Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11667
Title: Sex differences and outcomes of management of acute cholecystitis.
Authors: Nikfarjam, Mehrdad;Harnaen, Efrant;Tufail, Farrukh;Muralidharan, Vijayaragavan;Fink, Michael A;Starkey, Graham;Jones, Robert M;Christophi, Christopher
Affiliation: Department of Surgery, Austin Health, University of Melbourne, Melbourne, VIC, Australia. mehrdad.nikfarjam@gmail.com
Issue Date: 1-Feb-2013
Citation: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques; 23(1): 61-5
Abstract: Several series have reported differences in characteristics, severity, operative complexity, and outcomes of patients with symptomatic gallstone disease according to sex. Whether sex truly influences outcomes of patients with acute cholecystitis in the current era of early laparoscopic cholecystectomy for acute cholecystitis is unknown.Patients with histologically confirmed acute cholecystitis treated by a specialized unit in a tertiary hospital between November 2005 and January 2011 were identified. Retrospective review of data was undertaken and patients were compared according to sex.There were 386 cases of confirmed acute cholecystitis in this series, with 181 (47%) occurring in male patients. Male patients with acute cholecystitis tended to be older (66 vs. 57 y; P < 0.001) and were more likely to have underlying diabetes (21% vs. 9%; P = 0.001), ischemic heart disease (24% vs. 8%; P < 0.001), chronic liver disease (6% vs. 1%; P = 0.015), and chronic obstructive airways disease (11% vs. 5%; P = 0.025). They were also more likely to be febrile, tachycardic, hypotensive, and exhibit right upper quadrant rigidity at presentation than females (P < 0.05), despite similar duration of symptoms before presentation (P = 0.970). The operative technique, operative time, and rate of conversion to open surgery were similar between the sexes. Gangrenous pathology was, however, more common in male patients (45% vs. 23%; P < 0.001). The overall complication, mortality, and readmission rates were similar between the 2 groups. Males, however, had a longer postoperative length of stay (4 vs. 3 d; P = 0.001).Male patients with acute cholecystitis are older, have more comorbidities, and are more likely to have gangrenous cholecystitis than female patients. Despite these differences, operative outcomes and postoperative morbidity and mortality are similar between male and female patients.
Internal ID Number: 23386154
URI: http://ahro.austin.org.au/austinjspui/handle/1/11667
DOI: 10.1097/SLE.0b013e3182773e52
URL: http://www.ncbi.nlm.nih.gov/pubmed/23386154
Type: Journal Article
Subjects: Age Factors
Aged
Cholecystectomy, Laparoscopic.statistics & numerical data
Cholecystitis, Acute.pathology.surgery
Conversion to Open Surgery.statistics & numerical data
Female
Gallbladder.pathology
Gangrene.etiology
Humans
Length of Stay
Male
Middle Aged
Operative Time
Sex Factors
Appears in Collections:Journal articles

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