European Journal of Molecular & Clinical Medicine

Aim: To assess the gallbladder volume in T2DM patients and in healthy controls by using Ultrasonography.
Methodology: This cases control study was conducted among 55 diabetic patients enrolled from the diabetes clinic of the RVM Institute of Medical Sciences & Research Centre, Laxmakkapally, Telangana, India and 55 healthy patients (control group). 30-60 year patients of type 2 diabetes mellitus diagnosed since 5 year or more and functioning gall bladder with well controlled blood sugar levels. The diagnosis of diabetes in these patients was in accordance with WHO criteria i.e., fasting plasma glucose level ≥126 mg/dl, and ≥200 mg/dl plasma glucose level after 2hr of ingestion of standardised 75 gm glucose. An informed consent was taken from all the subjects in the study and control groups. All the patients were randomly selected for the study among patients regularly attending diabetic clinic of this hospital and following our criteria’s of selection.
Results: Mean age of diabetic Patient was 48.5 years in study group and 53 years in control group. 45.5% of diabetics were males and remaining 54.5% were females, whereas in control group male to female ratio was equal, means 49% males and 50% females. 85.5% cases in control group had no gall bladder disease, while only 63.6% cases in group with diabetes had no gall bladder disease. In group with DM type 2, 20% had cholelithiasis, 9.1% had cholecystitis, and 7.3% had sludge: while in control group, 5.5% had cholelithiasis, 3.6% had cholecystitis, and 5.5% had sludge. The percentage of contraction of gall bladder had reduced markedly in chronic diabetics (45.6 + 9.57) as compared to controls (65.2 + 7.34) (p value- 0.001). The fasting gall bladder volume in chronic diabetics was higher (43.47 + 5.35) than that of controls (28.45 + 4.26) and the difference of values was found to be highly significant (p value 0.001).
Conclusion: In patients of diabetes mellitus type 2, higher fasting gall bladder volume and decreased percentage of contraction are observed. Therefore, all T2DM patients should be evaluated using ultrasonography for the presence of increased fasting gallbladder volumes to assess the risk of progression to gall stone disease.

Background : Laparoscopic [LC] surgeries or minimally invasive surgeries are associated
with lesser parietal pain and haemorrhage, compared to the open surgeries. However visceral
pain persists. The effect of volume and concentration on intra-peritoneal instillation of local
anaesthetics for pain relief has not been studied . In this study we have compared the intraperitoneal
instillation of local anaesthetic with transversus abdominis plane block (TAP).
This study is aimed at assessing the superiority of effect of volume of local anaesthetic
instilled intra-peritoneally versus TAP block on post-operative pain relief in laparoscopic
cholecystectomy.

Aim: To assess the gallbladder volume in T2DM patients and in healthy controls by using
Ultrasonography.
Methodology: This cases control study was conducted among 50 diabetic patients enrolled
from the diabetes clinic of the Medicine Department of Maharishi Markandeshwar medical
college and hospital Kumarhatti, Solan, Himachal Pradesh and 50 healthy patients (control
group). 30-60 year patients of type 2 diabetes mellitus diagnosed since 5 year or more and
functioning gall bladder with well controlled blood sugar levels. The diagnosis of diabetes in
these patients was in accordance with WHO criteria i.e., fasting plasma glucose level ≥126
mg/dl, and ≥200 mg/dl plasma glucose level after 2hr of ingestion of standardised 75gm
glucose. An informed consent was taken from all the subjects in the study and control groups.
All the patients were randomly selected for the study among patients regularly attending
diabetic clinic of this hospital and following our criteria’s of selection.
Results: Mean age of diabetic Patient was 48.5 years in study group and 53 years in
control group. 46% of diabetics were males and remaining 54% were females, whereas in
control group male to female ratio was equal, means 50% males and 50% females. 90% cases
in control group had no gall bladder disease, while only 66% cases in group with diabetes
had no gall bladder disease. In group with DM type 2, 10% had cholelithiasis, 8% had
cholecystitis and 3% had sludge: while in control group, 4% had cholelithiasis, 2% had
cholecystitis and 4% had sludge. The percentage of contraction of gall bladder had reduced
markedly in chronic diabetics (45.6 + 9.57) as compared to controls (65.2 + 7.34) (p value-
0.001). The fasting gall bladder volume in chronic diabetics was higher (43.47 + 5.35) than
that of controls (28.45 + 4.26) and the difference of values was found to be highly
significant (p value 0.001).
Conclusion: In patients of diabetes mellitus type 2, higher fasting gall bladder volume and
decreased percentage of contraction are observed. Therefore, all T2DM patients should
be evaluated using ultrasonography for the presence of increased fasting gallbladder
volumes to assess the risk of progression to gall stone disease.