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Does sex affect the outcome of laparoscopic cholecystectomy?: A retrospective analysis of single center experience
Author(s) -
Kamran Khawar,
Afridi Ziauddin,
Muqim Roohul,
Khalil Jawad
Publication year - 2013
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/j.1758-5910.2012.00152.x
Subject(s) - medicine , odds ratio , cholecystectomy , confidence interval , retrospective cohort study , surgery , gallbladder , gallbladder disease
The aim of our study was to determine the effect of sex on the outcome of laparoscopic cholecystectomy in terms of operative time, conversion to open cholecystectomy, postoperative complications and mean hospital stay. Methods In this retrospective observational study, we analyzed the medical records of 2061 patients who underwent laparoscopic cholecystectomy in the surgical department of K hyber T eaching H ospital ( P eshawar, P akistan) between M arch 2008 and J anuary 2010. χ 2 test and t –test were respectively used to analyze categorical and numerical variables. P ≤ 0.05 was considered significant. Results The study included 1772 female and 289 male patients. The mean age for male patients was 44.07 ± 11.91 years compared to 41.29 ± 12.18 years for female patients ( P = 0.706). Laparoscopic cholecystectomy was successfully completed in 1996 patients. The conversion rate was higher in men ( P < 0.001), and the mean operating time was longer in men ( P < 0.001). Bile duct injuries occurred more frequently in men ( P < 0.001). Gallbladder perforation and gallstone spillage also occurred more commonly in men ( P = 0.001); similarly severe inflammation was reported more in male patients ( P = 0001). There were no statistically significant differences in mean hospital stay, wound infection and port‐site herniation between men and women. Multivariate regression analysis showed that the male sex is an independent risk factor for conversion to open cholecystectomy (odds ratio = 2.65, 95% confidence interval: 1.03–6.94, P = 0.041) and biliary injuries (odds ratio = 0.95, 95% confidence interval: 0.91–0.99, P ‐value = 0.036). Conclusions Laparoscopic cholecystectomy is often challenging in men on account of more adhesions and inflammation. This leads to higher conversion rates and more postoperative complications. Optimized planning and a more experienced operating surgeon may help overcome these problems.