Treatment of gallbladder infection and gallstones

  Cholecystitis gallstones is a common disease that endangers the health of the general public. The incidence is significantly higher in women than in men, and the older the age, the higher the incidence. The incidence of gallstones in the population is about 6.62%, and the incidence over the age of 40 is about 10.16%. The population of Guizhou is more than 30 million, and the number of gallstones is estimated to be as high as 2.4 million, which is quite alarming.  The gallbladder is located in the bed of the gallbladder below the liver, shaped like a pear, with a volume of about 50 ml, connected with the cystic duct and the common duct, which is generally 0.2-0.3 cm in diameter, and opens into the duodenum.  Bile is secreted by the liver, and the gallbladder mainly plays the role of storage and concentration of bile. After eating, the gallbladder contracts and discharges the stored bile into the duodenum through the cystic duct and common bile duct to help digestion. The components of bile are mainly bile alcohol, bile salts and phospholipids, which normally form microcolloids in a certain proportion. Once these components are changed, together with bile stagnation and other reasons, cholesterol can precipitate and precipitate to form stones. The causes of gallstones are complex and not yet understood, but diet is indeed associated with gallstone disease.  Stones in the gallbladder can occur without any symptoms. When gallbladder stones are complicated by chronic cholecystitis, they can produce symptoms similar to those of “gastric disease,” with patients often experiencing epigastric fullness and indigestion. Ultrasound is the most reliable way to diagnose gallbladder stones, and patients suspected of having “stomach problems” should undergo ultrasound to exclude gallbladder stones and avoid misdiagnosis and mistreatment.  When gallbladder stones obstruct the gallbladder neck and cystic duct, severe pain may occur and may radiate to the right shoulder and back. In case of acute septicemia, chills and fever may occur, and in severe cases, gallbladder perforation with peritonitis may threaten the life of the patient. Gallbladder stones can drain into the bile duct and become secondary bile duct stones, cholangitis, jaundice or even acute pancreatitis to complicate the condition.  In 1982, British doctors performed the first successful cesarean cholecystectomy for gallbladder stones, which laid the foundation for the surgical treatment of gallbladder disease. However, because surgery is relatively painful and recovery is slow, patients and doctors always hope to treat gallstones by non-surgical methods, thus the emergence of lithotripsy, lithotripsy and lithotripsy.  Lithotripsy can be used for primary bile duct stones (referring to stones in the common bile duct and hepatic duct) without bile duct stricture complications, while gallbladder stones with small numbers are usually large, most of them are more than 1-2 cm in diameter, and it is impossible to drain them through the 0.2-0.3 cm gallbladder duct. The gallbladder stones are usually the size of bracts and peppers, which are not easy to discharge and difficult to exhaust, moreover, they are painful when discharged, and stones discharged into the common bile duct will complicate the condition if they cannot be discharged into the intestine. Therefore, gallbladder stones are generally not suitable for lithotripsy.  Lithotripsy and lithotripsy are only suitable for patients with a small amount of gallstones and a normal functioning gallbladder with a minor gallbladder lesion. Lithotripsy and lithotripsy are not suitable for patients whose gallbladder is full of stones and whose gallbladder has atrophied.  Therefore, at this stage, surgical removal of the gallbladder is still the most effective, satisfactory and safe treatment for gallbladder stones.  Laparoscopic cholecystectomy was first performed by French surgeons in 1987 and has since been rapidly promoted at home and abroad, representing a major advance in surgical technology. At present, millions of patients worldwide have undergone this procedure. Hundreds of thousands of successful cases have been reported in China. The operation is performed only by making four small 0.5-1 cm incisions in the abdomen and completing the operation with instruments in the abdomen, which results in less injury and less pain. This surgery is very popular among patients and surgeons. The authors were the first to perform this surgery in Guizhou province and have performed tens of thousands of such surgeries with good results. So far, laparoscopic cholecystectomy has been clinically adopted as the first choice for cholecystitis and cholelithiasis and as the gold standard for gallbladder removal.