The gallbladder is what we often refer to as the bitter bile, shaped like a pear, which is the organ that stores and concentrates the bile. Gallbladder inflammation occurs mostly in middle-aged people. Gallbladder stones are changes in the composition of the bile (digestive fluid excreted from the liver) in the gallbladder, which in turn causes stones from its composition. It has become a common and prevalent disease worldwide and is a serious health hazard to human beings. According to statistics, the proportion of simple gallbladder stones in China rose from 52.8% in the 1980s to 79.9% in the 1990s.
Gallbladder stones are caused by various factors.
1. abnormal lipid metabolism, secretion of lithogenic bile, supersaturation of bile cholesterol, reduction in the formation of cholesterol-dissolving “bubbles”, and formation of calcium bilirubin.
2, abnormalities in the concentration and secretion functions of the gallbladder, reduced contraction of the gallbladder, biliary sludge and bile sludge formation.
3, biliary tract infection, biliary tract obstruction, biliary tract foreign bodies.
Under normal circumstances bile can promote the digestion and absorption of fat, while middle-aged people around 40 years old, one is due to the pressure of work, lifestyle changes, often have varying degrees of neural regulation and metabolic disorders, affecting the normal contraction and diastole of the gallbladder, so that the excretion of bile is not smooth; second, middle-aged people slowly gain weight, due to fat metabolism disorders, more likely to stimulate strong contraction of the gallbladder; third, at the same time there is infection, The third is the simultaneous infection, indigestion, stone formation will be more likely to induce the onset of cholecystitis.
What does cholecystitis mean?
Stones are embedded in the neck of the gallbladder or in the gallbladder ducts, which distends the gallbladder and prevents the discharge of concentrated bile inside. As a result of bacterial attack, the gallbladder wall becomes edematous and inflamed, which in turn can cause impaired blood supply to the gallbladder wall, thus further worsening the inflammation of the gallbladder wall drastically. Triggers often include: satiety, eating greasy food, exertion and mental factors.
The main clinical manifestations of cholecystitis, which includes acute cholecystitis and chronic cholecystitis, have different clinical manifestations. Acute cholecystitis mainly manifests as.
1, sudden onset.
2. pain in the right upper abdomen, which is prolonged and often aggravated by breathing and changing position.
3, chills and fever, elevated leukocytes and neutrophils in the blood.
4. nausea and vomiting, which are not violent and the vomitus is often bile-containing food.
5. most acute cholecystitis is an acute attack of chronic cholecystitis.
Chronic cholecystitis mainly manifests as.
1. momentary obstruction of the gallbladder duct by stones, causing episodes of biliary colic, with pain mostly in the upper abdomen or right upper abdomen, lasting from a few minutes to several hours, which may involve the back or right scapula and may be accompanied by nausea and vomiting.
2. usually there is often a series of indigestion symptoms such as abdominal distension, epigastric or right upper abdominal discomfort, heartburn, belching, acid reflux, etc., and eating fried or fatty foods often exacerbates these symptoms.
3. Chronic cholecystitis can be a sequel to an acute gallbladder attack, and patients almost inevitably develop chronic cholecystitis after an episode of acute cholecystitis.
The dietary considerations of cholecystitis remind us that once an attack of cholecystitis has occurred, the usual diet requires attention to several aspects.
1. Patients should temporarily fast during an acute attack to allow the gastrointestinal tract and liver and gallbladder to get adequate rest, reduce the secretion of bile and gastrointestinal digestive juices, lower the pressure in the gallbladder, reduce inflammation and relieve pain. After the acute inflammation is relieved, a light liquid diet with low fat, low cholesterol and high carbohydrate, such as rice soup, lotus root powder and soybean milk, can be eaten appropriately. When the condition further improves, a low-fat semi-liquid diet or low-fat and less residue soft rice, such as rice porridge, tofu brain, soft noodles, noodle sheets, etc., can be eaten.
2, usually you should limit high-fat and high-cholesterol foods. Strictly limit fat intake, avoid eating fatty meat, animal offal, fish roe, crab roe, chocolate and fried food and other foods containing high cholesterol. Foods such as shiitake mushrooms and fungus have a cholesterol-lowering effect and can be eaten more often as appropriate.
3. foods based on complex carbohydrates, such as rice, noodles, potatoes, etc. Limit the intake of sugar, such as granulated sugar and glucose, as appropriate. Eat more fish and shrimp, lean meat, tofu, etc., which are rich in high-quality protein, and eat more fruits and vegetables such as carrots and tomatoes, etc., which are rich in vitamin A. Increase the supply of dietary fiber.
4, avoid alcohol and spicy food. Garlic, onion, ginger, chili and other spicy food, as well as tobacco, wine, coffee and other stimulating food, will promote excessive secretion of gastric acid, gallbladder contraction intensified, gallbladder stones are prone to neck embedment, and can even cause spasm of the lower bile duct sphincter, which can induce severe biliary colic.
5, usually should take the principle of eating less and more meals, avoid overeating. A small amount of food can reduce the burden on the digestive system. Increase the number of meals can stimulate bile secretion, reduce the concentration of bile in the gallbladder and keep the bile ducts open, which can effectively avoid acute attacks of cholecystitis.
6. Orders and treatment from the attending physician should be followed.
Severe cases require surgical treatment, and active conservative treatment for 12-24 hours is generally advocated to choose surgical treatment. The surgical approach preferred minimally invasive method: laparoscopic cholecystectomy.
Laparoscopic cholecystectomy is performed by inserting a special catheter into the peritoneal cavity and injecting about 2-5 liters of carbon dioxide to reach a certain pressure before making 2-3 small 0.5-1.5 cm holes in your abdomen, dissecting the gallbladder triangle structure, dissecting and clamping the cystic duct and gallbladder artery, and then removing the entire gallbladder including the stones. If the gallbladder is too large, the gallbladder can be moved to the abdominal wall puncture port, the gallbladder can be incised, the bile can be sucked out by suction, or the stones can be clamped out, and the gallbladder can be removed from the body after collapse. The gallbladder is then removed very carefully under laparoscopic manipulation. The procedure takes about 30 minutes to 1.5 hours and is simple and safe. This minimally invasive approach has the advantages of small incision, quick recovery, short hospital stay and less bleeding.
Laparoscopic cholecystectomy should be performed in the following cases.
1, symptomatic gallbladder diseases: gallbladder stones, gallbladder polyps, chronic cholecystitis, early acute cholecystitis, acute pancreatitis, etc.
2, asymptomatic but comorbid gallbladder diseases: with diabetes, stable stage of cardiopulmonary dysfunction disease.
3, gallbladder diseases that can easily cause gallbladder cancer: gallbladder stones aged > 60 years, huge stones (diameter > 2cm), ceramic gallbladder, atrophic gallbladder, single gallbladder polyp > 1cm in diameter, rapidly growing gallbladder polyps, polyps with wide base, gallbladder neck polyps, etc. However, minimally invasive approach can not be performed in all cases.