title: Is laparoscopic cholecystectomy more challenging in male patients?
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, St. Elisabeth-Kreiskrankenhaus Grevenbroich, Akademisches Lehrkrankenhaus der RWTH Aachen, Von-Werth-Straße 5, 41515, Grevenbroich, Germany. peter.ambe@kkh-ne.de
authors.forename: Peter
authors.initials: P
authors.lastname: Ambe
authors.forename: Babak Janghorban
authors.initials: BJ
authors.lastname: Esfahani
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Tasci
authors.forename: Hildegard
authors.initials: H
authors.lastname: Christ
authors.forename: Lothar
authors.initials: L
authors.lastname: Köhler
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002983:Clinical Competence; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome