Acute cholecystitis in diabetic patients

Postoperative outcome and severity of acute cholecystitis in 32 diabetic patients (DM) who underwent urgent cholecystectomy were compared on a case-control basis with 32 nondiabetic age/sex matched controls. There was no difference in incidence of renal and lung diseases or duration of acute symptoms before surgery. Cardiovascular diseases were more often seen in the diabetic group (16/32 in DM, 7/32 in controls, P = 0.03). Bactobilia was more often in diabetics (19 in DM, 11 in controls, p = 0.07). Postoperatively, there was a trend toward higher incidence in overall complication rate. Infectious complications (wound and respiratory infections, hepatic abscess) were higher in DM, although the difference was not statistically significant. One patient in DM group died as a result of multiorgan failure. There was no difference in total and postoperative hospital stay. The severity of acute cholecystitis was greater in diabetics (26 patients with moderate-to-severe cholecystitis in DM group, 18 in control group, P = 0.05). The study indicates that although pathological findings were more severe in DM group, the postoperative course is comparable in diabetics as compared to age and sex matched nondiabetic controls. Our findings justify reconsideration of prophylactic cholecystectomy in asymptomatic diabetic patients.