Shilling Bailey Kimberly, Marsh Wallis, Daughtery Levi, Hobbs Gerry, Borgstrom David
Am Surg. 2019 Aug 1;85(8):830-833.
Although gallbladder disease (GBD) is more common in females, we have noticed a trend toward more complicated cases in male patients. We reviewed all cholecystectomies performed at our institution over the last five years. After eliminating cases with confounding variables, we identified 1529 records. Charts were reviewed for age, gender, BMI, procedure performed, operative time, length of stay, and preoperative diagnosis. Descriptive and inferential statistical analyses were conducted along with linear regression. There were 1444 laparoscopic, 64 laparoscopic converted to open, and 21 primary open cases. Patients were 1008 (66%) females and 521 (34%) males. Average operative time was 89.8 minutes. Cholecystectomy averaged 17.7 minutes longer in males ( = 0.0046). Two per cent of female patients and 7.9 per cent male patient converted to open. Males were more likely to have complicated GBD, whereas women had uncomplicated disease. Average age was 51.9 years for males 42.7 years for females. Age, gender, BMI, length of stay, and preoperative diagnosis were all independently significant in predicting operative time. In our study, women presented with uncomplicated GBD, whereas men presented with complicated GBD. This suggests that male patients present at a later stage of disease.
尽管胆囊疾病(GBD)在女性中更为常见,但我们注意到男性患者中出现复杂病例的趋势有所增加。我们回顾了过去五年在我们机构进行的所有胆囊切除术。在排除具有混杂变量的病例后,我们确定了1529份记录。对病历进行了年龄、性别、体重指数、所实施的手术、手术时间、住院时间和术前诊断等方面的审查。进行了描述性和推断性统计分析以及线性回归分析。其中有1444例腹腔镜手术、64例腹腔镜转为开放手术和21例初次开放手术病例。患者中女性有1008例(66%),男性有521例(34%)。平均手术时间为89.8分钟。男性的胆囊切除术平均比女性长17.7分钟(P = 0.0046)。2%的女性患者和7.9%的男性患者转为开放手术。男性更有可能患有复杂的GBD,而女性则患有非复杂性疾病。男性的平均年龄为51.9岁,女性为42.7岁。年龄、性别、体重指数、住院时间和术前诊断在预测手术时间方面均具有独立的显著性。在我们的研究中,女性表现为非复杂性GBD,而男性表现为复杂性GBD。这表明男性患者在疾病的较晚阶段就诊。