Clinical presentation and outcomes of cholecystectomy for acute cholecystitis in patients with diabetes - A matched pair analysis. A pilot study

Adv Med Sci. 2020 Sep;65(2):409-414. doi: 10.1016/j.advms.2020.08.001. Epub 2020 Aug 18.

Abstract

Purpose: The primary aim of this study is to compare the clinical course and laboratory parameters of acute cholecystitis in patients with diabetes vs. patients without diabetes.

Materials and methods: The study involved patients who underwent emergency cholecystectomy in the Department of General, Endocrine and Transplant Surgery of University Clinical Center in Gdansk (Poland) between 2007 and 2017. There were 267 patients included in the study. The control group of 197 patients was age and sex matched at a 3:1 ratio. The following was compared between the groups: symptoms at admission, course of surgery, postoperative course, length of hospitalization, total costs of hospitalization and antibiotic therapy, other than routine perioperative prophylaxis.

Results: There was no significant difference between the patients with and without diabetes regarding symptoms at admission. Operative and postoperative complication rates were significantly higher in the patients with diabetes. The operative time and length of hospitalization were significantly longer in the study group. The conversion rate was not higher in the study group, but classic surgery was performed significantly more often. The patients without diabetes had less pronounced symptoms with more locally advanced disease.

Conclusions: Our study demonstrates that patients with diabetes have a significantly more eventful course of acute cholecystitis than patients without diabetes. Patients with diabetes should therefore be qualified for cholecystectomy early in the course of acute cholecystitis.

Keywords: Cholecystitis; Complications; Diabetes; Postoperative course.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cholecystectomy / adverse effects*
  • Cholecystitis, Acute / complications
  • Cholecystitis, Acute / pathology
  • Cholecystitis, Acute / surgery*
  • Diabetes Mellitus / physiopathology*
  • Female
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Pilot Projects
  • Poland / epidemiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology*
  • Prognosis
  • Retrospective Studies
  • Time Factors