To reduce the risk of operation and postoperative complications, further explore the optimal operation time for diabetic patients with acute cholecystitis.

In combination with three centers in Urumqi, a retrospective analysis was made of 1 320 patients with diabetes mellitus who underwent surgery for acute cholecystitis from June 2010 to May 2019. According to the groups data of 0-3 d, >3-7 d and >7 d after admission, the incidence of postoperative biliary complications, incidence of conversion from surgery to open surgery and length of stay were analyzed. Multivariate Logistic regression analysis was used to analyze the correlation between operation timing and prognosis.

There were 858 cases in 0-3 d group, 330 cases in >3-7 d group and 132 cases in >7 d group. The proportion of patients who needed ERCP after operation were 0.9%, 1.5% and 3.0% respectively, the proportion of patients whoneeded common bile duct (CBD) reconstruction during operation were 0.2%, 0.6% and 1.5% respectively. The median age was 65 years old in >7 d group, and the proportion of male and CCI≥2 was the highest (56.1%, 23.5%) (P<0.001). The risk factors of ERCP were CCI≥2, preoperative preparation time more than 3 days, and SIRS (P<0.01). Age≥70 years old, female patients, CCI ≥2, preoperative preparation time more than 3 days, and SIRS were the risk factors of bile duct injury requiring common bile duct reconstruction (P<0.01).

For diabetes mellitus patients with acute cholecystitis, early appropriate surgical treatment on the basis of accurate analysis of patients’ condition can make patients benefit, while the preoperative CCI and SIRS score included in the assessment of surgery is conducive to risk assessment.