Impact of diabetes mellitus on cholecystectomy rate: A population-based follow-up study

Abstract

Summary Background/Introduction Some reports suggest early cholecystectomy for diabetic patients with asymptomatic gallstone disease (GSD) to prevent subsequent serious infection. However, only a few studies have examined the incidence of cholecystectomy in response to GSD in diabetic patients. Our study attempts to elucidate the relationship between GSD and diabetes using the high coverage rate health insurance system of Taiwan and thus evaluate the validity of early cholecystectomy in diabetic patients. Purpose(s)/Aim(s) To investigate the rate of cholecystectomy in diabetic patients with GSD. Methods Diabetic patients without prior treatment for GSD on hospitalization or ambulatory visits were identified and compared with age- and sex-matched controls and were followed up for 8 years. Cholecystectomy incidence density rates were estimated according to the patients' diabetic status. Cox proportional hazards regression models were used to analyze the age- and sex-specific effects of diabetes on the risk of surgery for GSD. Results The incidence rates of patients who developed GSD and underwent cholecystectomy were 18.65% and 17.15% in the diabetic and control groups, respectively; thus, the rate of cholecystectomy was higher in the diabetic group than in the control group. Male sex and old age were associated with a high rate of cholecystectomy, irrespective of the diabetic status. Hypertension, cholangitis, and Caroli disease were associated with an increased risk of cholecystectomy in patients with GSD. Overall, diabetic patients exhibited a higher incidence of cholecystectomy than nondiabetic patients did over an 8-year follow-up period. Conclusion Men with GSD are more likely to undergo cholecystectomy than women, irrespective of the diabetic status; therefore, an aggressive GSD management approach for men must be considered for early identification of these patients before the need for emergency surgery.