This study has several limitations

This study has several limitations. First, the study has a retrospective and nonrandomized design. The number of peritoneal dialysis patients was relatively small. Consequently, large variations and nonsignificant differences may occur between pre- and postoperative PAS scores in this patient group. A recent large series from Tainan showed that 82 (9%) of 888 ESRD patients undergoing parathyroidectomy were on peritoneal dialysis. Differences between dialysis modalities would be more pronounced in a larger cohort of patients. In addition, our study was limited by its relatively short follow-up period, which restricts the ability to make meaningful conclusions regarding recurrence.
Introduction Gallstone disease (GSD) is a prevalent medical condition causing considerable economic and social burdens. Epidemiological evidence indicates that the prevalence of GSD ranges from 10% to 15%. Major risk factors for GSD are old age, obesity, and female sex. Other factors associated with an increased risk of GSD are ethnicity, a high-fat or high-carbohydrate diet, ionophores use, and Gilbert\'s syndrome. By contrast, alcohol and coffee consumption, a high-fiber diet, and statin use seem to lower the risk of GSD. Furthermore, studies have reported a higher hospital admission rate among the diabetic population. The estimated age-standardized hospital admission rate for GSD was 0.6 per 1000 persons. However, since the 1990s, an increasing trend has been observed in the hospital admission rates for gallstones, which is probably caused in part by the use of improved technology, notably the use of laparoscopic cholecystectomy (LC) as a treatment option. Approximately 70–80% of all types of cholecystectomy in western countries are the LC type. Few studies have evaluated the outcome of LC in diabetic patients or the effect of diabetes-associated comorbidities on the surgical risk in these patients. Some studies have reported that diabetes predisposes patients to a high risk of conversion from LC to open cholecystectomy. 3Evidence reveals that diabetes is a risk factor for GSD, and the prevalence of GSD is higher in diabetic patients than in nondiabetic patients. In clinical settings, cholecystectomy-related decisions regarding patients diagnosed with diabetes remain controversial, particularly in patients with asymptomatic GSD. Several studies have suggested that more attention should be paid to operative and postoperative complications, GSD-associated morbidities, or both of these factors in diabetic patients, resulting in superior management and favorable outcomes in these patients. Currently, little is known about the rate of cholecystectomy for GSD in diabetic patients compared with that in nondiabetic patients in the general population. An understanding of this situation in the general population may enable public health authorities to provide appropriate health care services and resources in a cost-effective manner.
Materials and methods
Results We recruited 60,734 patients with diabetes without prior GSD and 48,116 nondiabetic persons without prior GSD in 2000 from the NHRI datasets in this study (Table 1). The mean ± standard deviation ages were 62.9 ± 11.1 and 62.1 ± 11.3 years for nondiabetic controls and diabetic patients, respectively. Age and sex distributions between the diabetic and control groups were similar, with women accounting for 56.6% of the nondiabetic controls and 55.3% of diabetic patients. In both groups, approximately 50% of participants were aged >64 years, and 45% were aged between 45 and 64 years. Diabetic patients had a slightly lower, but not significantly lower, mean insurance premium than the nondiabetic controls did. The mean preoperative Charlson\'s Comorbidity Index score was substantially higher for diabetic patients than for nondiabetic controls (1.4 ± 0.8 vs. 0.2 ± 0.5, respectively). Urbanization was prominent in both groups regarding the geographical area, and the geographical distributions between the two groups were similar.