Female surgeons have better outcomes in cholecystectomies but longer operating times
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Key takeaways:
- Male surgeons had more surgical and total complications when performing cholecystectomies.
- Female surgeons had significantly longer operating times.
Female surgeons had fewer surgical and total complications in elective and acute care cholecystectomies but longer operating times compared with male surgeons, according to data in JAMA Surgery.
“Female surgeons are still in the minority worldwide,” My Blohm, MD, of the Karolinska Institute in Stockholm, told Healio. “Previously published studies have demonstrated that female and male physicians practice medicine differently, but less is known about differences between female and male surgeons.”
In a population-based cohort study, researchers investigated whether female and male surgeons differ in outcomes and operating time of cholecystectomies, a frequently performed surgical procedure.
Using data from the Swedish National Registry of Gallstone Surgery, they included 150,509 patients who underwent elective (64.9%) or acute care (35.1%) cholecystectomy between January 2006 and December 2019. The procedures were performed by 2,553 surgeons, of whom 67.7% were men and 33.3% were women.
According to results, female surgeons performed fewer cholecystectomies per year compared with male surgeons (18 vs. 26) and were “somewhat better represented” at universities and private clinics.
Researchers reported that male surgeons had more surgical complications, including bleeding, visceral perforation, bile duct injury, postoperative bile leakage and abscesses, in elective and acute care cholecystectomies.
Further, patients operated on by male surgeons had more surgical (OR = 1.29; 95% CI, 1.19-1.4) and total (OR = 1.12; 95% CI, 1.06-1.19) complications, as well as bile duct injuries in elective surgery (OR = 1.69; 95% CI, 1.22-2.34). Male surgeons also converted to open surgery more often in acute care cholecystectomies (OR = 1.22; 95% CI, 1.04-1.43) and their patients had longer hospital stays (OR = 1.21; 95% CI, 1.11-1.31).
Bleeding complications also were more common among patients whose procedures were performed by male surgeons (OR = 1.66; 95% CI, 1.24-2.23), but there were no significant differences in 30-day mortality between patient groups.
Researchers also noted women had significantly longer operating times for both elective (100 mins. vs. 89 mins.) and acute care (126 mins. vs. 111 mins.) cholecystectomies.
“As for all observational studies these results should be interpreted with some caution,” Blohm said. “We have tried to identify and include factors in our analysis that may confound the results, but there can still be unidentified factors. In some countries there is a general belief that male surgeons are superior to female surgeons. Research within this area of interest is important to change this belief, and most published studies indicate that female surgeons are at least as good as male surgeons, or even slightly better.”
Blohm continued: “We hope that our study can contribute to an increased understanding of gender differences and promote gender equity within the surgical specialty.”
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