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Updated: Mar 28, 2026

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
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Does the Difficulty of Laparoscopic Cholecystectomy Differ Between Genders?

Adem Akcakaya1, Ismail Okan2, Gurhan Bas3

  • 1Faculty of Medicine, Department of Surgery, Bezmialem Vakif University, Molla Gurani Mah. Turgut Ozal Cad., 92/8, 34093 Fatih Istanbul, Turkey.

The Indian Journal of Surgery
|January 6, 2016
PubMed
Summary

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Laparoscopic gallbladder surgery appears more challenging in men due to increased anatomical difficulty and inflammation. This study found higher conversion rates and more adhesions in male patients undergoing cholecystectomy.

Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • General Surgery

Background:

  • Laparoscopic cholecystectomy is a common procedure for symptomatic cholelithiasis.
  • Previous studies suggest potential gender-based differences in surgical outcomes.
  • Severe fibrosis and anatomical anomalies may be more prevalent in men, potentially increasing surgical complexity.

Purpose of the Study:

  • To investigate the impact of gender on laparoscopic cholecystectomy outcomes.
  • To compare conversion rates, histological inflammation severity, and anatomical difficulty between male and female patients.
  • To identify gender-specific factors influencing the complexity of gallbladder surgery.

Main Methods:

  • Retrospective review of 915 patients undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis.
Keywords:
ConversionGenderLaparoscopic cholecystectomyOperation time

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  • Patients were divided into male (group 1) and female (group 2) cohorts.
  • Comparison of demographic data, inflammation severity, anatomical difficulty, operative time, conversion rates, and adhesions.

    • Main Results:

    • Male patients (19%) exhibited significantly longer operative times and higher rates of gallbladder-related adhesions.
    • Histological analysis revealed significant differences in inflammatory findings between genders.
    • Male patients experienced greater anatomical difficulty and a higher conversion rate during laparoscopic cholecystectomy.

    Conclusions:

    • Laparoscopic gallbladder surgery is demonstrably more difficult in male patients.
    • Higher anatomical difficulty, increased inflammation, and greater adhesion frequency contribute to increased conversion rates in men.
    • Gender is a significant factor influencing the complexity and outcomes of laparoscopic cholecystectomy.