title: Is male gender a risk factor for bile duct injury during laparoscopic cholecystectomy?
abstract: BACKGROUND
  Since its introduction in the late 1980s laparoscopic cholecystectomy has become the treatment of choice for gallstone disease. Unfortunately, the rate of iatrogenic biliary duct injuries (BDIs) has at least doubled after the adoption of the laparoscopic method. Population-based studies reporting the distribution of laparoscopic BDI patients according to gender and the severity of the BDI are mostly lacking. The purpose of the present study was to analyze the BDIs sustained during laparoscopic cholecystectomy in and around Turku University Central Hospital, with a special reference to the distribution of patients according to gender and the severity of the BDI.
  
  
  METHODS
  A total of 3,736 laparoscopic cholecystectomies (2,627 female patients, 1,109 male) was performed in and around Turku University Central Hospital from 1995 to 2002 (by the end of April). The number and severity of BDIs and the gender of BDI patients were recorded, and the risk of BDI during laparoscopic cholecystectomy was calculated for the total patient population and for both genders separately.
  
  
  RESULTS
  The risk of BDI was 0.86% for the total patient population, 0.95% for female and 0.63% for male. The most conspicuous finding was that the female gender was predominant in the severe types of BDI. However, the risk of mild BDI seemed to be fairly equal in both genders.
  
  
  CONCLUSIONS
  We conclude that female gender seems to be a risk factor for severe iatrogenic BDI during laparoscopic cholecystectomy.
authors.affiliation: Department of Surgery, University of Turku, PB 52, 20521 Turku, Finland. juha.gronroos@tyks.fi
authors.forename: Juha M
authors.initials: JM
authors.lastname: Grönroos
authors.forename: Matti T
authors.initials: MT
authors.lastname: Hämäläinen
authors.forename: Jukka
authors.initials: J
authors.lastname: Karvonen
authors.forename: Risto
authors.initials: R
authors.lastname: Gullichsen
authors.forename: Simo
authors.initials: S
authors.lastname: Laine
mesh_terms: D017734:Bile Ducts, Extrahepatic / Q000293:injuries*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000706:statistics & numerical data*; D008297:Male; D012307:Risk Factors; D012737:Sex Factors