1 What is the gallbladder? Where does the bile come from? What does it do?
A: The gallbladder is a pear-shaped bag-like structure attached to the underside of the liver and opening into the extrahepatic bile ducts, and is called the gallbladder because it stores a portion of the bile from the liver. Bile is produced by liver cells and discharged into the intestine through the intrahepatic and extrahepatic bile ducts to help digestion of food and absorption of nutrients.
2.How is it formed?
A: There are many things in bile that are normally in a dissolved state, just like sugar or table salt dissolved in water. If the concentration is too high, some of them will form crystals, which then grow further and become clumps, staying or blocking in the biliary system, affecting the flow of bile, and stones are formed. Due to the different composition of gallstones, the formation of different parts and growth time, their appearance and structure are also varied, large like eggs, small like mud and sand, beautiful like colored beads.
3.What are the dangers of gallstones? What are the dangers of gallbladder stones?
A: In addition to gallstones causing biliary colic, hidden pain and indigestion, the greater danger is bile duct obstruction causing jaundice, bile duct suppuration, pancreatic inflammation, and even death. Long-term irritation of the bile duct wall or gallbladder wall by gallstones can cause cancer. Patients with gallbladder stones all have chronic inflammation of the gallbladder, and long-term irritation causes the gallbladder to lose its contractile function, and a small percentage can become cancerous. If the stone is blocked in the jugular abdomen or the cystic duct, it can cause right upper abdominal biliary colic. If changing position or medication cannot make the stone leave the obstruction site, high pressure will be generated in the gallbladder, and the blood supply to the gallbladder wall will be reduced or stopped, so bacteria can easily enter and produce a lot of toxins, causing necrosis or even perforation of the gallbladder wall; some small stones or bile sludge can be discharged to the common bile duct by the gallbladder, causing obstruction of the common bile duct, producing jaundice and purulent cholangitis. Some stones are in the lower end of the common bile duct for a long time to stimulate the narrowing of the lower end, so that this special structure like a door is destroyed, and that will be a lifelong sequelae. So with gallbladder stones should be treated early, do not have a fluke mentality.
4.How does biliary colic occur? Is it unnecessary to treat the pain after it disappears?
A: When stones are blocked in the gallbladder duct or bile duct, the body will naturally produce a series of reactions to overcome it, such as gallbladder spasm or contraction of the lower sphincter of the common bile duct, which will produce severe pain if the stones cannot be discharged with great effort. If the pain disappears as a result of the total discharge of the stone, then no treatment is needed, but this rarely happens. The majority of cases are due to the stone temporarily leaving the site of blockage, and under certain conditions, such as eating greasy food, fatigue, drinking alcohol, etc., it can come back again. Therefore, as long as the stone exists, it should be removed firmly.
5.Why do gallstones cause yellow eyes, chills and fever?
A: Bile is produced by the liver and enters the intestine through the bile duct. The bile duct is like a tree, the intrahepatic bile duct is like a branch and the common bile duct is like a trunk. If there is an obstruction in the trunk, the bile produced by the liver cannot be discharged and flows backwards into the bloodstream, where the bilirubin in the bile settles in the eyes and skin, manifesting as yellow sclera and skin staining, which is called jaundice. With stones in the bile duct causing poor bile flow, intestinal bacteria will easily enter and multiply, producing toxins, and the body will react with chills and fever.
6.Does gallstones have to be treated?
A: Strictly speaking, as long as there are stones, they should be treated because there should not be stones in the normal biliary system. Because gallstones will inevitably cause different degrees of harm to the human body, some harm in the early stage, no obvious performance, and some have developed to the point where treatment is necessary, medical practice has proved that the earlier any disease is treated, the better.
7.Is it necessary to treat gallbladder polyps?
A: There are three types of gallbladder polyps. Cholesterol polyps are multiple, generally less than 3mm in diameter, not cancerous, so no need to treat; inflammatory polyps are multifocal mucosal hyperplasia on the background of gallbladder inflammation, although rarely cancerous, but if the gallbladder inflammation for a long time, affecting the quality of life, it is better to remove; the third is the real polyps, generally single, varying in size, more than 10mm easy to cancer, should be particularly vigilant. The following conditions should be operated in time: (1) older patients; (2) single polyps or polyps with less occurrence, diameter greater than 8mm; (3) recent ultrasound examination found that the polyps have grown significantly; (4) recent occult pain or pain in the gallbladder area. In fact, it is incomplete and even wrong to decide whether to operate by the size of polyps. Polyps do not tell you when they will change, and once clinical symptoms or ultrasound suggest cancer, it is often too late, and lessons in this regard are not uncommon. Happily, with the improvement of people’s economic and cultural level and the enhancement of disease prevention awareness, especially the emergence of laparoscopic cholecystectomy surgery, the incidence of gallbladder polyp cancer has been significantly reduced.
8.What lesions can be produced by the gallbladder?
A: The gallbladder is a disease-prone structure, with cholecystitis, gallbladder stones, gallbladder polyps, gallbladder cancer and some rare lesions. There is a layer of mucous membrane inside the gallbladder, which is a tissue prone to pathological changes, not only related to stone formation, but also can undergo some changes itself, such as polyps, adenomatous hyperplasia, tumors, etc.
9.Who is prone to gallbladder stones?
A: A large number of epidemiological surveys have been conducted at home and abroad, and the following groups of people are found to be prone to gallbladder stones.
1) Female patients;
2) Those who are over 40 years old;
3) Obese people;
4) People with gallbladder stones in their family or those who have had gallbladder stones before;
5) High fat diet;
6) Those with liver disease;
7) Breakfast fasters;
8) Oral contraceptive pill users;
9) Those who have had previous gastrointestinal surgery.
The occurrence of gallbladder stones may be related to dietary habits, genetic factors, endocrine factors, and liver disease.
10. What if there are no stones in chronic inflammation of the gallbladder?
A: There are two types of chronic inflammation of the gallbladder, one with stones and one without stones, called non-stone gallbladder inflammation, which may be related to allergic reactions or microbial infections, or may be part of hepatitis. The main clinical manifestations are upper abdominal fullness and vague pain, and the symptoms are aggravated by eating fatty food, some of which can be more severe and occur frequently, affecting daily life. Despite the absence of stones, the only solution to this problem is surgical removal of the gallbladder, due to the poor effect of medication and the irreversible chronic inflammatory process of the gallbladder wall.
11.What are the methods of treatment for gallbladder stones?
A: There are two major types of treatment methods: one is the treatment method to preserve the gallbladder, such as herbal lithotripsy, Chinese and Western medicine lithotripsy, shock wave lithotripsy and lithotripsy; the other is the method to remove the gallbladder, such as cesarean cholecystectomy, small incision cholecystectomy and laparoscopic cholecystectomy. The purpose of the first type of methods is to retain the gallbladder, but the disadvantage is that the treatment effect is too poor, and it is easy to grow stones again; the second type of methods although there is a certain trauma, but the treatment effect is reliable, without the disadvantage of stone recurrence.
12.What is the best way to treat gallbladder stones?
A: An ideal treatment method should have the following conditions.
(1) no damage to the body; (2) preservation of gallbladder function; (3) reliable results; and (4) no recurrence of stones. But so far there is no treatment method with the above conditions, currently medical experts are more recognized is laparoscopic cholecystectomy, because retaining the gallbladder means inevitable recurrence, in the absence of a solution to this problem, only this method is close to the above conditions, it is very little damage to the human body, the treatment effect is nearly 100%, gallbladder stones are not likely to recur.
13.What is the effect on human body after gallbladder removal?
A: First of all, gallbladder is a useful auxiliary organ, but practice proves that it is not indispensable, only a few patients have a change in stool habit for a period of time after surgery, which can be restored to normal within 1-3 months by adjusting diet and proper regulation of intestinal function; secondly, we remove the gallbladder which is diseased and may cause many serious complications. Finally, more than 100 years of clinical practice have proved that gallbladder removal will not cause serious effects on human body.
14.What do I need to pay attention to in my diet after gallbladder removal?
A: In the near future after surgery, you should eat low-fat and easily digestible food, and as the gastrointestinal function recovers, you can gradually let go of the restriction later, and you can eat anything you want. There is a wrong view that after gallbladder removal, you cannot eat fatty or high protein food, which is not based on science. However, if you have other problems and need to adjust the structure of your diet, then the original plan does not need to be changed. After gallbladder removal, the function of the gastrointestinal tract is temporarily affected to some extent. Together with the temporary disorder of the original dependence of the biliary-intestinal circulation, there is a process of adaptation to the diet. This process varies from person to person generally recovering within a few months, as fast as a few days. Usually the guiding principles are: less first, more second, soft first, hard second, vegetarian first, meat second, small amount and many meals. In the most practical words, as long as you feel comfortable, don’t be too dogmatic.
15.What is the cause of diarrhea for a period of time after gallbladder removal surgery?
A: Although some patients have heavy clinical symptoms, the gallbladder function is not completely lost, and there is still some regulation of the flow of bile. After gallbladder removal, bile flows directly into the intestine during the inter-digestive period, causing intestinal peristalsis to accelerate, resulting in an increase in the number of stools.
16.Why do I still feel pain in the upper abdomen after gallbladder removal?
A: Most of the symptoms will disappear after gallbladder removal, but some patients still have symptoms. This is because the causes of upper abdominal pain or other symptoms, in addition to gallbladder stones, are chronic gastritis, bile reflux, chronic pancreatitis, colonic hepatic flexure syndrome, etc. These pathological states can coexist with gallbladder stones, so the original symptoms can persist after gallbladder removal. If you encounter this situation, you need to make further examination and do not just think of gallbladder problems to avoid misdiagnosis.
17.A one-centimeter stone was found in my gallbladder, can I take Chinese medicine to expel it?
A: The idea is good, but in fact it is impossible because two conditions must be met in order for the stone to be expelled from the gallbladder: first, the gallbladder has good contraction function, and second, the outside diameter of the stone is smaller than that of the cystic duct and common bile duct. Under normal circumstances, the internal diameter of the gallbladder duct is only 2~3mm and the internal diameter of the common bile duct is 6mm, plus the gallbladder function of gallbladder stone patients is often poor, so it is very difficult to expel the stones. Your stone is 10mm, which is 3 times bigger than the gallbladder duct, so don’t make stone removal treatment, otherwise it is a waste of money.
18.What kind of stones can be dissolved by medication?
A: Indeed, there are very few gallbladder stones that can be dissolved by taking medicine, but the conditions are very high. Requirements: (1) the gallbladder function is basically normal; (2) the stones are purely cholesterol-based; (3) the stones are not larger than 10mm; (4) insist on taking medicine for 1~2 years. Even so, only 8-10% of stones can be completely dissolved. However, as soon as you stop taking the medicine, the stones will come out again, so the cure is not the root cause.
19.There is a method to break up the stones and excrete them. Is this method reliable?
A: Logically speaking, breaking up the stones is good for discharging, which is the purpose of inventing shock wave lithotripter. However, medical experts at home and abroad have treated millions of cases with unsatisfactory results, why? Firstly, gallbladder stones are not easy to be broken, and the efficacy of lithotripsy for stones larger than 15 mm is very low; secondly, even if stones are broken, most of them are still not small enough to be discharged; furthermore, the clinical standard for effective gallbladder stone treatment is to eliminate all stones, and as long as one stone is left, it cannot be considered a successful treatment; finally, the process of lithotripsy and stone discharge can cause complications. This method was prevalent in the late 80’s, but now it has been eliminated.
20.Can a small hole be made in the abdominal wall to remove the stone?
A: Yes. This method is called percutaneous cholecystectomy, and there are two methods: one is to puncture the gallbladder under ultrasound guidance, then gradually cut the abdominal wall, put in a one-centimeter outside diameter tube, and then remove the stone through the tube; the other method is to cut 1~2 centimeters directly on the abdominal wall, then separate into the abdominal cavity, find the gallbladder, and then cut a small opening at the bottom of the gallbladder to remove the stone. The advantage of this method is that the results are more certain and there are no special requirements for the size, number and composition of the stones. The disadvantage of this method is the damage to the abdominal wall, the possibility of contamination of the abdominal cavity, the possibility of residual stones in some patients, and the high recurrence rate of stones. Since the availability of laparoscopic cholecystectomy, this method has been used less and less. However, for older patients with a small number of stones, it is still a possible option.
21. What is laparoscopic cholecystectomy all about?
A: Cesarean cholecystectomy is performed by cutting open the abdominal wall and then operating directly under the naked eye. The incision is usually 15-20 cm, and the doctor enters the abdominal cavity with instruments in hand to perform various operations. In contrast, laparoscopic cholecystectomy, as the name implies, the doctor does not observe the abdominal cavity with the naked eye, but transfers the image to the TV screen through a 1cm thick laparoscope to watch the TV surgery, so that the doctor just has to make 3~4 small holes (usually in 0.5-1cm) in the abdominal wall, insert special instruments, cut the gallbladder down completely, and then remove it from the small holes in the abdominal wall. Therefore, this operation is also called TV laparoscopic surgery, commonly known as “small-hole cholecystectomy”.
22.What are the advantages of laparoscopic surgery?
A: It has many advantages, summarized as follows: (1) small incision, light injury, fast postoperative recovery, generally the same day can get out of bed, the next day can eat, 1 ~ 3 days can be discharged, 7 days can resume daily activities; (2) clear intraoperative field of view, while other organs can be observed; (3) the operator’s hands do not enter the abdominal cavity, less interference with other organs; (4) no obvious scars after surgery, does not (5) last but not least, because of the removal of the gallbladder, such stones will not recur.
23.What if gallbladder and bile duct stones are present at the same time?
A: In terms of risk, bile duct stones are more important than gallbladder stones and are the main focus of treatment, usually a caesarean biliary exploration is considered and the gallbladder is removed by the way. However, for some patients with better conditions, if the bile duct stones are single or not many, it is estimated that the stones are not embedded and can be removed by choledochoscopy, then both problems can be solved simultaneously under laparoscopy; also, the bile duct stones can be removed first through duodenoscopy by incising the duodenal papillary sphincter, and then the gallbladder can be removed through laparoscopy.
24.Stones have been detected by ultrasound for many years, but only symptoms such as vague pain in the upper abdomen, abdominal distension and indigestion are related to stones?
A: There are three possibilities: first, it is caused by gastrointestinal lesions or pancreatitis lesions; second, it is caused by gallstones; third, both conditions exist at the same time. It is especially worth emphasizing that the presence or absence of biliary colic alone should not be used to determine whether stones cause symptoms. The clinical symptoms of gallbladder stones come from two sources: first, from stones obstructing the gallbladder duct, causing typical biliary colic; second, from chronic inflammation of the gallbladder wall, manifesting as symptoms similar to gastrointestinal discomfort. In fact, most patients with gallbladder stones have these atypical manifestations.
25.Does gallstones necessarily recur after surgery?
A: For gallbladder stones, as long as the gallbladder is removed, there will be no recurrence, but if only the stones are removed and the gallbladder is left, recurrence is inevitable. For common bile duct stones, especially from the gallbladder, if the damage to the common bile duct is not serious or not long, recurrence can be avoided after treatment. However, most patients are not treated in time and wait until the common bile duct is significantly damaged before surgery, which makes them prone to recurrence. For multiple stones in the liver, if the stones are removed together with part of the liver, the stones in this area will not recur, but if the stones are only removed, recurrence is inevitable. In short, as long as the growth site of stones is not removed, stones will recur.
26.Why do gallstones cause pancreatitis?
A: The pancreas is at the back of the stomach and its main role is to produce enzymes for digesting proteins, fats and starches, which are dissolved in pancreatic juice and discharged through the pancreatic duct to the intestines to digest food. In the very majority of cases, the bile ducts and pancreatic ducts converge before entering the intestine. If the opening is blocked, bile may flow back into the pancreas, activating the digestive enzymes in the pancreatic fluid and causing the pancreas to “self-digest”, thus causing pancreatitis, which is called cholestatic pancreatitis.
27. What are the causes of pancreatitis? Can it be prevented?
A: The most common cause of pancreatitis is the obstruction or stimulation of the common opening of the bile duct and pancreatic duct by gallstones. Therefore, on the one hand, we should pay attention to the regularity of life, not to drink and overeat, and more importantly, we should treat gallstones in time. It is worth pointing out that if you have multiple stones in your gallbladder, you should not casually carry out stone removal treatment.
28.Is pancreatitis dangerous?
A: Pancreatitis can be divided into edematous pancreatitis and hemorrhagic necrotizing pancreatitis, the latter is very dangerous and has a very high clinical mortality rate. Hemorrhagic necrosis of the pancreas can cause extensive damage, in addition to direct damage to surrounding organs, it can also cause changes in the heart, lungs, liver, kidneys and other major organs, which can lead to systemic failure and death if not effectively controlled in time.
29.Does gallstones affect the heart?
A: Although the gallbladder and the heart are located far apart, the human being is a whole body, so it can be said that “the whole body is involved”, because the gallbladder and the heart are innervated by the same nerves, sometimes the high pressure or severe pain in the gallbladder can cause the heart vasoconstriction through the nerve reflex, reducing the heart blood supply and causing changes in heart rhythm. If the patient already has heart problems, such as coronary heart disease, then it may trigger or aggravate the heart disease, which is clinically called “biliary heart syndrome”. If this situation exists, for safety, the gallbladder stones should be treated as early as possible when the patient is not too old and still in good health condition.
30.Can I have laparoscopic cholecystectomy for heart disease?
A: With the improvement of the level of anesthesia and the reduction of surgical trauma, in most cases, even with heart problems, gallbladder can still be removed. However, patients with significant cardiac failure or hemodynamically compromised heart rhythm disturbances should be performed after these problems have improved. The advent of laparoscopy has made gallbladder removal safer for patients with heart disease.
31. Is laparoscopic cholecystectomy safe for diabetic patients?
A: Laparoscopic cholecystectomy can be performed safely in almost all diabetic patients as long as the complications caused by diabetes are properly controlled. The biggest concern in the past was incisional infection. Since laparoscopic cholecystectomy only uses 3~4 small holes, this problem can be avoided.
32.Can laparoscopic cholecystectomy be done for hypertensive patients?
A: Hypertension can be mild or severe. If there are no serious heart, kidney or cerebrovascular complications, laparoscopic cholecystectomy is safe as long as the blood pressure is controlled at a slightly higher than normal level. In fact, the trauma of laparoscopic surgery itself is minimal, and as long as the other organs can withstand the effects of anesthesia, there is no problem at all.
33.Is there any contraindication to laparoscopic cholecystectomy?
A: Like other surgeries, laparoscopic cholecystectomy also has contraindications, such as severe cardiopulmonary disease, coagulation disorders, concomitant intra- and extrahepatic bile duct stones, proliferative lesions in the gallbladder suspected of being cancerous, recurrent acute attacks of chronic cholecystitis with hyperthermia, suspected extensive intra-abdominal adhesions, etc. But contraindications are relative. However, contraindications are relative, and with the improvement of technology, many contraindications have been broken through, such as. Atrophic cholecystitis, acute onset of gangrenous cholecystitis, intra-abdominal adhesions with previous history of abdominal surgery, and even internal fistulae formed between gallbladder and colon are possible to be done laparoscopically.
34.Can I work as normal after gallbladder removal?
A: You must establish the belief that since a diseased gallbladder has been cut away, it must be healthier than the original. Many patients who have had surgery will have the psychological idea that they are not as good as others, which is very wrong. Remember this famous saying: As long as you think you are sick, you will be sick, and as long as you think you are healthy, you will be healthier. So as long as you get reasonable treatment, there is no need to worry about working. Of course, if you really feel discomfort somewhere, you can ask your physician to check again. Generally, there will always be mild discomfort, and you will recover after some time, so there is no need to have a psychological burden.
35.What should I do before laparoscopic cholecystectomy?
A: Just do some routine preoperative examination. If the operation is performed in the morning of the next day, only fasting after dinner on the same day is required, no intestinal preparation is needed, and no gastric tube needs to be inserted before the operation. There is no blood preparation, which is very different from traditional caesarean operation.
36.What should I pay attention to after laparoscopic cholecystectomy?
A: 6-8 hours after surgery, you can get up to urinate and defecate by yourself or with the help of your family, do not rely on the potty, and the next day you should get out of bed, wash and eat liquid or soft and easily digestible food, without waiting for the anal vent to eat. After surgery, there will be mild pain at the site of the puncture hole, which is usually tolerable, or if you are sensitive, you can use painkillers. In conclusion, striving for early resumption of daily activities after surgery should forget the traditional practice, and early activity is beneficial for postoperative recovery.
37.Is it a recurrence of common bile duct stone found soon after gallbladder removal?
A: No! Recurrence means that stones grow back in the area where they were originally found. There are two possibilities for finding stones in the common bile duct: one is that the common bile duct already has primary stones, and the other is that the stones were drained from the gallbladder to the common bile duct before surgery. Because the lower end of the common bile duct is covered by the intestine, the ultrasound may not be able to see it clearly, so even if the diagnosis is missed, it is not the fault of the ultrasonographer or his technical skills. The good news is that the incidence of this is less than 1%. Therefore, the key is early detection and treatment.
38.How to deal with common bile duct stones if found?
A: There are three ways: firstly, you can try Chinese herbal medicine for stone removal under close observation; if it is not effective, then use fiberoptic duodenoscope to insert from the mouth to the duodenum at the opening of the common bile duct, make a partial incision, and then remove the stone with a mesh basket; finally, if the above methods are not effective, then use abdominal biliary exploration to remove the stone. Surgeons mostly advocate direct surgical treatment, because the first two methods are not only poorly reliable, but also have a certain possibility of complications.
39.What if both gallbladder stones and chronic gastritis are present?
A: Both diseases can have the same clinical manifestations. If there is typical biliary colic, of course, gallbladder removal is performed first and then gastritis is treated. If the symptoms are not typical, it makes one indecisive. The normal thinking is still to address the gallbladder problem first and then treat the gastritis. The cost of removing the stomach is much greater than removing the gallbladder, and it is difficult to establish the effect of long-term medication because the medication for the stomach is not effective for the gallbladder.
40.Does the weather affect the effect of laparoscopic cholecystectomy?
A: Not at all. It is natural to think that incisional infections are prone to occur in hot weather, but this is not true for modern medicine. Modern aseptic conditions, the air-conditioned environment of the ward coupled with the small poke holes in the laparoscopic cholecystectomy itself, make it extremely rare for infection to occur.
41.Is this method of laparoscopic cholecystectomy safe?
A: The safety of a medical technique is determined by many factors, such as the age of the patient, the functional status of the vital organs, the pathological changes of the gallbladder, the experience and skill level of the surgeon, and the management and equipment level of the hospital. Cholecystectomy has been performed for 116 years and has proven to be the most effective method for the treatment of gallbladder stones, and its overall safety is very high. The emergence of laparoscopic cholecystectomy has undoubtedly further improved the safety in terms of development trend. However, there is a learning and maturation process for the application of any new technology. In the early stage of carrying out this technology, intraoperative and postoperative bleeding, biliary tract injury and surrounding organ damage, etc., occur in a high proportion, but gradually decrease or even do not occur as the number of cases increases. Therefore . The key for patients is to understand and find a surgeon they fully trust and to follow the surgeon’s advice to perform the surgery at the most suitable time.
42.What are the new directions of laparoscopic cholecystectomy at present?
A: Compared with the traditional open cholecystectomy, laparoscopic cholecystectomy is already a minimally invasive procedure, but surgeons are still working hard to find ways to achieve less trauma, faster recovery and more beautiful appearance. At present, there are two new directions: (1) mini-laparoscopic cholecystectomy: the surgical operation is performed by making small holes of only 3 mm and 5 mm in diameter in the abdominal wall with mini-laparoscopic surgical instruments, and the incision is reduced by 50% compared with that of ordinary laparoscopic cholecystectomy; (2) foreign body-free laparoscopic cholecystectomy: instead of using metal titanium clips in ordinary laparoscopy, the gallbladder duct is ligated with absorbable threads. Clamping the gallbladder duct, so that no foreign body is left in the abdominal cavity and the adverse reaction of foreign body is reduced.
43.What are the advantages of mini-laparoscopic cholecystectomy? For which patients?
A: Compared with ordinary laparoscopic cholecystectomy, mini-laparoscopic cholecystectomy has the advantages of less trauma, faster postoperative recovery and more beautiful appearance. It is especially suitable for young women with high cosmetic requirements and patients with mild gallbladder inflammation. The treatment effect is better for patients with gallbladder polyps, gallbladder stones without a history of acute and chronic inflammatory episodes.
44.Can laparoscopy be used for other procedures besides gallbladder?
A: It can be said with certainty that almost all abdominal surgeries can be accomplished in a minimally invasive way with the assistance of laparoscopy. In addition to laparoscopic cholecystectomy, our hospital and Beijing experts are preparing to carry out in our hospital.
(1) laparoscopic fundoplication for gastroesophageal reflux; (2) laparoscopic gastric volume control for obesity;
(3) laparoscopic abdominal wall and inguinal hernia repair; (4) laparoscopic colorectal resection;
(5) laparoscopic splenectomy; (6) laparoscopic hysterectomy and adnexal hysterectomy;
(7) laparoscopic ultrasonic knife lower limb venous traffic branch dissection; (8) laparoscopic appendectomy.
45.My father is old and has gallstones, can he be operated?
A: The incidence of emergency gallstone disease in the elderly has increased in recent years, with a higher rate of gallbladder necrosis and perforation, and even death due to toxic shock, so gallstone disease in the elderly should not be underestimated, and surgery should be performed early. Laparoscopic cholecystectomy should be the preferred surgical approach.
46.What are the characteristics of geriatric cholelithiasis?
A: Geriatric cholelithiasis is prone to gallbladder perforation, accounting for about 13% of emergency cases of geriatric cholelithiasis. The reasons for this are as follows: (1) because the elderly are more unresponsive to pain, th