Background: Laparoscopic cholecystectomy (LC) is the gold-standard treatment for symptomatic gallstone disease, offering reduced postoperative pain, shorter hospital stay, and faster recovery compared to open surgery (1,2). Diabetes mellitus is associated with altered immune function, microvascular disease, and delayed wound healing, potentially increasing perioperative risks (3,4). Understanding early outcomes and complications in diabetic versus non-diabetic patients undergoing LC is critical for optimizing surgical strategies and perioperative care (5,6)..
Objective:
To compare early postoperative outcomes and complications of LC between diabetic and non-diabetic patients, and to assess the influence of diabetes on surgical recovery and complication rates.
Methods: A prospective observational study was conducted at a tertiary-care surgical unit between January 2022 and December 2024. Adult patients undergoing elective or emergency LC were categorized into diabetic and non-diabetic groups based on preoperative diagnosis and laboratory confirmation (7). Data included demographic details, comorbidities, operative findings, conversion to open surgery, intra- and postoperative complications, and length of hospital stay (8,9). Secondary data from published multicenter studies and local hospital records were integrated to strengthen comparative analysis (10,11). A short patient survey assessed subjective recovery experience and satisfaction with outcomes (12)..
Results: A total of 240 patients were included: 110 diabetics and 130 non-diabetics. Diabetic patients had a higher incidence of intraoperative difficulty, including adhesions (32% vs. 18%), gallbladder wall thickening (41% vs. 21%), and need for subtotal cholecystectomy (6% vs. 2%) . Conversion to open surgery occurred in 8.2% of diabetics versus 3.1% of non-diabetics . Postoperative complications were more frequent among diabetics, notably surgical-site infection (7% vs. 2%), bile leak (3% vs. 1%), and prolonged ileus (4% vs. 0.8%) (13,14). Mean hospital stay was longer for diabetics (4.2 ± 1.1 days) compared to non-diabetics (3.1 ± 0.9 days) . Survey responses indicated delayed return to normal activity in diabetics (median: 12 vs. 9 days) .
Conclusion: Diabetes is associated with more challenging intraoperative findings, higher conversion rates, and increased postoperative morbidity following LC. Enhanced perioperative optimization, meticulous glycemic control, and early surgical intervention may improve outcomes in diabetic patients (15). These findings underscore the need for tailored surgical planning and targeted postoperative monitoring in this high-risk group.
Keywords: Laparoscopic cholecystectomy, diabetes mellitus, surgical outcomes, postoperative complications, conversion rate, gallbladder surgery, glycemic control.