[Clinical and paraclinical features in diabetic patients cholecystectomized for gallstones]

Gallstones and diabetes mellitus represent a major economic burden especially when surgical treatment is involved.

The purpose of our study is to identify particular laboratory, imaging and pathological aspects that correlate with gallstones in diabetic patients that undergo cholecystectomy.

This retrospective study enrolled 234 subjects diagnosed and treated through cholecystectomy for gallstones during 01.01-31.12.2008 at the 1" Surgical Clinic, Iaşi "St. Spiridon" Hospital. The subjects were divided into 2 groups comprising 62 patients diagnosed with diabetes mellitus and gallstones (group i), respectively 172 patients diagnosed only with gallstones (group II).

There is a statistically significant difference between the two groups regarding ASA class (p = 0.002), body mass index, leukocyte count, serum amylase (p = 0.001) and alanine-aminotransferase levels. Ultrasound examination revealed thickness of the gallbladder wall as an edematous aspect at 29.03% of the diabetic patients vs 13.95% nondiabetic patients and cholesterolotic appearance at 6.45% diabetics vs 2.91% nondiabetics. Pathological examination identified chronic cholecystitis at 88.96% of the diabetic and 70.97% of the nondiabetic patients; there was no significant difference regarding the gallbladder pathological aspects.

Diabetes mellitus does not appear to modify substantially the pathological course in patients with gallstones. There is a greater surgical risk for diabetic patients, possibly due to higher body weight and older age in this group and an increased risk for hepatopancreatic lesions.