Mortality of Urgency Versus Elective Videolaparoscopic Cholecystectomy for Acute Cholecystitis

Background: Laparoscopic cholecystectomy is the preferable treatment for chronic or acute cholecystitis. Some factors may increase the rate of laparoscopic conversion to open cholecystectomy and perioperative complications. The role of gender as a risk factor for laparoscopic cholecystectomy is controversial. Aim: To evaluate the role of the gender on the operative findings and outcome of laparoscopic cholecystectomy. Method: All patients who underwent laparoscopic cholecystectomy for chronic or acute cholecystitis were included. Demographic, clinical, laboratory, imaging exams, intraoperative and postoperative data were obtained and analyzed. The data was obtained retrospectively from electronic medical records and study protocols. Results: Of a total 1,645 patients who were subjected to laparoscopic cholecystectomy, 540 (32.8%) were men and 1,105 (67.2%) were women. Mean age was similar in both genders (p=0.817). Operative time has longer in the male (72.48±28.50) than in the female group (65.46±24.83, p<0.001). The rate of acute cholecystitis was higher in the male (14.3%) than in the female group (5.1%, p<0.001). There was no difference between the genders in regard to the rate of conversion (p=1.0), intraoperative complication (p=1.0), postoperative complication (p=0.571), and operative mortality (p=1.0). Conclusion: Male gender is not an independent risk factor for laparoscopic conversion and perioperative complications.

“…Gallstone is one of the most common diseases, with a prevalence of about 10% in the general population of Brazil and in most western countries 6 , 9 , 10 .…”

Section: Introductionmentioning

confidence: 99%

Does Male Gender Increase the Risk of Laparoscopic Cholecystectomy?

Coelho

Dalledone

Schiel³

et al. 2019

“…A 5-year retrospective study from Germany showed that male cases presented more frequently both gangrenous (29.0% vs. 20.3%; p<0.05) and necrotizing cholecystitis (33.3% vs. 10.1%; p<0.05) and a higher median of intraoperative blood loss (250 mL vs. 180 mL; p<0.05) compared to female cases 3 . In Brazil, Felício et al demonstrated that the number of deaths was higher among men in both elective (0.0006% vs. 0.0004%) and urgent (0.0027% vs. 0.0022%) cholecystectomies in a comparative study on acute cholecystitis 12 .…”

Section: Discussionmentioning

confidence: 99%

“…A longitudinal study placed in the Department of General Surgery at a University Hospital in Poland evaluated 504 patients (178 males and 326 females) admitted and scheduled to cholecystectomy due to GBDs and showed that male cases had a higher mean of length of hospital stay (92.5 h vs. 80.7 h) 22 . In Brazil, a retrospective study evaluated 250,439 patients undergoing cholecystectomies from 2009 to 2014 and demonstrated that men had longer in-hospital stay in days (5.3 days vs. 4.4 days) 12 .…”

Section: Discussionmentioning

confidence: 99%

A Population Study on Gender and Ethnicity Differences in Gallbladder Disease in Brazil

Nascimento

Tomaz

Souza-Filho

et al. 2022

- BACKGROUND: Gallbladder diseases (GBD) are one of the most common medical conditions requiring surgical intervention, both electively and urgently. It is widely accepted that sex and ethnic characteristics mighty influence both prevalence and outcomes. AIM: This study aimed to evaluate the differences on distributions of gender and ethnicity related to the epidemiology of GBD in the Brazilian public health system. METHODS: DATASUS was used to retrieve patients’ data recorded under the International Code of Diseases (ICD-10) - code K80 from January 2008 to December 2019. The number of admissions, modality of care, number of deaths, and in-hospital mortality rate were analyzed by gender and ethnic groups. RESULTS: Between 2008 and 2019, a total of 2,899,712 patients with cholelithiasis/cholecystitis (K80) were admitted to the hospitals of the Brazilian Unified Health System, of whom only 22.7% were males. Yet, the in-hospital mortality rate was significantly higher in males (15.9 per 1,000 male patients) than females (6.3 per 1,000 female patients) (p<0.05). Moreover, men presented a significantly higher risk of death (RR=2.5; p<0.05) and longer hospital stay (4.4 days vs. 3.3 days; p<0.05) than females. Compared to females, men presented a higher risk of death across all self-declared ethnic groups: whites (RR=2.4; p<0.05), blacks (RR=2.7; p<0.05), browns (RR=2.6; p<0.05), and Brazilian Indians (RR=2.13; p<0.05). CONCLUSION: In the years 2008-2019, women presented the highest prevalence of hospital admissions for GBD in Brazil, and men were associated with worse outcomes, including all ethnic groups.

“…Cholelithiasis affects more than 20 million Americans in adulthood at an annual cost of $ 6.2 billion 6 . Approximately 15% of patients may develop complications with high potential for morbidity and choledocholithiasis, which often requires the use of invasive methods for their definitive diagnosis 7 . Recurrent symptoms, acute pancreatitis or acute cholangitis are common 19 .…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Magnetic Resonance Cholangiopancreatography and Perioperative Cholangiography in Patients With Suspect Choledocholithiasis

Perales¹,

Souza²,

Crema³

2019

Background:Cholelithiasis is a highly prevalent condition, and choledocholitiasis is a high morbidity complication and requires accurate methods for its diagnosis. Aim:To evaluate the population of patients with suspected choledocholitiasis and check the statistical value of magnetic resonance cholangiopancreatography, ultrasonography, the laboratory and the clinic of these patients comparing them to the results obtained by perioperative cholangiography. Methods:This is a retrospective cohort study, which were evaluated 76 patients with cholelithiasis and suspected choledocholithiasis. Results:It was observed that the presence of dilatation of the biliary tract or choledocholithiasis in the ultrasonography was four and eight times increased risk of perioperative cholangiography for positive choledocholithiasis, respectively. For each unit increased in serum alkaline phosphatase was 0.3% increased the risk of perioperative cholangiography for positive choledocholithiasis. In the presence of dilatation of the bile ducts in the ultrasonography was four times greater risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. In the presence of pancreatitis these patients had five times higher risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. On the positive magnetic resonance cholangiopancreatography presence to choledocholithiasis was 104 times greater of positive perioperative cholangiography for choledocholithiasis. Conclusions:The magnetic resonance cholangiopancreatography is a method with good accuracy for propedeutic follow-up for the diagnosis of choledocholithiasis, consistent with the results obtained from the perioperative cholangiography; however, it is less invasive, with less risk to the patient and promote decreased surgical time when compared with perioperative cholangiography.