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目的 分析胆石症和糖尿病发病率之间的关系，讨论糖尿病合并无症状胆石症时是否应该手术治疗以及糖尿病病人胆道手术的围手术期处理。方法 对４０例合并高血糖的胆石症病人进行回顾性分析。结果 外科治疗胆石症６９３例，其中４０例合并高血糖。男性１４例，女性２６例；平均年龄６０．１岁。确认糖尿病１５例，可疑糖尿病１１例，应激性高血糖１４例。手术治疗３３例，胆囊切除１４例，胆囊切除、胆总管探查１６例，胆肠内引流２例，腹腔镜胆囊切除１例。术后切口感染２例，肺部感染３例，泌尿系感染２例。伴发急性胰腺炎２例，慢性胰腺炎１例。同时伴发急性梗阻性化脓性胆管炎、冠心病、Ⅲ度房室传导阻滞，未手术死亡１例。结论 糖尿病合并无症状胆石症时，即使不做预防性胆囊切除，也应在一旦出现症状时立即手术治疗。围手术期应严密监测血糖，根据病情持续静滴含胰岛素的葡萄糖液体，并注意维持好代谢平衡。
Objective To analyze the relationship between cholelithiasis and the incidence of diabetes mellitus, and to discuss whether perioperative management should be performed in patients with diabetes mellitus complicated with asymptomatic cholelithiasis and biliary surgery in patients with diabetes mellitus. Methods 40 cases of cholelithiasis patients with hyperglycemia were retrospectively analyzed. Results Surgical treatment of cholelithiasis 693 cases, of which 40 cases with hyperglycemia. 14 males and 26 females with an average age of 60.1 years. Confirm 15 cases of diabetes, 11 cases of suspicious diabetes, stress hyperglycemia in 14 cases. Surgical treatment of 33 cases, 14 cases of cholecystectomy, cholecystectomy, common bile duct exploration in 16 cases, bile duct drainage in 2 cases, laparoscopic cholecystectomy in 1 case. Postoperative incision infection in 2 cases, 3 cases of lung infection, urinary tract infection in 2 cases. Accompanied by acute pancreatitis in 2 cases, 1 case of chronic pancreatitis. At the same time with acute obstructive suppurative cholangitis, coronary heart disease, Ⅲ degree atrioventricular block, no operative death in 1 case. Conclusions Diabetes mellitus with asymptomatic cholelithiasis should be treated immediately in the event of a symptom, even if prophylactic cholecystectomy is not performed. Perioperative monitoring of blood glucose should be closely, according to the disease continued intravenous infusion of insulin-containing glucose fluid, and pay attention to maintaining a good metabolic balance.