Comparative Evaluation of Gallstone Disease in Diabetic & Non-Diabetic Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Introduction: Gallstone disease is a common biliary disorder requiring surgical management, and diabetes mellitus may increase operative difficulty by causing gallbladder dysmotility, chronic inflammation, dense adhesions and associated comorbidities.

Aim & Objective: To compare gallstone disease in diabetic and non-diabetic patients undergoing laparoscopic cholecystectomy with respect to clinical profile, ultrasonographic findings, operative difficulty, surgical outcome and histopathological changes.

Material & Methods: This comparative cross-sectional study was conducted over 1.5 years in the Department of Surgery, Hamdard Institute of Medical Sciences and Research and associated Hakeem Abdul Hameed Centenary Hospital, New Delhi. A total of 372 adult patients with gallstone disease scheduled for laparoscopic cholecystectomy were included and divided into diabetic and non-diabetic groups, with 186 patients in each group. Clinical history, comorbidities, ultrasonographic findings, operative procedure, Nassar intraoperative grade, operative duration, recovery from anesthesia and histopathological findings were recorded and statistically analyzed.

Results: Diabetic patients were significantly older than non-diabetic patients, with mean age of 52.24 ± 10.75 years versus 42.96 ± 11.32 years (p<0.001), and had a significantly higher burden of medical comorbidities (p<0.001). Gallbladder wall thickening was more common among diabetic patients (37 vs 16; p<0.001). Standard laparoscopic cholecystectomy was less frequent in diabetics, while subtotal or near-total cholecystectomy and laparoscopic-to-open conversion were higher. Diabetics also showed higher intraoperative difficulty grades, longer operative duration and delayed recovery from anesthesia. Xanthogranulomatous cholecystitis was significantly more frequent in diabetics (31 vs 9; p<0.001).

Conclusion: Diabetes mellitus is associated with greater inflammatory gallbladder changes, increased operative difficulty, prolonged operative time and more severe histopathological findings in patients undergoing laparoscopic cholecystectomy.

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