Patient Question:Disease:Gallstones mud-like cholecystitis
Description of the disease:After eating a bowl of noodles at noon on November 7 (Saturday), the pain was unbearable and vomiting occurred (I also felt comfortable vomiting some), then I went to Liaoning Provincial People’s Hospital and was diagnosed with gallstones, and kidney stones were found 2 months ago.
Hope to provide help:1. What is the best means for this condition, conservative treatment, surgery to cut the gallbladder or minimally invasive bile preservation which is better
2. It is said on the internet that the sediment-like stones from the gallbladder can escape to the common bile duct.
3, please help the doctor to give a detailed explanation of the good idea, in addition, the Internet said that the natural treatment of drinking apple juice is feasible
Hospital Department: Liaoning Provincial People’s Hospital Emergency Department
Medication: Name of medication: Lemeine Nedze (all drip)
Dosing instructions: One drip per day for three days
Lemetine (pazufloxacin mesylate injection) 0.3g per dose, once a day
Nedzi (Ornidazole sodium chloride injection) (continuous infusion) (no additional drugs) 0.5g per time, once a day
Doctor’s reply.
Suggestion: Click here to refer to my article “Laparoscopic cholecystectomy and post-operative precautions
Patient Question.
Dr. Wang, is it possible to perform minimally invasive biliary surgery in this case?
Doctor’s reply.
Sediment-like stones are not suitable for biliary preservation
Patient’s question.
Now I have yellow urine, the third day of the drip, I ate half a pancake at noon, and the pain in my upper right abdomen has started again.
Doctor’s reply.
Need to check liver function and evaluate the possibility of combined bile duct stones
Patient Question.
So please ask Dr. Wang, now the patient ate half a cake at noon, the right upper abdomen is still some pain, continued for three or four hours, until 7:00 p.m., that does not indicate that the inflammation has not been eliminated, then what drugs should continue to be good? (Fosfomycin injection) and Nedzi (Ornidazole sodium chloride injection) (continuous infusion)
Doctor’s reply.
You can continue to use antibiotics, at the same time should strictly control the diet, as soon as possible to improve the examination
Patient’s question.
The patient has pain and sometimes chills, but no fever, is this also a symptom of gallstones, and if it is a bile duct stone, what treatment is available?
Doctor’s reply.
It may be a sign of cholangitis or aggravated cholecystitis, stronger antibiotics can be used, if there is still no significant improvement, surgery should be considered
Patient Question.
I’m not sure what the problem is, but the MRI shows no stones in the bile ducts.
Doctor’s reply.
Please provide detailed information and test results, including imaging data and recent laboratory results, you can upload the test results and MRI report as photos
Patient Question.
The patient was hospitalized and underwent liver function and MRI tests at a medical university because of yellowing and painful chills after the third day of the IV. The bilirubin was high but did not show a blockage of the common bile duct. After 2 days of anti-inflammatory medication, the bilirubin decreased (I was unable to get the diagnostic results in time, but according to the doctor, it decreased a bit). Also, if we do not operate, will there be any bad effects of conservative treatment in this case, such as serious effects on the liver or something?
Doctor’s reply.
The patient has no history of hepatitis virus infection, if the liver itself is not a big problem, the current symptoms may be due to gallbladder stones into the bile ducts, causing a transient biliary obstruction and cholangitis, and then the bile duct stones discharged into the duodenum on their own, the biliary obstruction is lifted, jaundice slowly subsided, so MRI and ultrasound can not see the bile duct stones
Patient Question.
There is no history of hepatitis virus infection, but the blood test liver function is already bad, this disease will not affect the liver or anything ah, I think now if the jaundice slowly disappears, physical signs back to normal, first take a month of conservative treatment, think about the treatment plan such as drinking Chinese medicine or something, this will not immediately relapse what is dangerous, you see now two ultrasound gallbladder wall thickness of 0.45cm (non-fasting) and 0.4cm, respectively. The wall thickness of the gallbladder is 0.45cm (non-fasting) and 0.4cm (fasting), can this tell whether the gallbladder still has contraction function?
Doctor’s reply.
At present, we can take conservative treatment means, anti-inflammatory, liver protection, do not recommend Chinese medicine treatment, gallbladder inflammation is heavy, but also need to be alert to the possibility of pancreatitis
Patient Question.
I am now in the hospital on a drip, was ready to do surgery, now from the ultrasound, the pancreas should not have any problems ah, please ask director Wang, then conservative treatment to how to treat ah, how to be alert to pancreatitis, what anti-inflammatory drugs should be taken at home is better
Doctor’s reply.
Fasting, gastrointestinal decompression, antibiotics, hepatoprotective drugs, enough fluids, so that the inflammation fully subsided before surgery is safer, of course, if the continued inflammation does not subside, then consider surgery as soon as possible
Patient Question.
Our doctor said that the liver function is not very good, so please ask Director Wang, this liver function is not very good is not caused by this blockage ah, the blockage of the liver damage, if conservative treatment, and then recurrence, is not very harmful to the liver ah, in addition, the doctor said, from the case of no fever, inflammation is not very big, so this situation, in the end, the body is not very harmful, including liver and kidney what, please I have spent several times to pay, I am really anxious
Doctor’s reply.
Most cases of poor liver function are caused by bile duct stone obstruction and cholangitis, if the obstruction is lifted, liver function will quickly return to normal, generally will not leave serious complications. Of course, bile duct stones may recur and cause another bile duct obstruction, so it is recommended that the conditions allow early surgical treatment, according to the local medical conditions and the actual condition of the patient to take individualized treatment, do not worry too much