Diagnosis and treatment of gallbladder stone disease

  Onset: Gallbladder stones are mainly seen in adults and are common in women, especially in menstruating women and those taking birth control pills.  Clinical manifestations: The symptoms of gallbladder stones depend on the size and location of the stones, as well as the presence of obstruction and inflammation. About 50% of patients with gallbladder stones are asymptomatic for life, which is known as occult stones. Larger gallbladder stones may cause symptoms of indigestion such as stuffiness and distension in the upper or right side of the abdomen, belching and aversion to fatty foods. Smaller stones cause biliary colic and acute cholecystitis when they block the gallbladder duct after a full meal, eating fatty food, or lying down at night. The diagnosis of gallbladder stones with a history of acute attack is generally not difficult to make a diagnosis based on clinical manifestations. However, if there is no history of acute attack, the diagnosis mainly relies on auxiliary examinations such as ultrasound examination which can show the light mass in the gallbladder and the sound shadow behind it, and the correct diagnosis rate can be more than 95%.  Treatment: The main treatment is surgery, including the most commonly used cholecystectomy and cholecystectomy for stone extraction, and cholecystectomy is divided into trans-laparoscopic cholecystectomy and open small incision cholecystectomy.  Postoperative recurrence prevention: (a) dietary attention 1. prohibit alcohol and alcoholic beverages 2. Excessive cholesterol intake can increase the metabolic and cleaning burden of liver and gallbladder, and cause excess cholesterol to crystallize, accumulate and precipitate in the gallbladder wall, thus forming stones. Therefore, cholesterol intake should be reduced, especially at night, and foods with high cholesterol such as eggs (especially egg yolk), fatty meat, seafood, scaleless fish, animal offal and other foods should be avoided.  (B) Drugs to prevent recurrence Mainly goose deoxycholic acid, ursodeoxycholic acid and the third generation litholytic drug ursodeoxycholic acid taurate.  Whether it is cancerous or not The chance of gallbladder stones complicating gallbladder cancer is about 0.5% to 1%, and the incidence of gallbladder cancer in patients with gallbladder stones increases with age. It is generally believed that the risk of gallbladder cancer is 10 times higher for gallbladder stones larger than 3 cm in diameter than for stones less than 1 cm in diameter.