DOI: http://dx.doi.org/10.18203/2349-2902.isj20204992

Is gender a determinant for the outcome of laparoscopic cholecystectomy?

Akshay Bahadur, S. D. Bisht, Yanshul Rathi, Ashish Shukla, Aman Aggarwal

Abstract


Background: Currently, laparoscopic cholecystectomy is one of the most desirable procedures to treat symptomatic gallstone disease. Yet, various risk factors govern its conversion to open surgery. The impact of male sex as a risk factor for conversion has been a questionable issue.  The study aimed to evaluate the role of male sex on outcomes of laparoscopic cholecystectomy.

Methods: As per inclusion and exclusion criteria, medical records of all the patients aged 18-70 years who underwent elective LC for a period of 14 months were accessed retrospectively. Data related to patients’ demographic details, intra-operative and post-operative findings was recorded and subjected to analysis.

Results: Out of 232 selected cases, 17.67% were males and 82.32% were females. Mean age in both gender groups was similar (p=0.139). Body mass index was also found to be similar in both the groups (p=0.232). There was no significant difference (p=0.85) in the mean operative time between men (29.37±9.29) and women (28.88±15.66). Conversion to open surgery was seen only in female group (1.57%) but it is not significantly from the male group (p=0.42). No significant difference was observed in both groups regarding unwanted intra-operative events (p=0.231) and post-operative complications (p=0.70) and post- operative stay (p=0.50).

Conclusions: This study suggests that male gender may not be considered as an independent risk factor for outcome of laparoscopic cholecystectomy. However, extensive research in future may cast further light on this issue.


Keywords


Gall stone disease, Laparoscopic cholecystectomy, Male sex, Conversion

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References


McMahon AJ, Baxter JN, Anderson JR, Ramsay G, O'Dwyer PJ, Russell IT, et al. Laparoscopic versus minilaparotomy cholecystectomy: a randomised trial. Lanc. 1994;343(8890):135-8.

Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D. Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trauma responses. Br J Surg. 1994;81(9):1362-5.

Trondsen E, Reiertsen O, Andersen OK, Kjaersgaard P. Laparoscopic and open cholecystectomy. A prospective, randomized study. Eur J Surg. 1993;159(4):217-21.

Acar T, Kamer E, Acar N, Atahan K, Bağ H, Hacıyanlı M, et al. Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of results between early and late cholecystectomy. Pan Afr Medic J. 2017;26.

Haribhakti S, Mistry J. Techniques of laparoscopic cholecystectomy: Nomenclature and selection. J Minim Access Surg. 2015;11(2):113-8.

Ekici U, Yılmaz S, Tatlı F. Comparative Analysis of Laparoscopic Cholecystectomy Performed in the Elderly and Younger Patients : Should We Abstain from Laparoscopic Cholecystectomy in the Elderly ? 2018;10(6).

Licciardello A, Arena M, Nicosia A, Di Stefano B, Cali G, Arena G, et al. Preoperative risk factors for conversion from laparoscopic to open cholecystectomy. Eur Rev Med Pharmacol Sci. 2014;18(2):60-8.

Sakuramoto S, Sato S, Okuri T, Sato K, Hiki Y, Kakita A. Preoperative evaluation to predict technical difficulties of laparoscopic cholecystectomy on the basis of histological inflammation findings on resected gallbladder. Am J Surg. 2000;179(2):114-21.

Genc V, Sulaimanov M, Cipe G, Basceken SI, Erverdi N, Gurel M, et al. What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations. Clinics. 2011;66(3):417-20.

Tang B, Cuschieri A. Conversions during laparoscopic cholecystectomy: Risk factors and effects on patient outcome. J Gastrointest Surg. 2006;10(7):1081-91.

Tayeb M, Raza S, Khan M, Azami R. Conversion from laparoscopic to open cholecystectomy: Multivariate analysis of preoperative risk factors. J Postgrad Med. 2005;51(1):17-20.

Lipman JM, Claridge JA, Haridas M, Martin MD, Yao DC, Grimes KL, Malangoni MA. Preoperative findings predict conversion from laparoscopic to open cholecystectomy. Surgery. 2007;142(4):556-65.

Chauhan S, Masood S, Pandey A. Preoperative predictors of conversion in elective laparoscopic cholecystectomy. Published online 2019.

Zhang W-J, Li J-M, Wu G-Z, Luo K-L, Dong Z-T. Risk factors affecting conversion in patients undergoing laparoscopic cholecystectomy. ANZ J Surg. 2008;78(11):973-6.

Bazoua G, Tilston MP. Male gender impact on the outcome of laparoscopic cholecystectomy. JSLS J Soc Laparoendosc Surg. 2014;18(1):50-4.

Al-Mulhim AA. Male gender is not a risk factor for the outcome of laparoscopic cholecystectomy: a single surgeon experience. Saudi J Gastroenterol Off J Saudi Gastroenterol Assoc. 2008;14(2):73-9.

Alqahtani R, Ghnnam W, Alqahtani M, Qatomah A, Alkhathami A, Alhashim A. Role of male gender in laparoscopic. 2015;1:38-42.

Akcakaya A, Okan I, Bas G, Sahin G, Sahin M. Does the Difficulty of Laparoscopic Cholecystectomy Differ Between Genders? Indian J Surg. 2015;77L:452-6.

Peters JH, Krailadsiri W, Incarbone R, Bremner CG, Froes E, Ireland AP, Crookes P, Ortega AE, Anthone GA, Stain SA. Reasons for conversion from laparoscopic to open cholecystectomy in an urban teaching hospital. Am J Surg. 1994;168(6):555-9.

Section G, Article O, Manandhar K, Manandhar S, Hospital B, Centre NT. Does the male gender govern conversion of laparoscopic cholecystectomy?. 2019;6(1):14-20.

Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: Cholelithiasis and cancer. Gut Liver. 2012;6(2):172-87.

Kumar J, Kumar P, Meena K, Siddiqui A. Male gender as an independent risk factor for laparoscopic cholecystectomy: An outcome analysis at a teaching institute. Saudi J Heal Sci. 2017;6(2):104-9.

Zisman A, Gold-Deutch R, Zisman E, Negri M, Halpern Z, Lin G, Halevy A. Is male gender a risk factor for conversion of laparoscopic into open cholecystectomy?. Surg Endosc. 1996;10(9):892-4.

Al-Mulhim AS, Amin TT. Outcome of laparoscopic cholecystectomy at a secondary level of care in Saudi Arabia. Saudi J Gastroenterol Off J Saudi Gastroenterol Assoc. 2011;17(1):47-52.

Ambe PC, Köhler L. Is the male gender an independent risk factor for complication in patients undergoing laparoscopic cholecystectomy for acute cholecystitis? Int Surg. 2015;100(5):854-9.

Kanakala V, Borowski DW, Pellen MG, Dronamraju SS, Woodcock SA, Seymour K et al. Risk factors in laparoscopic cholecystectomy: a multivariate analysis. Int J Surg. 2011;9(4):318-23.

Nachnani J, Supe A. Pre-operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. Indian J Gastroenterol Off J Indian Soc Gastroenterol. 2005;24(1):16-8.

Ibrahim S, Hean TK, Ho LS, Ravintharan T, Chye TN, Chee CH. Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World J Surg. 2006;30(9):1698-704.

Coelho JC, Dalledone GO, Schiel W, Berbardin JD, Claus CM, Matias JE, et al. Does male gender increase the risk of laparoscopic cholecystectomy?. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo). 2019;32(2).

Hu ASY, Menon R, Gunnarsson R, de Costa A. Risk factors for conversion of laparoscopic cholecystectomy to open surgery - A systematic literature review of 30 studies. Am J Surg. 2017;214(5):920-30.