Effect Of Diabetes On Operative Outcome Of Laparoscopic Cholecystectomy: A One Year Case Series Study At Tertiary Care Hospital, Belgaum

Abstract

Background and objectives Diabetes is reported to be a risk factor for gallstone formation and these patients are generally more prone to operative and post-operative morbidities. This study was aimed to find intra-operative difficulties and complications during laparoscopic cholecystectomy in diabetics and non diabetics. Methodology This one year case series was carried out in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. A total 60 patients (30 diabetics and 30 non diabetics) undergoing elective laparoscopic cholecystectomy from January 2014 to December 2014 were studied and the operative difficulties during the surgery and complications encountered were noted. In patients with diabetes, the mean duration of diabetes was 9.08 ± 5.15 years and most of the patients (60%) were on oral hypoglycaemic agents and had moderate glycaemic control (43.33%). Results The male to female ratio was 1.30:1 and 56.67% of the patients were males in diabetic as well as and non diabetic group. Among the patients with diabetes, 60% were aged between 46 to 60 years compared to 23.33% in non diabetics (p<0.001). Other pre operative characteristics including clinical presentation duration of symptoms, history of other associated diseases and vitals were comparable in diabetic and non diabetics patients (p>0.050). Significantly higher number of patients in diabetic group underwent open pneumoperitoneum (40% vs 16.67%; p=0.045). Statistically significant difference was noted with regard to the appearance of gall bladder, adhesions, dissection of Calot’s triangle, releasing adhesions, intra operative bleeding, grasping of gallbladder, removal of gallbladder from liver bed, extraction of specimen, drain placement and conversion (p<0.050). The operative time was significantly higher in patients with diabetes mellitus (103.00 ± 26.54 vs 78.83 ± 19.06 minutes; p<0.050). Conclusion and interpretation Diabetes mellitus is significantly associated with several operative difficulties and prolonged surgical time during laparoscopic cholecystectomy.