Medknow Publications on behalf of Association of Surgeons of India
Abstract
BACKGROUND : Mortality and morbidity from gallstones in the diabetic
patients in comparison with the nondiabetics are always controversial.
AIMS : To evaluate the risk factors associated with morbidity from
gallstones. MATERIALS AND METHODS : We have analyzed data from 669
cholecystectomies performed between March 2002 and December 2003.
RESULT S: Among 669 patients, 116 had complications. Complications
included 68 adhesions, 26 gangrenes of the gallbladder, 14
pancreatitis, 20 hydropses, and 5 perforations. In univariate analysis,
age, diabetes, hypertension, and ischemic heart disease were
significantly associated with high risk of complications. In
multivariate analysis, only diabetes caused a significant increase in
complications with odds ratio (OR) of 6.1 [95% Confidence Interval
(CI): 3.8-9.9]. Diabetes was also significantly associated with high
risk of adhesion (OR = 5.9; 95% CI: 3.3-10.5), gangrene (OR = 7.6; 95%
CI: 3.1-18.5) and pancreatitis (OR = 4.5; 95% CI: 1.3-15.8).
CONCLUSION: Although this study does not directly support prophylactic
cholecystectomy, the increased morbidity in the diabetics implies that
diabetic patients with asymptomatic gallstone need more care and
attention