Common symptoms
Fever and chills: Fever is related to the degree of inflammation of the gallbladder. Chills and high fever may be present in gangrenous cholecystitis and purulent cholecystitis.
Gastrointestinal symptoms: In acute attacks of gallbladder stones, gastrointestinal reactions such as nausea and vomiting are often present following abdominal pain. Vomit is mostly stomach contents, and abdominal pain is not significantly relieved after vomiting. Acute attacks are often followed by aversion to greasy food, abdominal distension and indigestion.
Jaundice: Some patients with gallbladder stones can develop transient jaundice, mostly after severe abdominal pain, and the jaundice is mild. Jaundice can be caused by gallbladder stones with cholangitis, partial obstruction due to compression of the common bile duct by an enlarged gallbladder, or transient damage to liver cells due to infection. This is manifested as yellowing of the sclera of the eyes.
Abdominal pain: abdominal pain is one of the main clinical manifestations of gallbladder stones. Most gallbladder stone attacks have typical biliary colic. It is characterized by paroxysmal spasmodic pain in the epigastrium or right epigastrium with progressive aggravation, often radiating to the right shoulder and back. The abdominal pain is caused by stones moving from the gallbladder lumen to the cystic duct causing stone impaction. As the gallbladder duct is obstructed by the stone, the internal pressure of the gallbladder increases, the smooth muscle of the gallbladder contracts and spasms, and attempts to expel the gallstone, resulting in severe biliary colic.
More than 90% of biliary colic attacks are sudden, often after a full meal, overexertion or strenuous exercise. Stones can easily fall into the cystic duct when lying down, and some patients can have sudden attacks at night. In addition to severe pain, there is often restlessness, even tossing and turning, distraction, sweating, and pallor. Each attack can last from 10 minutes to several hours, and it often takes several days for the attack to resolve. Pain relief or disappearance indicates that the stone has retreated into the gallbladder, at which point other symptoms disappear.
Causes and process
As a general rule of stone formation, they have a basic process of precipitation, precipitation, nucleation and accumulation of bile components. The pathogenesis consists of several elements: first, the bile must be supersaturated with cholesterol or calcium; second, the solute must nucleate and precipitate as solid crystals from the solution; third, the crystals must aggregate and fuse to form stones, and the crystals grow and collect in the mucus and gel spread throughout the wall of the gallbladder.
Cholesterol stones —- are formed on the basis of an imbalance in the ratio of cholesterol, bile acids and lecithin in the bile, resulting in supersaturation of cholesterol in the bile and crystallization, precipitation, aggregation and stone formation. Most of the cholesterol in bile originates from the biosynthesis of hepatocytes rather than from the secretion of cholesterol from the diet. The formation of cholesterol stones is mainly due to the supersaturation of cholesterol in the bile synthesized by hepatocytes and the nucleation of cholesterol crystals by proteins in the bile. In addition, some studies have shown that changes in prostaglandin synthesis in the gallbladder and high calcium concentrations in the bile may also contribute to gallstone formation. In some patients, the prerequisite for gallstone formation is bile sludge production. The so-called bile sludge is composed of stagnant glycoproteins containing cholesterol crystals. This bile sludge can be detected on ultrasound and may be the only abnormality detected on ancillary testing in patients with biliary colic, pancreatitis or cholangitis.
Bile Pigment Stones
Bile pigment stones —- include both black stones and brown stones. Black stones form mainly in the gallbladder in patients with hepatic sclerosis or chronic hemolytic disease, while brown stones can form both in the gallbladder and in the bile duct. Bacterial infection is the main cause of primary bile duct stone formation. Primary bile duct stones are common in Asia, and the source of infection may be attributed to parasites such as Toxoplasma gondii or other less clear causes. The prevalence of gallstones increases with age and is more prevalent in women. Pregnancy, obesity, westernized diet, and total parenteral nutrition may increase the risk of gallstones. In addition, ethnic factors are also associated with the incidence of gallstones, for example, the prevalence rate of western American Indians is more than 75%, which is the highest incidence of gallstones in the world. A survey of 11,342 gallstone patients in 26 provinces and cities in China from 1983 to 1985 showed that the distribution and type of gallstones were related to geography, diet, occupation, and infection. In the dietary habits, those who ate more protein, fat, or sugar in any of these categories had gall
intrahepatic bile duct stones
The incidence of cystic or cholesterol stones is higher, whereas bile duct stones and bile pigment stones are higher in those who eat a regular diet or more vegetables. Bile duct stones are about 3-5:1 in urban areas and 15:1 in rural areas, with nearly 70% of gallbladder stones and 20% of bile duct stones among workers, nearly 60% of gallbladder stones and 30% of bile duct stones among workers, and only 25% of gallbladder stones and 65% of bile duct stones among farmers. Cholesterol stones are 73% in the gallbladder and 17% in the intra- and extra-hepatic bile ducts; bile pigment stones are 62% in the intra- and extra-hepatic bile ducts and 27% in the gallbladder. In the United States, approximately 10% to 20% of men and 20% to 40% of women suffer from gallstone disease, with the latter causing approximately 10,000 deaths annually. More than 500,000 people have their gallbladders removed each year because of gallstone-related diseases, at a cost of more than $6 billion.
The main reasons for the “preference for women over men” in gallstones may be.
1. Prefer to be quiet and less active.
Many women, especially middle-aged women, tend to spend more time at home and less time exercising and doing physical work, which inevitably decreases the contraction force of their gallbladder muscle over time and delays the emptying of bile, easily causing bile stasis and cholesterol crystals to precipitate, creating conditions for the formation of gallstones. In addition, the high level of estrogen in women affects the formation of glucuronide bilirubin in the liver, which increases non-conjugated bilirubin, and estrogen affects the emptying of the gallbladder, causing stagnation of bile and sweat and promoting stone formation. The incidence of gallstones increases significantly in those who use estrogen after menopause.
2, physical obesity.
Many women usually love to eat high-fat, high-sugar, high cholesterol drinks or snacks, the direct result of this hobby is body fat, and obesity is an important basis for the development of gallstones. Research shows that people who weigh more than 15% of the normal standard, the incidence of gallstones is 5 times higher than normal. 40 years old and above fat women, is the highest incidence of gallstones, at this time, female estrogen will make more cholesterol gathered in the bile.
3, do not eat breakfast.
I’m afraid that modern women do not eat breakfast more than they eat breakfast, and long-term skipping breakfast will increase the concentration of bile, which is conducive to bacterial reproduction and easy to promote the formation of gallstones. If you insist on eating breakfast, you can promote the flow of some bile, reduce the viscosity of the bile stored overnight, reducing the risk of gallstones.
4. Multiple pregnancies.
During pregnancy, women are prone to biliary tract function disorders, resulting in smooth muscle contraction weakness, so that the gallbladder bile retention, coupled with the relative increase in blood cholesterol during pregnancy, prone to precipitation, the chance of forming gallstones is greatly increased, and the incidence is higher in women with multiple births.
5, snacks after meals.
Now many families in China can see the situation, the family after dinner, sitting leisurely on the sofa, while eating snacks and chatting while watching TV. This habit of sitting and eating snacks after meals may be one of the reasons for the high incidence of gallstones in China. When a person is in a curled position, the intra-abdominal pressure increases, the gastrointestinal tract peristalsis is restricted, which is not conducive to the digestion and absorption of food and bile excretion, sitting after a meal prevents the reabsorption of bile acids, resulting in an imbalance in the ratio of cholesterol to bile acids in bile, cholesterol is easy to deposit.
6.Sclerosis.
This is related to the lowering of estrogen inactivation function in the body of patients with cirrhosis, the lowering of estrogen inactivation function in the body, the higher level of estrogen, coupled with the low contraction function of the gallbladder in cirrhosis, poor emptying of the gallbladder, biliary varices, elevated bilirubin in the blood and other factors can cause gallstones.
7, genetic factors.
Genetic factors obviously play an important role in clarifying the risk of gallstones. Gallstones are more frequently produced in close relatives of patients with cholesterol cholelithiasis. The fact that local Americans in the southwestern United States have a high risk of cholesterol gallstone disease (>80%) seems to include a genetic factor.
Why middle-aged women are prone to gallstones
Gallstone disease is a disease that can affect people of all ages, but is more common in women, with surveys showing that it is 2 to 4 times more common in women than in men, with middle-aged women predominating in terms of age. What are the reasons for this?
Endocrine changes in women’s bodies can directly affect the metabolism of liver enzymes, thus changing the composition of bile secreted by liver cells – the content of bile acid decreases and cholesterol increases. In addition, estrogen can also interfere with the contractile function of the gallbladder, causing obstruction of bile drainage, resulting in bile stasis and contributing to the formation of gallstones.
It is more common in women with multiple pregnancies and multiple births. Because cholesterol in the blood rises during pregnancy, cholesterol in the bile also increases, and the ratio of cholesterol to bile and lecithin changes to form an imbalance, cholesterol is easily deposited to form stones.
Lack of exercise in middle-aged women who are tied up with household chores and prefer to be quiet and do not like to exercise, thus reducing the contraction ability of the gallbladder and delaying the emptying, resulting in the accumulation of bile and excessive concentration, which reduces the ability of bile salts to dissolve cholesterol and makes cholesterol easy to crystallize and precipitate and gradually cascade into stones.
Some women who do not eat breakfast to lose weight are also prone to gallstones. People who do not eat breakfast, bile is stored in the gallbladder for a long time, and water reabsorption increases, resulting in excessive concentration, and the chemical stimulation of bile salts can inflame the gallbladder mucosa and change its function. And bile retention, bile alkalinity increases, the ability of bile salts to dissolve cholesterol decreases, prompting the formation of gallstones.
A sweet tooth is prone to gallstones
Researchers in the United States found [5] that women around the age of 50 who eat too many sweets can lead to gallstones: excess sugar increases insulin secretion, causing a serious imbalance in the ratio of cholesterol, bile acids and lecithin in the bile. Excess sugar can also convert itself into fat, leading to human obesity. Obesity does not cause all people to grow stones, but for middle-aged women, it is a breeding ground for gallstones. Long-term excessive sugar consumption will also accelerate the aging of cells. Because sugar is an acidic food, eating large amounts of sugar can make body fluids become neutral or weakly acidic, prompting cellular aging. Eating large amounts of sugar also consumes too much calcium in the body, causing bone decalcification, leading to osteoporosis and fractures.
The result of untreated gallstones – biliary colic
About 20% of patients with “asymptomatic” gallbladder stones develop biliary colic each year. During asymptomatic intervals, the stones float around in the gallbladder, in which case the patient does not feel anything. Once the stones become lodged, the bile in the gallbladder does not flow out, causing the pressure in the gallbladder to rise and the gallbladder to expand, and the gallbladder has to contract more in order to discharge its bile. The rapid expansion and contraction of the gallbladder in a short period of time produces severe colic. This colic is often persistent and worsens in paroxysms, and in severe cases, shock or even life threatening.
The result of untreated gallstones – gallbladder cancer
A hepatobiliary surgery expert said that in the past, people were familiar with gallstones and cholecystitis, but nowadays, bile duct cancer is also common, and gallbladder cancer patients often have gallstones, which proves that gallbladder cancer and gallstones are directly related, and some data show that about 0.5%-1% of gallbladder stones are complicated by gallbladder cancer. This situation leads to misdiagnosis from time to time, and some statistics show that the misdiagnosis rate can reach 79.5%. Often, gallbladder cancer is found only when gallstone surgery is performed, which is mostly at an advanced stage with very poor outcome, and most patients die within a year. Experts point out that if gallbladder cancer without metastasis can be diagnosed early and removed from the gallbladder in time, the 5-year survival rate can reach 92%.
Experts point out that prevention should be the main focus of any cancer, so that early detection and early treatment can be achieved. For gallstones larger than 3 cm in diameter, age over 50 years old, especially for women, preventive cholecystectomy should be considered.
The result of untreated gallstones – various types of inflammation of biliary origin
Gallstones leading to cholecystitis may be well known. In addition, some small stones fall into the common bile duct and drain into the duodenum, and each time they fall into the common bile duct, they can damage the hepatopancreatic sphincter at the end of the common bile duct. Some large stones may become embedded and compress the gallbladder and its adjacent organs to form biliary fistula, such as cholecystoduodenal fistula, gallbladder transverse colon fistula, cholecystocholedochal fistula, etc.
Carcinogenesis
Gallstones are the cause of gallbladder cancer. Chronic inflammation of gallbladder and the stimulation of bile acid and choline in gallstones can easily cause cancerous changes in gallbladder mucosa. Since patients with gallbladder cancer often have gallstones, they are often misdiagnosed during diagnosis.
Prevention
Diet regulation is the most ideal prevention method to prevent the occurrence of gallstone disease and gallbladder cancer. In addition, cold, greasy, high-protein, stimulating foods and strong alcohol, which can help to generate heat and bile accumulation, should also be consumed sparingly.
This also reminds us from the opposite side, although living conditions are constantly improving, friends and family gatherings are gradually increasing. Many people have more opportunities to eat big meals during the holidays, and the frequency of eating big fish and meat is also very high, and binge drinking and fatty has become the main cause of gallstones and other stone diseases. Some men who are often busy with socializing, nightlife, and long-term business trips may even develop kidney stones. Experts believe that people around 40 years old generally have stones in their bodies to varying degrees, but small stones can generally be discharged gradually through their own excretory function, as long as attention to a reasonable diet, most can avoid the pain of stones and the pain of surgery.
Vegetables and fruits rich in vitamin A and vitamin C, fish and seafood can help to clear the bile and dissolve stones, so you should eat more of them.
It is also very important to have a regular life, pay attention to the combination of work and rest, participate in regular physical activities, eat breakfast on time, avoid gaining weight, and reduce the number of pregnancies. Drinking a glass of milk every night or eating a fried egg for breakfast can cause the gallbladder to contract and empty regularly, reducing the time bile stays in the gallbladder.
Recent studies have also found that nut intake appears to reduce the risk of gallstones. A large portion of a healthy diet’s fat source comes from nuts.
The causes of gallbladder stone formation are more complex, but changes in the composition of the bile, particularly the levels of bile salts and cholesterol in the bile, are an important factor in the formation of gallstones. Under normal circumstances, these two are kept in a certain proportional relationship in bile. Cholesterol is in a dissolved state and is excreted with the bile. If there is too little bile salt or too much cholesterol, the two lose their normal proportional relationship and the cholesterol becomes supersaturated, and the excess cholesterol in the bile precipitates and forms stones.
If there is also inflammation of the gallbladder, roundworm eggs, necrotic tissue and bile pigments, stones are more likely to form. Sugar stimulates insulin secretion from pancreatic β-cells, and insulin increases cholesterol, leading to supersaturation of cholesterol in the bile and the formation of gallstones.
Some people have 267 gallstone patients and 600 healthy people’s diet, the results of the survey analysis, showing that the more sugar eaten, the higher the incidence of gallstones.
Therefore, to prevent the occurrence of gallstones, it is necessary to eat less sugar.
Living with gallstones
1. Maintain the ideal weight.
2. Maintain the habit of exercise.
3. Pay attention to the safety and hygiene of diet and regular rationing.
4. Absolutely prohibit overeating.
5. Avoid prolonged work in a sitting position.
6. Avoid excessive fatigue.
7. Do not wear tight clothing that binds the chest and abdomen.
8. If you have constipation, you should actively treat it.
Examination and diagnosis
1. Ultrasonography
2. Oral or intravenous cholecystography
3. Computed tomography (CT) scan
4. Transendoscopic retrograde cholangiopancreatography (ERCP)
5. Percutaneous hepatic puncture cholangiography (PTC)
6. Ultrasound endoscopy (EUS)
7. Magnetic resonance cholangiopancreatography MRCP
8. Spiral CT bile duct imaging
9. Radionuclide scan
Treatment
(A) Non-surgical treatment of gallstones
1, lithotripsy (oral lithotripsy with bile acids): The main mechanism of gallbladder stone formation is the change of bile physicochemical composition, the reduction of bile acid pool and the increase of cholesterol concentration. In 1972, Danjinger was the first to apply goose deoxycholic acid, which successfully dissolved cholesterol stones in the gallbladder in 4 cases. However, this drug has certain toxic reactions on the liver, such as elevated glutamate transaminase, and can irritate the colon and cause diarrhea.
At present, the main drugs for lithotripsy are goose deoxycholic acid and its derivative ursodeoxycholic acid. Indications for treatment: ① gallbladder stones less than 2 cm in diameter; ② gallbladder stones with little calcium that can be transmitted by X-ray; ③ gallbladder duct patency, i.e. a functional gallbladder can be shown on oral cholecystography; ④ the patient’s liver function is normal; ⑤ there is no obvious history of chronic diarrhea. The therapeutic dose is 15 mg/g per day for 6 to 24 months. The efficiency of stone dissolution is generally 30-70%. Ultrasound or oral cholecystography was performed once every six months during the treatment period to understand the dissolution of stones. Since the value of such lithotripsy drugs is expensive, and there are certain side effects and toxic reactions, and must be taken for life, if 3 months after stopping the drug, the cholesterol in the bile will become supersaturated again, the stones will recur, according to statistics, the recurrence rate of 3 years can reach 25%, there are still some limitations of such lithotripsy treatment. In addition, some new drugs, such as Rowachol and metronidazole, also have some lithotripsy effect. In 1985, some people reported the use of percutaneous liver puncture gallbladder cannula to inject glycerol monolipid octanoate or methyl tert-butyl ether to lithotripsy directly in the gallbladder, which has achieved certain efficacy.
2, Chinese medicine lithotripsy and lithotripsy for stone removal (suitable for patients with fine sand-like stones and intact gallbladder function)
(B) Surgical treatment of gallstones
1.Traditional open surgery to remove gallbladder stones
2.open exploration of bile ducts for stone extraction
3.Laparoscopic microincision for gallbladder removal
4.Laparoscopy combined with choledochoscopy for bile duct extraction
5.Small incision bile stone extraction method (suitable for those patients with intact gallbladder function and young age, it is also a better method to remove stones and preserve the gallbladder at the same time.)
6.Extracorporeal shock wave-lithotripsy (ESWL): In 1984, Lauerbwch first used extracorporeal shock wave-lithotripsy (ESWL) to treat gallstone disease. The commonly used shock wave lithotripsy machine is EDAP LT-01, which consists of 320 piezoelectric crystals embedded in a paraboloidal disc, synchronously emitting shock waves to form a 4 mm wide and 75 mm long aggregation area with an acoustic pressure of 9×107 PZ. The stones can be crushed. In addition, B-mode ultrasound is used for real-time imaging to localize the stones and to monitor the process of lithotripsy. The main indications for the treatment of gallbladder stones by shock wave lithotripsy are cholesterol stones in the gallbladder, negative stones on oral cholecystography, no more than 3 stones with a diameter of 12-15 mm, and only 1 stone with a diameter of 15-20 mm, and a normal contractile gallbladder function. Zhongshan Hospital of Shanghai Medical University has applied EDAP-LT 01 shock wave lithotripter to treat 687 gallbladder stone cases since January 1988, and the stone crushing rate was 98%. The disappearance rate of gallbladder stones 1, 2, 3, 4 and 6 months after one shock wave treatment was 27%, 33%, 40%, 45% and 50%, respectively. The side effects after treatment were mild, such as vague discomfort in the right upper abdomen (45%), biliary colic (16%) and weakness, and no complications of organ damage to the liver, bile, pancreas and gastrointestinal tract were observed.
In order to improve the disappearance rate after stone crushing, ursodeoxycholic acid (UDCA) 8 mg/kg/d was administered before and after shock wave to achieve the synergistic effect of stone crushing and lithotripsy. To consolidate the efficacy after the disappearance of stones, it can be continued for six months. This method is safe and effective, but still has about 11,2% stone recurrence rate, expensive treatment, and strict treatment indication, all of which are shortcomings.
What are the clinical characteristics of hepatobiliary duct stones?
Hepatic bile duct stones are stones in the intrahepatic bile duct system, therefore, they are also called intrahepatic bile duct stones. They often exist in combination with extrahepatic bile duct stones, but there are also simple intrahepatic bile duct stones, also known as true intrahepatic calculi. In recent years, the number of cases of intrahepatic bile duct stones has increased, and such stones account for 15, 4% of the 474 cases of surgically confirmed gallstone disease reported in China. Most of them are accompanied by common bile duct stones. The classification of stones is mostly bilirubin stones. Hepatobiliary stones are mostly yellowish-green masses or “mud-like” stones, mostly bilirubin calcium. Therefore, some physicians believe that hepatobiliary stones are caused by bile duct obstruction caused by biliary roundworms and bacterial infections. Hepatobiliary stones are mostly found in the left lobe of the hepatic duct. The bile ducts at the confluence of the upper and lower hepatobiliary ducts in the left outer lobe of the liver are slightly enlarged, and the stones are mostly found in this area. Clinical features are mostly manifested as follows.
(1) Patients are younger than those with gallbladder stones, and some patients are associated with congenital abnormalities of the intrahepatic bile ducts. Patients often have a history of abdominal pain, chills, fever, and recurrent jaundice since early childhood.
(2) There is impairment of liver function, while gallbladder function may be normal. A variety of liver function abnormalities may occur during recurrent episodes, and alkaline phosphatase may rise during intervals; prolonged disease may lead to atrophy of liver lobe segments and liver fibrosis.
(3) Abdominal pain, jaundice and fever are the main symptoms, but the typical severe colic rarely occurs.
(4) Complications are numerous and more serious. The more common ones are purulent intrahepatic cholangitis, liver abscess, and biliary hemorrhage.
(5) Cholangiography may show dilated intrahepatic bile ducts without dilated extrahepatic bile ducts and small translucent areas in the hepatic ducts.
Dietary therapy for gallstones
The causes of gallbladder stone formation are complex, but changes in the composition of the bile, especially changes in the content of bile salts and cholesterol in the bile, are an important factor in the formation of gallstones. Under normal circumstances, these two are kept in a certain proportional relationship in bile. Cholesterol is in a dissolved state and is excreted with the bile. If there is too little bile salt or too much cholesterol, the two lose their normal proportional relationship and the cholesterol becomes supersaturated, and the excess cholesterol in the bile precipitates and forms stones. If there is also inflammation of the gallbladder, roundworm eggs, necrotic tissue and bile pigments, stones are more likely to form. Sugar can stimulate pancreatic beta-cells to secrete insulin, and insulin can increase cholesterol, resulting in cholesterol in the bile in a supersaturated state, prompting the formation of gallstones.
1, pay attention to dietary hygiene, to avoid parasitic infection.
2, it is appropriate to eat a low-fat diet, eat more fresh vegetables, fruits, lean pork, chicken, duck meat, egg whites.
3, avoid eating fried food, animal fat and offal, careful to eat egg yolk, fish, crustaceans.
4, avoid smoking, alcohol and spicy food. The purpose of dietary treatment is to achieve inhibition of stone production and relief of pain caused by stone obstruction. The principles of dietary therapy are: 1. The caloric supply should meet the physiological needs, but prevent excessive amount, generally 1500-2400 kcal. 2. Restrict fat to avoid stimulating gallbladder contraction for pain relief. The fat in the diet before and after surgery should be limited to about 20 grams, which can be slightly increased as the condition improves to improve the color and flavor of dishes and stimulate appetite. Avoid greasy, fried, deep-fried and fatty foods such as fatty pork, lamb, stuffed duck, fatty goose, butter, crispy snacks, cream cakes, etc.
Who are prone to gallstones?
A: Gallstones are a common disease with an incidence of about 15% in our population. Medical research has found that the following people are more likely to suffer from gallstones.
1. 70% of gallstones patients are women, and the more pregnancies, the higher the incidence. The reason is that the high level of estrogen in women’s body will affect the formation of bilirubin glucuronide in the liver and increase the non-conjugated bilirubin. The incidence of gallstones increases in postmenopausal estrogen users. The incidence of gallstones is 5 times higher than normal in obese people whose weight exceeds 15% of the normal standard, and the incidence of gallstones is 6 times higher in obese women between the ages of 20 and 30 than in their normal weight counterparts, and 40% of obese women over the age of 60 have gallbladder disease and gallstones. The reason is that most obese people have too much fat and cholesterol intake, coupled with obese people mostly less activity, easy to have gallstones.
2, the diet of meat and sweet people, their fat and cholesterol intake, easy to form cholesterol stones. Too much sweet food and promote insulin secretion, will accelerate cholesterol deposition.
3, often do not eat breakfast will reduce the content of bile acid, bile concentration, conducive to stone formation. 4, roundworm infected people do not pay attention to dietary hygiene infected with roundworm disease, roundworms reflux to the biliary tract to lay eggs or die, it will become the core of stones, the generation of stones. 5, cirrhosis patients with cirrhosis of the liver, the incidence of gallstones significantly higher than normal people, which is related to cirrhosis patients in the body to estrogen inactivation function is reduced, the body Estrogen inactivation function is reduced, higher estrogen level in the body, as well as and chronic hemolysis, low gallbladder contraction function, poor gallbladder emptying, biliary varices, elevated bilirubin in the blood and many other factors.
What diseases can be complicated by gallstones?
Gallstones may become cancerous Gallstones are the causative factor of gallbladder cancer Gallbladder is stimulated by chronic inflammation and bile acid and bile base in gallstones for a long time, which may cause cancerous changes in gallbladder mucosa Since gallbladder cancer patients often have gallstones, they are often misdiagnosed during diagnosis
2.Secondary bile duct stones
3.Secondary infection of liver
Common surgical methods of bile duct stones
Hepatobiliary stone disease refers specifically to stones originating in the intrahepatic bile duct system, which can exist alone or in conjunction with extrahepatic bile duct stones. Surgery is a method of treating hepatobiliary stones. The surgical methods include: (1) removal of the stone and resection of the lesion by: (1) transhepatic hilar intrahepatic choledochotomy; (2) transhepatic parenchymal intrahepatic choledochotomy; (3) lobectomy or segmental resection of the liver. (2) Commonly used procedures for cutting stenosis, relieving obstruction, and repairing bile duct defects: ① stenosis bile duct incision and plasticization with tipped jejunal flap to repair bile duct defects; ② stenosis bile duct incision and plasticization with gallbladder flap to repair hepatic bile duct defects; ③ stenosis bile duct incision and plasticization with hepatic round ligament umbilical vein intima to repair hepatic bile duct defects. (3) The procedure to make the bile duct drainage unobstructed (bile-intestinal internal drainage): ① bile duct jejunostomy Lu’s Y anastomosis; ② interposition jejunostomy bile duct duodenostomy; ③ interposition jejunostomy bile duct jejunostomy What diseases can be complicated by gallstones?
1.Gallstones may become cancerous Gallstones are the causative factor of gallbladder cancer Long-term stimulation of gallbladder by chronic inflammation and bile acids and bile bases in gallstones may easily cause cancerous changes in gallbladder mucosa Since gallbladder cancer patients often have gallstones, they are often misdiagnosed 2.Secondary bile duct stones 3.Secondary infection of liver
Common surgical methods of bile duct stones
Hepatobiliary stone disease refers specifically to stones originating in the intrahepatic bile duct system, which can exist alone or in conjunction with extrahepatic bile duct stones. Surgery is a method of treating hepatobiliary stones. The surgical methods include: (1) removal of th