Acute cholecystitis in the diabetic. A case-control study of outcome.

The influence of diabetes on the risks associated with the operative treatment of acute cholecystitis has not been clearly defined. Therefore, a case-control study of 72 diabetics requiring urgent operation for acute cholecystitis was undertaken. Patients were matched for age, gender, and date of surgery with nondiabetic controls. Review of patient records revealed no significant difference in hospital stay or severity of operative and pathologic findings. However, diabetics suffered significantly more morbidity (38.9%) than nondiabetics (20.8%). Moreover, diabetic infection-related complications occurred at a rate nearly three times that of controls (19.4% vs 6.9%). The only mortalities were experienced by diabetics (4.2%) and were the direct result of the effects of sepsis. These findings suggest that acute cholecystitis in diabetics is associated with a higher incidence of infection-related complications and supports the need for expeditious operative therapy in symptomatic patients.