SpringerLink
Log in

Is laparoscopic cholecystectomy more challenging in male patients?

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Attili F, Carulli N, Roda E, Barbara B, Capocaccia L, Menotti A, Okoliksanyi L, Ricci G, Capocaccia R, Festi D, Lalloni L, Mariotti S, Sama C, Scafato E, M.I.COL Group (1995) Epidemiology of gallstone disease in Italy: prevalence data of the Multicenter Italian Study on Cholelithiasis (M.I.COL). Am J Epidemiol 141(2):158–165

    PubMed  CAS  Google Scholar 

  2. Acalovschi M (2001) Cholesterol gallstones: from epidemiology to prevention. Postgrad Med J 77(906):221–229

    Article  PubMed  CAS  Google Scholar 

  3. Bateson MC (2000) Gallstones and cholecystectomy in modern Britain. Postgrad Med J 76(901):700–703

    Article  PubMed  CAS  Google Scholar 

  4. Shaffer EA (2005) Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep 7:132–140

    Article  PubMed  Google Scholar 

  5. Balzer K, Goebell H, Breuer N, Rü** KW, Leder LD (1986) Epidemiology of gallstones in a German industrial town (Essen) from 1940–1975. Digestion 33:189–197

    Article  PubMed  CAS  Google Scholar 

  6. Diehl AK (1991) Epidemiology and natural history of gallstone disease. Gastroenterol Clin North Am 20(1):1–19

    PubMed  CAS  Google Scholar 

  7. Heaton KW, Braddon FE, Mountford RA, Hughes AO, Emmett PM (1991) Symptomatic and silent gall stones in the community. Gut 32:316–320

    Article  PubMed  CAS  Google Scholar 

  8. Strasberg SM (2008) Acute calculous cholecystitis. N Engl J Med 358(26):2804–2811

    Article  PubMed  CAS  Google Scholar 

  9. Afdhal NH (2007) Diseases of the gallbladder and bile ducts. In: Goldman L, Ausiello D (eds) Cecil textbook of medicine, 23rd edn. Saunders Elsevier, Philadelphia, Chap 159, pp 1152–1164

  10. Fink-Bennett D, Freitas JE, Ripley SD, Bree RL (1985) The sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis. Arch Surg 120:904–906

    PubMed  CAS  Google Scholar 

  11. Miller DR, Egbert RM, Braunstein P (1984) Comparison of ultrasound and hepatobiliary imaging in the early detection of acute total common bile duct obstruction. Arch Surg 119:1233–1237

    PubMed  CAS  Google Scholar 

  12. Gurusamy KS, Samraj K (2007) Cholecystectomy versus no cholecystectomy in patients with silent gallstones. Cochrane Database Syst Rev 1:CD006230

    PubMed  Google Scholar 

  13. Rehfuss ME (1936) Medical treatment of gall bladder disease. Am J Dig Dis 3(1):66–68

    Google Scholar 

  14. Eldar S, Sabo E, Nash E, Abrahanson J, Matter I (1997) Laparoscopic versus open cholecystectomy in acute cholecystits. Surg Laparosc Endosc 7(5):407–414

    Article  PubMed  CAS  Google Scholar 

  15. Chang TC, Lin MT, Wu MH, Wang MY, Lee PH (2009) Evaluation of early versus delayed laparoscopic cholecystectomy in the treatment of acute cholecystitis. Hepatogastroenterology 56(89):26–28

    PubMed  Google Scholar 

  16. Keus F, Gooszen HG, Van Laarhoven CJ (2009) Systematic review: open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis. Aliment Pharmacol Ther 29(4):359–378

    Article  PubMed  CAS  Google Scholar 

  17. Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev 18(4):CD006231

    Google Scholar 

  18. Rivas H, Varela E, Scott D (2010) Single-incision laparoscopic cholecystectomy: initial evaluation of a large series of patients. Surg Endosc 24(6):1403–1412

    Article  PubMed  Google Scholar 

  19. Ponsky TA (2009) Single port laparoscopic cholecystectomy in adults and children: tools and techniques. J Am Coll Surg 209(5):e1–e6

    Article  PubMed  Google Scholar 

  20. Bucher P, Pugin F, Morel P (2010) From single-port access to laparoendoscopic single-site cholecystectomy. Surg Endosc 24(1):234–235

    Article  PubMed  Google Scholar 

  21. Salinas G, Saavedra L, Agurto H, Quispe R, Ramírez E, Grande J, Tamayo J, Sánchez V, Málaga D, Marks JM (2010) Early experience in human hybrid transgastric and transvaginal endoscopic cholecystectomy. Surg Endosc 24(5):1092–1098

    Article  PubMed  Google Scholar 

  22. Schlager A, Khalaileh A, Shussman N, Elazary R, Keidar A, Pikarsky AJ, Ben-Shushan A, Shibolet O, Horgan S, Talamini M, Zamir G, Rivkind AI, Mintz Y (2010) Providing more through less: current methods of retraction in SIMIS and NOTES cholecystectomy. Surg Endosc 24(7):1542–1546

    Article  PubMed  Google Scholar 

  23. Mann HB, Withney DR (1947) On a test of whether one of 2 random variables is stochastically larger than the other. Ann Math Stat 18:50–61

    Article  Google Scholar 

  24. Ibrahim S, Hean TK, Ho LS, Ravintharan T, Chye TN, Chee CH (2006) Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World J Surg 30(9):1698–1704

    Article  PubMed  Google Scholar 

  25. Pavlidis TE, Marakis GN, Symeonidis N, Psarras K, Ballas K, Rafailidis S, Sakantamis AK (2008) Considerations concerning laparoscopic cholecystectomy in the extremely elderly. J Laparoendosc Adv Surg Tech A 18(1):56–60

    Article  PubMed  Google Scholar 

  26. Annamaneni RK, Moraitis D, Cayten CG (2005) Laparoscopic cholecystectomy in the elderly. JSLS 9(4):408–410

    PubMed  CAS  Google Scholar 

  27. Al-Mulhim AA (2008) Male gender is not a risk factor for the outcome of laparoscopic cholecystectomy: a single surgeon experience. Saudi J Gastroenterol 14(2):73–79

    Article  PubMed  Google Scholar 

  28. Yol S, Kartal A, Vatansev C, Aksoy F, Toy H (2006) Sex as a factor in conversion from laparoscopic cholecystectomy to open surgery. JSLS 10(3):359–363

    PubMed  Google Scholar 

Download references

Disclosures

Dr. Peter Ambe, Mr. Babak Janghorban Esfahani, Mr. Ibrahim Tasci, Mrs. Hildegard Christ, and Prof. Dr. Lothar Köhler have no conflicts of interest or financial ties to disclose

Author information

Authors and Affiliations

  1. Department of Surgery, St. Elisabeth – Kreiskrankenhaus Grevenbroich, Akademisches Lehrkrankenhaus der RWTH Aachen, Von-Werth-Straße 5, 41515, Grevenbroich, Germany

    Peter Ambe, Babak Janghorban Esfahani, Ibrahim Tasci & Lothar Köhler

  2. Department of Medical Statistics and Epidemiology, Uniklinik Köln, Kerpener Straße 68, 50937, Cologne, Germany

    Hildegard Christ

Authors
  1. Peter Ambe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Babak Janghorban Esfahani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ibrahim Tasci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hildegard Christ
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lothar Köhler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter Ambe.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ambe, P., Esfahani, B.J., Tasci, I. et al. Is laparoscopic cholecystectomy more challenging in male patients?. Surg Endosc 25, 2236–2240 (2011). https://doi.org/10.1007/s00464-010-1539-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-010-1539-3

Keywords

Search

Navigation