Farzana Memon, Roger Christopher Gill, Sumera Baloch, Mehmood A Khan, Amber Bawa, Eed Quraishy M Saeed, Noman Shehzad.
Conversion of laparoscopic to open cholecystectomy, is gender a predictor?.
Pak J Surg Jan ;30(4):290-5.

Background: It had generally been thought that male gender is associated with diffi cult cholecystectomies. Laparoscopic Cholecystectomy has been considered as a standard of care for treating patients with gall stone disease. However increased diffi culties are encountered when males undergo surgery with increased conversion rates to open procedures. Objective: Th e objective of our study was to analyze gender as predictor of conversion of laparoscopic to open cholecystectomy and to also fi nd out other factors predicting conversion of laparoscopic to open cholecystectomy. Material and methods: We conducted Retrospective Cohort Study at Surgical Unit IV Civil Hospital Karachi. Record of all the patients who had undergone Laparoscopic Cholecystectomy from Jan 2013 to Dec 2013 were retrieved and reviewed. Patients were divided into two sub groups based upon their gender. Exposed group included male patients with gall stones disease and control group included female patients with gall stone disease. Results: A total of 123 Laparoscopic Cholecystectomies were performed in the above mentioned period. 24%(30) of the participants were males while seventy six percent of the participants (93) were females. Mean age of the participants was 40 +/- 11.8 years. Mean age of males was 45 +/- 14.5 years while that of females was 38.6 +/- 10.5 years, p value 0.028. 12 (9.8%) patients required conversion of the laparoscopic to open procedure. Th e risk of conversation of laparoscopic cholecystectomy to open procedure in male patients was 4.34 times those of female patients which when adjusted for covariates including age and cholecystitis reduced to 2.95 and did not achieve statistical signifi cance. For male patients, adjusted relative risk for operating surgeon to encounter diffi culty during operation turned out to be 1.86 times than those for female patients but this did not achieve statistical significance. Conclusion: Male gender does exhibit increased difficulty and conversion to open procedures while performing laparoscopic cholecystectomy however in our study they did not achieve statistical significance. Whether gender is an important risk factor to encounter difficulties and increased conversions to open procedures still needs to be studied in prospective setting.

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