Effect of Di
Effect of Diabetes Mellitus on Patients Undergoing Laparoscopic Cholecystectomy: A Comparative Cross-Sectional Study
Saleh M. Aldaqal1, Alia T. Albaghdadi1, Hanaa M.Tashkandi1, Basem S. El-deek2, Ghada A. Al-Malki1; Ali M. Turki1, and Ahmed M. Makki1
1 Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
2Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia and Mansoura University, Egypt
Abstract: Diabetes was found to be a risk factor for gallstone formation, and complications. Diabetic patients are generally more prone to operative and post-operative morbidities than their normal counterparts. This study aimed to find whether diabetes is an independent risk factor for morbidities associated with laparoscopic cholecystectomy in our population. Material and Methods: This is a comparative cross-sectional study that was conducted at the Department of Surgery in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from June to December 2011. A total of 112 patients who have undergone laparoscopic cholecystectomy at our hospital were randomly selected and retrieved from the medical records department. Ethical Approval to conduct the study was obtained from the local ethical committee of king Abdulaziz University Hospital. A Performa designed by the study team was used to collect the data. Results: A total of 112 patients underwent laparoscopic cholecystectomy for cholelithiasis. 18 patients were male (16.1%) and 94 were female (83.9%) with a ratio of 1:5.2. The mean (±SD) age was 41.23 ± 13.82 years (range 15-75 years). Out of 112 patients, 18 were diabetics (16.1%) and 94 patients (83.9 %) were not diabetics. The operation was performed as an elective procedure in 104 patients (92.9%) and as an emergency in 8 patients (7.1%). Diabetics had a significantly higher rate of emergency admissions (22.2%) compared to non-diabetics (4.3%, p= 0.022). Laparoscopic cholecystectomy was converted to open procedure in 5 patients (4.5%) of which 3 were diabetics (16.7%) and 2 non-diabetics (2.1%). This shows a statistically significant higher (p=0.029) rate of conversion to open of diabetics compared to non-diabetics. Diabetics had a significantly higher (p= 0.029) mean length of post-operative hospital stay (2.06 ±1.60) compared to non-diabetics (1.43 ± 0.96). The level of HbA1c and fasting glucose level showed no significant effect on conversion to open procedure. The factors that were associated with higher risk of conversion to open were older age (p=0.004), male gender (p=0.029), diabetes (p=0.029), and acute calcular cholecystitis. Conclusion: Diabetes mellitus is associated with more emergency admission due to complicated cholelithiasis, more conversion rate from laparoscopic to open cholecystectomy and prolonged post-operative hospital stay. We found that neither fasting blood glucose level nor HbA1c level have any correlation with intraoperative or post-operative complication or conversion rate. We still however recommend a pre-operative control of blood glucose until we have a prospective randomized control trial comparing diabetic and non-diabetics patient going for laparoscopic cholecystectomy to know at which level of HbA1c or level of blood glucose should be achieved before surgery.
[Saleh M. Aldaqal, Alia T. Albaghdadi, Hanaa M. Tashkandi, Basem S. El-deek, Ghada A. Al-Malki; Ali M. Turki and Ahmed M. Makki Effect of Diabetes Mellitus on Patients Undergoing Laparoscopic Cholecystectomy: A Comparative Cross-Sectional Study. Life Sci J 2012;9(1):431-439]. (ISSN: 1097-8135). http://www.lifesciencesite.com. 64
Key words: Diabetes mellitus, laparoscopic cholecystectomy, open cholecystectomy, gall bladder, gall stone. Full Text 64