1.What are gallstones (gallstone disease)?
Gallstones are diseases caused by stones that occur in the gallbladder or surrounding bile ducts, and are a common disease. The incidence increases with age and is significantly higher in women than in men. With the improvement of living standards and changes in dietary habits, the incidence of gallstones has increased significantly.
2.Can gallbladder stones cause gallbladder cancer?
The formation of gallbladder stones in the gallbladder can stimulate the mucous membrane of the gallbladder, which can not only cause chronic inflammation of the gallbladder, but also cause secondary infection when the stones are embedded in the neck of gallbladder or bile duct, leading to acute and chronic inflammation of the gallbladder. Because of the chronic stimulation of gallbladder mucosa by stones, it may lead to the occurrence of gallbladder cancer, and the incidence of gallbladder cancer is reported to be 1~2%.
3.What are the causes of gallbladder stones?
The causes of gallbladder stones are very complex, some of them are unchangeable factors, such as: progressive age, female, race, gene and family history; some are acquired factors, some of them are reversible, such as: pregnancy, obesity, low fiber, high calorie diet structure, prolonged fasting, certain drugs such as ceftriaxone, lipid-lowering drugs, oral contraceptives, rapid weight loss, metabolic syndrome, special diseases, etc. The causes are not yet fully understood. The specific causes of formation are not yet fully understood.
4. Is there any gender difference in the development of gallbladder stones?
Ultrasound diagnostic studies show that the ratio of male to female gallbladder stones is about 1:2, and cholesterol stones are more common in women.
5.Is there a definite relationship between the development of gallbladder stones and dietary factors?
The incidence of gallbladder stones is significantly higher in people who eat low fiber and high calorie foods. This is because such foods increase the cholesterol saturation of bile, and once the cholesterol is precipitated, gallbladder stones are formed.
6.What are the clinical symptoms of gallbladder stones?
In general, gallbladder stones usually have no obvious symptoms in the early stage, and most of them are found during routine physical examination. Sometimes they can be accompanied by slight discomfort and are mistaken for stomach problems and not seen in time, which is called asymptomatic gallbladder stones. Small stones in the gallbladder can become lodged in the neck of the gallbladder and cause clinical symptoms, usually manifesting as biliary colic, pain in the right upper abdomen or epigastrium, radiating to the right scapula or back, and may be accompanied by nausea and vomiting. The pain can be exacerbated by gallbladder contraction, especially after eating a fatty diet, or during sleep due to a change in position. Jaundice occurs in a few cases and is usually mild.
7.Is there any relationship between gallbladder stones and acute cholecystitis?
Yes, gallbladder stones may induce acute cholecystitis. When gallstones are embedded in the neck of the gallbladder, they cause acute obstruction, resulting in increased pressure in the gallbladder, and bile cannot be drained through the neck of the gallbladder and the cystic duct, thus causing clinical symptoms.
In some patients, the clinical symptoms can be relieved by themselves after a few hours, during this period, close observation is needed without special treatment; if the condition continues to be unrelieved, follow the next step of treatment.
However, if the gallbladder stone is not relieved, the gallbladder will continue to increase in size and even become infected, thus progressing to acute cholecystitis.
In chronic hepatitis, when hepatitis causes abnormal liver function, there can be clinical manifestations such as vague pain and discomfort in the right upper abdomen and loss of appetite. Generally, B ultrasound and liver function tests can be used to differentiate.
8.How to prevent the occurrence of gallbladder stones in general?
Dietary control is the most ideal prevention method to prevent gallstone and gallbladder cancer. In addition, cold, greasy, high-protein, stimulating foods and strong alcohol are likely to cause bile accumulation and should be eaten sparingly. Vegetables and fruits rich in vitamin A and vitamin C, fish and seafood can be eaten more often.
In addition, it is important to have a regular life, pay attention to the combination of work and rest, participate in regular physical activities, eat breakfast on time, avoid gaining weight, and reduce the number of pregnancies. Drinking a glass of milk every night or eating a fried egg for breakfast can make the gallbladder contract and empty regularly, reducing the time of bile staying in the gallbladder.
9.What are the clinical manifestations of bile duct stones?
The clinical manifestations of bile duct stones can be multifaceted, ranging from early stones confined to a section of the intrahepatic bile duct with no obvious clinical symptoms to late cases of biliary cirrhosis, hepatic atrophy, liver abscess and even complications in the bile duct system inside and outside the liver.
Therefore, the clinical manifestations are very complex, including.
(1) epigastric pain, which may be typical biliary colic or persistent distension, or in some patients, pain is not obvious, but chills and fever are very obvious, with periodic attacks;
(2) A long history of biliary tract disease or acute cholangitis with chills and fever and jaundice;
(3) Frequent pain and discomfort in the affected hepatic area and lower chest, often radiating to the back and shoulders; in the case of hepatic duct obstruction on one side, there may be no jaundice or very mild jaundice;
(4) In case of an acute attack of bile duct stones, the symptoms of acute purulent cholangitis may appear in the acute phase, mainly in the form of paroxysmal colic in the right upper abdomen, with nausea and vomiting. A high fever of 39 to 40 degrees Celsius and jaundice of the skin and mucous membranes are also present.
(5) The hepatic area is marked by pressure and percussion pain, and the liver is asymmetrically enlarged with pressure pain.
10.What are the complications of gallbladder stones?
Gallbladder stones are closely related to the occurrence of cholecystitis, cholangitis, gallbladder cancer and other diseases. Chronic inflammation of the gallbladder and the stimulation of bile acid and choline in gallbladder stones can easily cause cancer of the gallbladder mucosa. Gallbladder stones can cause secondary bile duct stones and some complications of bile duct stones through the bile duct. Severe gallbladder stones can also cause systemic secondary infections.
11.Which gallbladder stones need to be treated?
Asymptomatic gallbladder stones can be followed and observed, but patients with the following conditions need to be seen in a timely manner.
(1) Filled gallbladder stones;
(2) porcelain gallbladder;
(3) diabetes mellitus;
(4) Gallbladder stones larger than 1 cm;
(5) Atrophic gallbladder;
(6) Family history of biliary tract disease;
(7) Combined with gallbladder polyps.
12.What are the surgical treatments for gallbladder stones?
Since laparoscopic cholecystectomy was performed in 1985, it has gradually replaced all other treatment methods as the standard procedure for gallbladder stone treatment because of its minimally invasive nature, few complications, broad indications, clear efficacy, and absence of gallbladder stone recurrence.
Other traditional surgical treatments for gallbladder stones include open surgery to remove gallbladder stones, open exploration of bile ducts to remove stones, and laparoscopy combined with choledochoscopy to explore bile ducts to remove stones, but each has its own indications.
13.Is non-surgical treatment of gallbladder stones less risky?
The indications for non-surgical treatment are very limited, and there are certain requirements for the nature, number and size of gallbladder stones, the course of treatment is longer, and there are certain side effects of oral lithotripsy drugs itself.
Lithotripsy treatment, especially extracorporeal lithotripsy, can cause mechanical damage to adjacent organs, and lithotripsy must be combined with stone removal, which may induce complications such as acute cholangitis and pancreatitis during stone removal.
In addition, all these treatments have the problem of recurrence of gallbladder stones. So it is necessary to choose carefully according to the doctor’s advice.
14.What problems will gallbladder removal bring?
Surgical removal of the gallbladder, although avoiding the recurrence of gallbladder stones, also brings problems caused by the loss of the gallbladder. After gallbladder removal, the patient loses the function of concentrating, storing and discharging bile from the gallbladder, causing the body to be unable to provide enough bile when eating, especially when eating high-fat and high-protein food, so the incidence of indigestion, bloating and diarrhea of the patient increases significantly.
In addition, the incidence of bile stones in the common bile duct increases due to compensatory dilatation of the common bile duct after cholecystectomy, resulting in relative narrowing of the terminal opening of the common bile duct and changes in the hydrodynamic characteristics of bile in the common bile duct. After cholecystectomy, the incidence of reflux esophagitis and inflammation of the stomach and duodenum is significantly higher in some patients. It will also have some effect on the immune defense function of the biliary tract.
15.What is common bile duct stone?
Most of them are bile pigment stones or bile pigment-based mixed stones, which are found in the lower part of the common bile duct. According to their origin, they can be divided into primary and secondary common bile duct stones. Stones formed in the bile duct become primary gallbladder stones, and their formation is closely related to biliary tract infection, biliary stasis, and biliary ascariasis. If the stones in the bile duct come from the gallbladder, they are called secondary bile duct stones, and cholesterol stones are more common.
16.What should I pay attention to in my diet after gallbladder stone surgery?
Generally speaking, the following points should be noted in the diet after gallbladder stone surgery to prevent recurrence.
(1) Eat less stimulating spices, carbonated drinks, alcohol and other foods that promote the secretion of gastric juice, which can stimulate the bile duct contraction and increase the occurrence of bile duct stones;
(2) three meals should be eaten at a fixed time, try to make the bile excretion rules;
(3) Food fiber has the function of reducing cholesterol in the blood, you can eat brown rice, germ rice, vegetables, seaweed, etc., which are rich in fiber;
(4) Limit high-fat diet. Elevated cholesterol can easily produce bile duct stones, so limit foods rich in animal fats such as eggs, cream, butter, liver, and fish eggs.