- To objectively verify the perceived increased difficulty of LC in male patients.
- To compare operative times and conversion rates between male and female cohorts undergoing LC.
- To analyze the impact of patient sex on laparoscopic cholecystectomy outcomes.
Main Methods:
- Retrospective analysis of 1571 laparoscopic cholecystectomies (501 males, 1071 females) performed between 2004-2009.
- Key parameters analyzed: operative time (Veress needle to wound closure) and conversion rate to open surgery.
- Statistical comparison of surgical duration and conversion rates between male and female patient groups.
Main Results:
- Male patients experienced significantly longer operative times compared to females (p<0.0001).
- The rate of conversion to open surgery was significantly higher in males (5.6%) versus females (2.9%) (p<0.0001).
- Male patients were significantly older than female patients at the time of surgery (p<0.001).
Conclusions:
- Laparoscopic cholecystectomy is associated with significantly longer duration in male patients.
- Male patients exhibit a significantly higher rate of conversion to open surgery.
- The findings support the conclusion that LC may indeed be more challenging in male patients.
Background:
Laparoscopic cholecystectomy (LC) seems to be more challenging in males than in females. The surgery seems to be longer in male patients. There also seems to be an increased rate of conversion to open surgery in male patients. We sought to objectively verify this widespread belief.
Methods:
We performed a retrospective analysis of laparoscopic cholecystectomies performed between January 2004 and November 2009 in our hospital. Within this period 1844 cholecystectomies were performed in our community-based hospital. After a strict inclusion procedure, 1571 cases of LC for symptomatic gallbladder disease were analyzed (501 males, 1071 females). The time for surgery, defined as the interval from placement of the Veress needle to wound closure in minutes, and the rate of conversion to open surgery were the main parameters considered.
Results:
The time for surgery in male patients was significantly longer compared to that for females (p<0.0001). The male cohort was significantly older than the female cohort at the time of surgery (p<0.001). The rate of conversion to open surgery was significantly higher in male patients (5.6%) compared to 2.9% for females (p<0.0001).
Conclusion:
Based on our analysis, LC had a significantly longer duration of surgery in the male cohort. The rate of conversion to open surgery was also significantly higher in male cohort. Thus, LC could be more challenging in male patients.
