Resumen

LUCENA OLAVARRIETA, JR. Dificultades de la colecistectomía laparoscópica en el hombre. RFM [online]. 2004, vol.27, n.2, pp.163-168. ISSN 0798-0469.

Background: Age and clinical presentation have consistently been found to be important predictors of cholecystectomy outcomes; male gender has been cited in disparate studies as possibly having prognostic significance. Objective: To determine the importance of gender in the clinical presentation and subsequent clinical outcome -risk of conversion from laparoscopic to open technique and risk of postoperative mortality for patients undergoing cholecystectomy. Method: A cases cohort registry of 1970 cases undergoing cholecystectomy between 1991-2003 was analyzed, log-linear modeling was used to identify associations between characteristics of clinical presentation. Multivariate logistic regression analysis was used to determine predictions of conversion and mortality. Results: Male gender was associated with twice the expected incidence of acute cholecystitis and pancreatitis in the elderly (= > 65 years) . male had significantly increased risk for conversion to open technique, but this decreased during the time frame of the study. Mortality was twice as high among males (confidence interval ,1,3-2.8, p = 0.0001. Conclusions: Males presenting for cholecystectomy are more likely to have severe disease. Independent of clinical presentation, they face increased risks of conversion to open technique and of operative mortality.

Palabras clave : Cholelithiasis; Conversión; Colecistitis; Cholecystectomy; Laparoscopic; Open technique.