Serban Dragos, Balasescu Simona Andreea, Alius Catalin, Balalau Cristian, Sabau Alexandru Dan, Badiu Cristinel Dumitru, Socea Bogdan, Trotea Andra Maria, Dascalu Ana Maria, Motofei Ion, Ardeleanu Valeriu, Spataru Radu Iulian, Sabau Dan, Smarandache Gabriel Catalin
4th Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.
Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania.
Exp Ther Med. 2021 Jul;22(1):758. doi: 10.3892/etm.2021.10190. Epub 2021 May 13.
The present study aimed to compare the clinical, paraclinical, intraoperative findings, and postoperative complications in acute cholecystitis in diabetic patients vs. non-diabetic patients. A 2-year retrospective study was performed on the patients who underwent emergency cholecystectomy for acute cholecystitis between 2017 and 2019 at the 4th Department of Surgery, Emergency University Hospital Bucharest. The diabetic subgroup numbered 46 eligible patients and the non-diabetic one 287 patients. Demographics, the severity of the clinical forms, biological variables (including white cell count, urea, creatinine, coagulation and liver function tests) comorbidity status, surgical approach, postoperative complications, and hospital stay were analyzed. Statistical analyses were performed to assess comparative results between the aforementioned data (SPSS V 13.0). The CCI and ASA risk classes were increased in the diabetic group, with 34.78% of patients having 3 or more associated comorbidities. No statistically significant associations were demonstrated between diabetes and the severity of the cholecystitis and risk for conversion. Postoperatively both minor complications such as surgical site infections and major cardiovascular events were more common in the diabetic subgroup (P=0.0254), well associated with the preoperative status and baseline cardiovascular comorbidities. Laparoscopic cholecystectomy is a safe procedure for diabetic patients, which can provide the best outcomes, by decreasing the risks of surgical wounds. Attentive perioperative care and good glycemic control must be provided to minimize the risk of complications.
本研究旨在比较糖尿病患者与非糖尿病患者急性胆囊炎的临床、副临床、术中发现及术后并发症。对2017年至2019年在布加勒斯特急诊大学医院外科四科因急性胆囊炎接受急诊胆囊切除术的患者进行了一项为期2年的回顾性研究。糖尿病亚组有46例符合条件的患者，非糖尿病亚组有287例患者。分析了人口统计学、临床症状严重程度、生物学变量（包括白细胞计数、尿素、肌酐、凝血和肝功能检查）、合并症状态、手术方式、术后并发症及住院时间。进行统计分析以评估上述数据之间的比较结果（SPSS V 13.0）。糖尿病组的CCI和ASA风险等级增加，34.78%的患者有3种或更多相关合并症。糖尿病与胆囊炎严重程度及中转风险之间未显示出统计学上的显著关联。术后，糖尿病亚组的手术部位感染等轻微并发症和重大心血管事件更为常见（P = 0.0254），这与术前状态和基线心血管合并症密切相关。腹腔镜胆囊切除术对糖尿病患者是一种安全的手术，通过降低手术伤口风险可提供最佳结果。必须提供精心的围手术期护理和良好的血糖控制，以尽量降低并发症风险。
