Outcomes and Complications of Early Cholecystectomy versus Conservative Management in Diabetic Patients with Asymptomatic Gallstones
DOI:
https://doi.org/10.51985/Keywords:
Cholecystectomy, Laparoscopic; Diabetes Mellitus; Gallbladder Calculi; Gallstones; Pancreatitis, BiliaryAbstract
Objective: To compare gallstone-related complication rates, emergency cholecystectomy conversions, morbidity, mortality, hospital stay duration, and 30-day readmissions between early laparoscopic cholecystectomy and conservative management in diabetic patients with asymptomatic gallstones.
Study design and setting: This was a prospective, comparative cohort study in which participants were recruited from the Department of General Surgery, Lady Reading Hospital, Peshawar, between January 2024 and December 2024. Those meeting inclusion criteria were allocated to either early laparoscopic cholecystectomy or conservative management groups, and outcomes were assessed at 3, 6, and 12 months.
Methodology: A total of 170 diabetic patients with ultrasound-confirmed asymptomatic gallstones were allocated equally into early cholecystectomy and conservative management group. The primary outcomes included gallstone-related complications, emergency cholecystectomy, and 30-day readmissions. Secondary outcomes included length of hospital stay and morbidity rates.
Results: The early cholecystectomy group showed significantly lower rates of complications (7.1% vs. 18.8%; p = 0.02) and emergency cholecystectomy (0% vs. 10.6%; p = 0.001) compared to the conservative group. Readmissions were also reduced in the early surgery group (2.4% vs. 8.2%; p = 0.04), and the mean hospital stay was shorter (2.5 ± 1.1 vs. 5.2 ± 1.8 days; p < 0.001). No mortality was observed in either group.
Conclusions: This study suggests that early cholecystectomy in diabetic patients with asymptomatic gallstones significantly lowers the risk of complications and healthcare utilization compared to conservative management, supporting the adoption of early elective surgery in high-risk populations.
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