Abstract:

Objective To explore the effect of diabetes on post-operative complications in elderly patients with laparoscopic cholecystectomy (LC). Methods Clinical data of 145 patients underwent LC (age≥60 years) were retrospectively analyzed. The incidences of complications were compared between diabetic and non-diabetic patients. Results There were 52 cases in the diabetic patient group, among which there were 5 ruptured gallbladder cases, 4 bile leakage cases, 4 wound infection cases, 3 abdominal infection cases, 4 pulmonary infection cases, 1 duodenal injury case, 1 umbilical hernia case, 3 intra-abdominal hemorrhage case, 1 bile duct injury case, and 3 residual bile duct stones cases. The post-operative complication rate was 19.2%. There were 93 cases in the non-diabetic patient group, among which there were 1 ruptured gallbladder case, 1 pulmonary infection case, 3 bile duct injury cases, 2 subcutaneous emphysema cases, and 3 residual bile duct stones cases. The post-operative complication rate was 8.6%. Six cases of diabetic patient group were undergone convertion laparotomy, while only two cases of nondiabetic patient group were undergone convertion laparotomy. The rates of convertion laparotomy were 11.5% and 2.2%, respectively. The difference was statistically significant (P<0.05). The rates of intraoperative rupture of the gallbladder, bile leakage and wound infection of diabetic patient group were significantly higher than those of non-diabetic patient group (P<0.05). The hospital days of diabetic patient group were also significantly longer than those of non-diabetic patient group (P<0.05). Conclusion Diabetes is one of the risk factors of operative complications after laparoscopic cholecystectomy and to which attention should be paid. The blood glucose of elderly diabetic patients should be regularly monitored during the peri-operative management. Intensive insulin therapy may performed to reduce the incidence of complications if necessary.

Key words: laparoscopic cholecystectomy, diabetes, postoperative complications, geriatric medicine