Q: Usually, when it comes to gallstones, many friends think that it is not a big deal and a minimally invasive surgery can solve the problem, but we don’t know that gallstones can have serious consequences if they are not properly controlled and treated in time. It is said that a famous movie star and entertainment show host in Hong Kong was hospitalized because of gallstones and 36 stones were taken out. What kind of disease is gallstones? Why do stones turn up in the gallbladder? What do gallstone stones look like? Are there different types? What is the largest size of stone you have seen removed from the gallbladder? A: You are right. Gallstones are a common disease of the biliary system and are a general term for gallbladder stones and bile duct stones (also divided into intrahepatic and extrahepatic). Gallstones are clots formed within the bile duct tree (including the gallbladder) and are one of the most common clinical diseases of the digestive system. Acute abdominal conditions caused by gallstones account for the second most common acute abdominal conditions, with 7-10% of the country’s population, suffering from gallstones. Clinical manifestations mainly include episodic abdominal pain, acute inflammation, and the following complications if stones enter the common bile duct and common hepatic duct: jaundice, cholangitis and pancreatitis; however, most patients can be asymptomatic. A sweet tooth is prone to gallstones, and the gallbladder is stimulated by chronic inflammation and bile acids and choline in gallstones for a long time, which can easily cause cancerous changes in the gallbladder mucosa. Diet regulation is the most ideal prevention method to prevent the occurrence of gallstone and gallbladder cancer. Prevention of gallstones should pay attention to dietary regulation and varied meals. Gallbladder stone formation is related to the chronic inflammation of the gallbladder. The necrosis of the mucosa of the gallbladder and the shedding of the mucosa and bacteria and viruses form a core that promotes the deposition of cholesterol and bilirubin, which forms stones over time; the metabolic disorders of cholesterol and bile acids. Excessive cholesterol content in the bile, bile stasis, bile salt reduction, it is very easy to form stones; preference for sweets, high-fat food and long-term use of certain drugs, bile is easy to concentrate, cholesterol is saturated; poor bile excretion; gallbladder muscle tone, resulting in the gradual accumulation of bile, concentration, deposition and formation of stones; genetic factors and estrogen levels are too high. Cholesterol stones: Cholesterol stones are white in appearance, often round or oval, with a smooth or granular surface. Most cholesterol gallstones occur in the gallbladder, and they are also called metabolic stones because they are closely related to metabolism. Bile pigment gallstones: most of the gallstones are mainly calcium bilirubin, of which melanin stones are indefinite in appearance, hard and smooth on the surface, and their main components are pigment polymers, calcium phosphate and calcium sulfate, which are often found in the gallbladder; while calcium bile pigment stones are often brownish-yellow granules, whose main components are calcium bilirubin, calcium fatty acids and cholesterol. The stones are commonly known as bile sand, which often occur in the bile ducts. Mixed gallstones: The main components of mixed gallstones are also cholesterol, bile pigment and calcium salts, which are polyhedral in shape, with smooth surface, dark green or brownish-yellow particles, often in large numbers, neatly arranged, with a circular lamellar section, and mostly occurring in the gallbladder. The largest gallbladder stone I removed was the size of a duck egg, and some doctors have reportedly seen even larger stones. Q: How dangerous are gallstones to our body? I heard that gallbladder infection may also lead to gallbladder cancer? What other diseases may be induced? A: Gallbladder stones can induce gallbladder cancer and can cause gallbladder abscess, necrosis, biliary peritonitis, jaundice, common bile duct stones, biliary pancreatitis, and duodenal and colonic fistula. Gallbladder cancer caused by calculous cholecystitis is 30 times higher than that caused by non-calculous cholecystitis; stones over 3 cm are 10 times higher than small stones; and the chance of cancer is significantly higher especially in patients with gallstones over 50 years of age. Acute abdomen caused by gallbladder stones, which accounts for the second most common acute abdomen, refers to acute biliary colic, an acute symptom caused by obstruction of the biliary system due to obstruction of the cystic duct or common bile duct, mostly caused by stones. It is characterized by persistent pain in the upper abdomen, aggravated by paroxysms, radiating to the shoulders and back or chest, accompanied by nausea and vomiting. Q: I heard that once you have gallstones, the pain is very strong when the disease attacks? A: The onset of gallstones is characterized by pain in the upper abdomen radiating to the shoulders and back, and low grade fever, nausea, vomiting, chills, profuse sweating and even jaundice. These symptoms are non-specific and similar to those of gastrointestinal and liver diseases, so patients may initially delay diagnosis on their own by mistaking gastrointestinal diseases or liver diseases for non-biliary system tests. Of course, there are also asymptomatic gallbladder stones. Usually, gallbladder stones with cholecystitis in the early stage: the right hypochondrium is often painful, the tongue is thick, red and dry, the stool is dry, and the urine is red. Acute attack: Most of the patients are referred from chronic cholecystitis, with clinical manifestations such as severe pain in the right hypochondrium, refusal to press, fever, vomiting, nausea, thick tongue coating, irritable heart, stool not passed for several days, and red hot urine. Q: What are the current treatment means? A: The treatment and prevention of gallstones consists of drugs (dissolving stones), surgery (removing stones) or diet (controlling the formation of gallstones); asymptomatic can be left untreated; lithotripsy is rarely used in regular hospitals; oral lithotripsy (goose deoxycholic acid and ursodeoxycholic acid) and perfusion lithotripsy (requiring gallbladder placement is not much used at present); lithotripsy; surgical treatment (open cholecystectomy, laparoscopic cholecystectomy, etc.) laparoscopic cholecystectomy, minimally invasive biliary lithotripsy). Q: What should I pay attention to after surgery? A: After surgery, you should lead a regular life, pay attention to exercise to promote liver bile secretion; eat a diet rich in fiber, three fixed meals, avoid stimulating spicy food and alcoholic beverages.