title: Is gallbladder inflammation more severe in male patients presenting with acute cholecystitis?
abstract: BACKGROUND
  The male gender is considered a risk factor for complications in patients undergoing laparoscopic cholecystectomy. The reasons for this gender associated risk are not clearly understood. The extent of gallbladder inflammation has been shown to influence surgical outcome. The aim of this study was to investigate whether or not gallbladder inflammation is more severe in male patients presenting with acute cholecystitis.
  
  
  METHODS
  A retrospective gender dependent comparison of the data of patients undergoing laparoscopic cholecystectomy for acute cholecystitis in a primary care facility within a five-year period was performed.
  
  
  RESULTS
  138 patients, 69 males and 69 females were included for analysis. Severe gallbladder inflammation (gangrenous and necrotizing cholecystitis) was seen in a significant portion of the male population compared to the female population (p = 0.002). The male gender was confirmed in a multivariate analysis as an independent risk factor for severe cholecystits (p = 0.018).
  
  
  CONCLUSIONS
  The male gender is a risk factor for severe gallbladder inflammation. An early surgical intervention may be needed to prevent complications.
authors.affiliation: Department of General, Visceral and thoracic surgery, St. Remigius Hospital Opladen, An St. Remigius 26, 51379, Leverkusen, Germany. peter.ambe@helios-kliniken.de.|Helios Klinikum Wuppertal, Department of Surgery II, Witten - Herdecke University, Heusner Str. 40, 42283, Wuppertal, Germany. peter.ambe@helios-kliniken.de.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Ambe
authors.affiliation: Department of Internal Medicine, St. Elisabeth Hospital Hohenlind, Werthmannstr. 1, 50937, Köln, Germany.
authors.forename: Sebastian A
authors.initials: SA
authors.lastname: Weber
authors.affiliation: Department of General, Visceral and thoracic surgery, St. Remigius Hospital Opladen, An St. Remigius 26, 51379, Leverkusen, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Wassenberg
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005734:Gangrene / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009336:Necrosis / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors