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Is the male gender an independent risk factor for complication in patients undergoing laparoscopic cholecystectomy
11 Helios Klinikum Wupperta, Department of Surgery II, Witten - Herdecke University, Wuppertal, Germany.
Insights
Male patients undergoing laparoscopic cholecystectomy for acute cholecystitis face a higher risk of complications. This surgery, a standard for gallbladder issues, shows men have longer procedures and hospital stays, indicating male gender as a risk factor.
Area of Science:
- Surgery
- Gastroenterology
- Clinical Research
Background:
- Laparoscopic cholecystectomy is the standard surgical treatment for acute cholecystitis.
- The influence of patient gender on surgical outcomes for this procedure is not fully understood.
Purpose of the Study:
- To investigate gender-specific risks of complications in patients undergoing laparoscopic cholecystectomy for acute cholecystitis.
- To determine if male gender is an independent risk factor for adverse outcomes in this surgical context.
Main Methods:
- Retrospective analysis of 1884 laparoscopic cholecystectomies performed over 5 years.
- Focus on 779 cases diagnosed with acute cholecystitis, comparing outcomes between male and female patients.
- Multivariate analysis to identify independent risk factors for complications.
Main Results:
- Male patients were significantly older and had longer operative times compared to females.
- Conversion to open surgery was more frequent in males over 65 years old.
- Male gender was identified as an independent risk factor for prolonged surgery and longer postoperative hospital stays.
Conclusions:
- Male gender is associated with increased operative time and hospital stay in laparoscopic cholecystectomy for acute cholecystitis.
- Male patients, particularly those over 65, may experience more challenging surgical outcomes.
- Further research is warranted to elucidate the mechanisms behind gender-dependent surgical risks in this patient population.
Abstract:
This paper was designed to investigate the gender dependent risk of complication in patients undergoing laparoscopic cholecystectomy for acute cholecystitis. Laparoscopic cholecystectomy is the standard procedure for benign gallbladder disorders. The role of gender as an independent risk factor for complicated laparoscopic cholecystectomy remains unclear. A retrospective single-center analysis of laparoscopic cholecystectomies performed for acute cholecystitis over a 5-year period in a community hospital was performed. Within the period of examination, 1884 laparoscopic cholecystectomies were performed. The diagnosis was acute cholecystitis in 779 cases (462 female, 317 male). The male group was significantly older (P = 0.001). Surgery lasted significantly longer in the male group (P = 0.008). Conversion was done in 35 cases (4.5%). There was no significant difference in the rate of conversion between both groups. However the rate of conversion was significantly higher in male patients > 65 years (P = 0.006). The length of postoperative hospital stay was significantly longer in the male group (P = 0.007), in the group > 65 years (P = 0.001) and following conversion to open surgery (P = 0.001). The male gender was identified as an independent risk factor for prolonged laparoscopic cholecystectomy on multivariate analysis. The male gender could be an independent risk factor for complicated or challenging surgery in patients undergoing laparoscopic cholecystectomy for acute cholecystitis.