The incidence of gallstones in China is as high as about 10%, with gallbladder stones being particularly prevalent. If not given enough attention, they can easily lead to serious complications and even life-threatening. The increase in the number of patients with these stones has genetic factors, but more and more importantly, it is related to dietary habits and the type of diet, such as skipping breakfast, preferring high-fat and high-protein foods, etc. Small active stones are more likely to cause biliary colic According to Director Liu Wen, 20 percent of gallbladder stone patients often do not feel any discomfort and are only detected during ultrasound exams. This asymptomatic static stones, even if they are two or three centimeters, should be left alone for the time being and should only be observed and followed up. However, if there are symptoms, such as fullness or vague pain in the upper abdomen after meals, sometimes radiating to the right shoulder or chest and back. Especially if these symptoms occur after eating high-fat or fatty foods, surgery is needed even if the stone is small. Some patients question why those with large stones are not operated instead, and those with only a centimeter or so instead need surgery? Director Liu explained that high-fat or fatty foods have a “decisive” role in the formation or triggering of gallstones. After eating high-fat and high-protein foods, people need a lot of bile to digest it, and the bile that boldly rushes outside the gallbladder will “prioritize” the small, weakly attached stones to the outside, making it easy for small stones to get stuck in the narrow neck of the gallbladder and cause symptoms such as biliary colic. If a symptomatic gallstone is not treated, if it causes complications, it will be more dangerous than the stone itself. The stone will be stuck or embedded in the bile duct causing obstruction, inducing acute septic obstructive cholecystitis, gangrene or even perforation, which will be life-threatening. In terms of treatment, many patients use drugs for lithotripsy. Director Liu Wen said, the international medical community does not advocate gallstones to take lithotripsy treatment, the risks and hazards are often greater than the stagnation of stones. Because once the movement of bile carrying stones to the neck of the gallbladder, it is the same hazard as the small stones mentioned above, i.e., stones are stuck, which can lead into severe cholecystitis; if stones are drained into the bile duct, or induce acute cholangitis with obstruction and jaundice; if stones are stuck in the distal end of the common bile duct, it can cause acute pancreatitis. And gallstones are often multiple stones, and it is impossible to drain all stones at once. It should be reminded that many elderly people with gallbladder stones are afraid to choose surgery and opt for conservative treatment such as lithotripsy. In fact, gallbladder stones are particularly unsuitable for lithotripsy. This is because, after crushing large stones into small ones, it will still cause the above-mentioned problems. In addition, biliary lithotripsy has been largely eliminated and is not a radical procedure. The reason is that after surgery, the basis of gallbladder-generated stones still exists, so gallstones are prone to recur in the gallbladder and often cause adhesions for re-operation, increasing the difficulty of surgery. In the early 1990s, many hospitals did many such operations, but the recurrence rate was so high that they eventually had to give up. Heart disease elderly people do “laparoscopic” surgery At present, gallbladder removal is the most thorough treatment of gallbladder stones. This is especially true for gallbladder stones combined with cholecystitis, and for intra- and extra-hepatic bile duct stones combined with cholecystitis. More specifically, for symptomatic stones, i.e., those with biliary colic or back pain once they eat fatty foods (mainly at night), surgery is required if they develop 1 to 2 times. In addition, if the stones fill the gallbladder, although there are no obvious clinical symptoms, surgery should be performed because the gallbladder loses its function. Early removal of the diseased gallbladder can effectively prevent the occurrence of the above complications. Minimally invasive laparoscopic surgery with short operation time and little trauma is the most effective treatment for gallbladder removal, even for patients of advanced age and some suffering from cardiovascular disease. 48-year-old Master Qiao was transferred to the hepatobiliary ward of the Sixth City Hospital after he developed gallbladder inflammation during the preparation for stenting in a hospital due to severe heart disease. If he underwent cholecystectomy, he had great difficulty with intraoperative coagulation (he had been taking anticoagulants). After consultation, they finely stopped the bleeding intraoperatively, which made the operation very smooth. Although his gallbladder stone was only 1 peanut rice size, but because it was located in the neck of gallbladder and embedded, it had been perforated when opening the abdomen, forming local peritonitis, and if delayed further, it would become diffuse peritonitis, causing infectious shock or even death. Fortunately, timely surgery, and now Master Qiao is recovering.