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Laparoscopic cholecystectomy for symptomatic gallstones in diabetic patients
A Bedirli1, E M Sözüer, O Yüksel
1Department of General Surgery, University of Erciyes, School of Medicine, Kayseri, Turkey. bedirlia@erciyes.edu.tr
Purpose:
To find out whether diabetes mellitus is a risk factor in patients who undergo laparoscopic cholecystectomy because of symptomatic gallbladder stones.
Patients And Methods:
Eight hundred sixty-two patients with symptomatic gallbladder stones underwent laparoscopic cholecystectomy at our institution between January 1993 and July 2000. Age, sex, risk classification of the American Society of Anesthesiologists (ASA), laboratory tests, operative records, morbidity, and length of hospital stay for each patient were analyzed.
Results:
There were 184 (21%) diabetic and 678 (79%) nondiabetic patients. The ASA class I applied to 534 nondiabetic (control) patients (79%), and ASA class II to 161 diabetic (study) patients (88%). There was no significant difference between the diabetic and nondiabetic patients regarding leukocyte count, bilirubin, or amylase levels. Operative and postoperative complication rates were significantly higher in the diabetic patients. Conversion to open surgery was required in 19 of 678 patients in the control group (2.8%) and 13 of 184 in the study group (7.1%). The operative time and length of hospital stay were not significantly different in the two groups.
Conclusions:
Although they had the same symptoms and laboratory findings, laparoscopic cholecystectomy in diabetic patients is associated with more morbidity and a higher conversion rate than in nondiabetic patients.