Gallstone disease is a common and frequent disease, and with the improvement of people’s life, rich nutrition and actual life span, there is a trend of increasing this disease year by year. Traditional drug lithotripsy and lithotripsy therapies are ineffective and have a high recurrence rate, bringing patients out of the misunderstanding of treatment. The high-tech laparoscopic surgical technique, known as keyhole surgery or microtrauma surgery, which is a milestone in the development of surgical science and technology in the 20th century, is undoubtedly the first choice in the treatment of gallstone disease. Compared with traditional caesarean surgery, laparoscopic cholecystectomy has won praise from patients and high praise from the medical community for its advantages of less trauma, less pain, shorter operation time, faster recovery period and cosmetic appearance.
1.What is the gallbladder? Where does the bile come from? What is its function?
The gallbladder is a pear-shaped pouch-shaped structure attached to the underside of the liver and open to the extrahepatic bile ducts, and is called the gallbladder because it stores part of the bile from the liver. Bile is produced by liver cells and is discharged into the intestine through the intrahepatic and extrahepatic bile ducts to help digestion of food and absorption of nutrients.
2.How are gallstones formed?
There are many things in bile that are normally in a dissolved state, just like sugar or table salt dissolved in water. If the concentration is too high, some of them will form crystals, which then grow further and become clumps that stay or block the biliary system, affecting the flow of bile, and stones are formed. Due to the different composition of gallstones, the formation of different parts and growth time, their appearance and structure are also varied, large like eggs, small like mud and sand, beautiful like colored beads.
3.What are the dangers of gallstones? What are the dangers of gallbladder stones?
In addition to gallstones causing biliary colic, hidden pain and indigestion, the greater danger is bile duct obstruction causing jaundice, bile duct suppuration, pancreatic inflammation and even death. Long-term irritation of the bile duct wall or gallbladder wall by gallstones can cause cancer. Patients with gallbladder stones all have chronic inflammation of the gallbladder, and long-term irritation causes the gallbladder to lose its contractile function, and a small percentage can become cancerous. If the stone is blocked in the jugular abdomen or the cystic duct, it can cause right upper abdominal biliary colic. If changing position or medication cannot make the stone leave the obstruction site, high pressure will be generated in the gallbladder and the blood supply to the gallbladder wall will be reduced or stopped, so bacteria can easily enter and produce a lot of toxins, causing necrosis or even perforation of the gallbladder wall; some small stones or bile sludge can be discharged to the common bile duct by the gallbladder, causing obstruction of the common bile duct, jaundice and purulent cholangitis. Some stones are in the lower end of the common bile duct for a long time to stimulate the narrowing of the lower end, so that this special structure like a door is destroyed, and that will be a lifelong sequelae. So with gallbladder stones should be treated early, do not have a fluke mentality.
4.How does biliary colic arise? Is it unnecessary to treat the pain after it disappears?
When stones are blocked in the gallbladder duct or bile duct, the bile cannot pass through and the body will naturally produce a series of reactions to overcome it, such as gallbladder spasm or contraction of the lower sphincter of the common bile duct, which will produce severe pain if the stones cannot be discharged with great effort. If the pain disappears as a result of the total discharge of the stone, then no treatment is needed, but this rarely happens. The majority of cases are due to the stone temporarily leaving the site of blockage, and under certain conditions, such as eating greasy food, fatigue, drinking alcohol, etc., it can come back again. Therefore, as long as the stone exists, it should be removed firmly.
5.Why do gallstones cause yellow eyes, chills and fever?
Bile is produced by the liver and enters the intestine through the bile duct. The bile duct is like a tree, the intrahepatic bile duct is like a branch and the common bile duct is like a trunk. Bile converges from the branches into the left and right branches of the bile duct and finally discharges into the intestine. If there is an obstruction in the trunk, the bile produced by the liver cannot be discharged and flows backwards into the bloodstream, where the bilirubin in the bile settles in the eyes and skin, manifesting itself as yellow sclera and skin staining, which is called jaundice. With stones in the bile duct causing poor bile flow, intestinal bacteria will easily enter and multiply, producing toxins, and the body will react with chills and fever.
6.Does gallstones have to be treated?
Strictly speaking, as long as there are stones, they should be treated because there should not be stones in the normal biliary system. Some people say that gallstones do not need to be treated if there are no symptoms. Because gallstones will inevitably cause different degrees of harm to the human body, some harm in the early stage, no obvious performance, and some have developed to the point where treatment is necessary, medical practice has proved that the earlier any disease is treated, the better.
7.Is it necessary to treat gallbladder polyps?
There are three types of gallbladder polyps. Cholesterol polyps are multiple, generally less than 3mm in diameter, not cancerous, so there is no need to treat; inflammatory polyps are multifocal mucosal hyperplasia on the background of gallbladder inflammation, although rarely cancerous, but if the gallbladder inflammation for a long time, affecting the quality of life, it is better to remove; the third is the real polyps, generally single, varying in size, more than 10mm prone to cancer, should be particularly vigilant. The following cases should be operated in time.
(1) Older patients;
(2) Single polyp or oligometastatic polyp with diameter greater than 8 mm;
(3) Recent ultrasound examination reveals significant polyp growth;
(4) Recent occult pain or pain in the gallbladder area. In fact, it is incomplete and even wrong to decide whether to operate based on the size of polyps. Polyps do not tell you when they will change, and once clinical symptoms or ultrasound suggest cancer, it is often too late, and lessons in this regard are not uncommon. Happily, with the improvement of people’s economic and cultural level and the enhancement of disease prevention awareness, especially the emergence of laparoscopic cholecystectomy surgery, the incidence of gallbladder polyp cancer has been significantly reduced.
8.What lesions can be produced by gallbladder?
The gallbladder is a disease-prone structure with cholecystitis, gallbladder stones, gallbladder polyps, gallbladder cancer and some rare lesions. There is a layer of mucous membrane inside the gallbladder, which is a tissue prone to pathological changes, not only related to stone formation, but also can undergo some changes of its own, such as polyps, adenomatous hyperplasia, tumors, etc.
9.Who is prone to gallbladder stones?
A large number of epidemiological surveys have been conducted at home and abroad, and the following groups of people are found to be prone to gallbladder stones.
1, female patients;
2.Age over 40 years old;
3, obese people;
4.Patients with gallbladder stones in their family or those who have suffered from gallbladder stones before;
5.Patients with high-fat diet;
6.Patients with liver lesions;
7.Breakfast fasters;
8.Oral contraceptive pill users;
9.People who have had gastrointestinal surgery in the past.
The occurrence of gallbladder stones may be related to dietary habits, genetic factors, endocrine factors and liver diseases.