Gallstone disease is a common and frequent disease caused by the formation of stones in the human biliary system (including the gallbladder and intra- and extra-hepatic bile ducts), with biliary colic as the main manifestation. According to the location of stones, they can be divided into gallbladder stones, common bile duct stones and intrahepatic bile duct stones, with gallbladder stones being the most common.
I. Causes of bile duct stones
The common causes of primary bile duct stones are
1, obstruction of bile ducts.
2, recurrent bile duct infections.
3, bile duct stenosis.
4, bile stagnation, etc.
There are no obvious symptoms, sometimes only mild digestive symptoms, and later there are different manifestations depending on the size and location of the stone, the presence or absence of obstruction, and the presence or absence of inflammation. Patients may experience epigastric boredom and discomfort, especially when people are tired, nervous at work, or eat a lot of fatty food, which may produce right upper abdominal cramps, and in severe cases, abdominal pain, chills, high fever and jaundice.
Second, gallstone treatment
Treatment methods include medication and surgery, and the appropriate treatment method should be chosen according to the location, size and condition of the stones. Therefore, patients with gallstone disease should be seen in a hospital, and the treatment plan should be proposed by a physician after a clear diagnosis of.
1.Gallbladder stones
First consider anti-inflammatory li, conservative treatment, and pay attention to diet and rest, most patients’ clinical symptoms will be controlled, but some of them will be induced again later by eating excessive greasy food, exertion and other factors for acute cholecystitis. For patients with recurrent gallstone cholecystitis, surgical removal of the gallbladder should be considered.
2. Common bile duct stones
In principle, surgery should be performed to remove stones from the common bile duct, “T” duct drainage, and Roux-en-y anastomosis of the common bile duct and jejunum.
3.Intrahepatic bile duct stones
Surgery is the main treatment for intrahepatic bile duct stones, with good efficacy. However, surgery cannot completely solve the lesions of intrahepatic bile duct stones, and other treatment methods are needed, such as lithotripsy, mechanical lithotripsy (choledochoscopy), Chinese medicine lithotripsy and laser lithotripsy.
Pre- and post-operative considerations for cholelithiasis.
1. Diet and nutrition: Patients with acute attack should not eat temporarily or enter a small amount of fluid or semi-fluid juice according to their condition, and should eat a light, easily digestible and multivitamin diet, avoid fatty meat, fried, deep-fried and other high-fat foods.
2, do all the biliary tract special examination.
3, jaundice patients with skin itching is due to bile stagnation caused by the increase of bile salts in the blood, stimulating the peripheral nerves caused. Apply medication or wash with warm water as prescribed by the doctor to relieve symptoms and keep the skin clean. Avoid using alkaline soap and other irritating detergents, loose clothes, and avoid scratching the skin with your hands, you can pat it with your hands to relieve the pain and itching.
4, 6 hours after surgery, blood pressure is stable after taking a semi-recumbent position, which is conducive to abdominal drainage and improve breathing.
5.After the recovery of gastrointestinal function, anal venting and removal of the gastric tube, the patient can eat a liquid-semi-liquid-soft diet, which is light, easy to digest, low-fat and multivitamin.
6.Patients after biliary surgery usually need to place gastric tube, abdominal drainage tube, “T” tube and indwelling catheter.
IV. What should be noted after discharge?
1.Cultivate good eating habits, with light, easy to digest, low fat, avoid overeating.
2.Patients who need to be discharged with “T” should pay attention to.
(1) Protect the tube properly to prevent slippage.
(2) Change the dressing at the hospital regularly.
(3) If you find that the bile flow suddenly increases or decreases, and the drainage is cloudy or bloody, accompanied by abdominal pain and fever, you should go to the hospital for examination in time. (3) If a sudden increase or decrease in bile drainage is observed, accompanied by abdominal pain and fever, the patient should be examined by a hospital.
(4) Take bile medication as prescribed by the doctor.
(3) Develop a good work, rest and diet routine, avoid strain and high mental tension.
(4) Follow the doctor’s prescription for regular re-examination.