Cholecystitis and gallstones are common diseases. Patients are often accompanied by cholecystitis and gallstones because of the change of bile composition and bile concentration with bacteria and inflammatory necrotic material as the core, which can easily form gallstones. If there are stones in the gallbladder or stones in the common bile duct obstruct the normal discharge of bile, when the gallbladder contracts strongly, it can cause severe pain and even induce an attack of cholecystitis or cholangitis. Some people with bacteria in the gallbladder can also develop the disease when the body’s resistance decreases. If treatment is not timely, the patient may have recurrent right upper abdominal pain radiating to the back of the right shoulder, and in severe cases, nausea, vomiting, fever and even gallbladder perforation.
Fiberoptic choledochoscopy for stone extraction, ending three years of abdominal pain
Mr. Mao, since three years ago, had persistent dull pain in the right upper abdomen, accompanied by nausea and vomiting, and the pain radiated to the back and right shoulder, and the symptoms worsened after eating fatty food. He visited a hospital in the city, where gallbladder stones were found by ultrasound examination, and his symptoms were relieved after anti-inflammatory and symptomatic treatment was given. In the following years, Mr. Mao’s stone pain recurred and gradually worsened, with no improvement after several treatments. A week ago, the pain flared up again and he was recommended by a friend to visit the hospital.
The hospital stone expert diagnosed Mr. Mao with chronic cholecystitis and gallstones based on his recurrent right upper abdominal pain for more than three years, pressure pain in the right upper abdomen and ultrasound examination showing chronic cholecystitis and stones, combined with his past history and the actual situation in our hospital during the auxiliary examination and surgery, and decided to perform fiberoptic choledochoscopic biliary stone extraction for Mr. Mao.
After the surgery, Mr. Mao was in good health, his vital signs were stable, no abnormal heart and lungs, abdominal symptoms disappeared, the incision healed well, his diet and bowel movements were normal, and his condition was completely cured.
Technical advantages of minimally invasive fiberoptic biliary choledochoscopy.
The introduction of fiberoptic choledochoscopy has made a big step forward in the diagnosis and treatment of primary bile duct stones. In particular, it has opened up a new way to treat residual stones after biliary surgery, allowing many patients to avoid the pain and danger associated with reoperation. Since fiberoptic choledochoscopy has the advantages of less patient pain, fewer complications and higher success rate of stone extraction, this method has been rapidly promoted and applied in various hospitals in China and abroad in recent years.
Minimally invasive: This advanced technology only requires 3 (about 0.5-2cm) micro-incisions in the patient’s abdominal wall to avoid leaving long scars in the patient’s abdomen, which is less invasive, less painful, safe and does not affect the beauty; the procedure is visualized and has a high safety factor.
Clear surgical field: With the help of high-tech products laparoscope and fiberoptic choledochoscope, the laparoscope is first inserted through abdominal puncture with a pneumoperitoneum needle to explore the position, appearance and whether there are adhesions of the gallbladder, and after confirming that the gallbladder is normal outside, a small incision of 2 cm is made under the rib cage to enter the abdomen, traction of the gallbladder, an incision of about 0.5 cm is made at the bottom of the gallbladder to insert the choledochoscope, the bile in the gallbladder is aspirated with a negative pressure suction device, and saline is put in to flush the gallbladder at the same time. The choledochoscope is inserted with a negative pressure aspirator to clean the bile in the gallbladder, and at the same time, saline is put in to flush the gallbladder cavity to make the field of vision clear.
The use of fiberoptic choledochoscope overcomes the blind spot of the old choledochostomy; the use of the latest special stone retrieval net instead of the past stone retrieval forceps can avoid the small stones left in the gallbladder or abdominal cavity due to the stone retrieval forceps, so the stone retrieval is complete and no sequelae are left.
Quick recovery: Since the patient suffers minimal trauma, he can move around and eat in 1 day after surgery, and can be discharged in 3-5 days after hospitalization, which does not affect normal work and life, and can also reduce the treatment cost.
◆ Not easy to recur: After the stone extraction is completed, the choledochoscope can clearly observe whether the gallbladder duct is open or not, which is the key to avoid stone recurrence.
The care after minimally invasive fiberoptic choledochoscopy for biliary stone extraction should pay attention to the following items.
1, pay attention to dietary safety and hygiene, regular rationing.
2. Avoid working in a sitting position for a long time.
3, maintain the habit of exercise.
4. Do not wear tight-fitting clothing that binds the chest and abdomen.
5.If you have constipation, you must actively treat it.
However, if the gallbladder has atrophied, has no function, or even has become cancerous, there is no value to keep the gallbladder. It is better to choose laparoscopic cholecystectomy to treat gallstones.
For gallstones, such as gallbladder stones, common bile duct stones, intrahepatic bile duct stones, etc., minimally invasive technology can achieve the treatment effect of minimally invasive gallbladder preservation, and generally patients can be discharged in only 2 days and can achieve full recovery in 7 days. “It has become the preferred surgical method for symptomatic cholecystitis, gallbladder stones and gallbladder polyps.