How to treat gallbladder stones

Gallbladder stones mainly occur in adults, with a higher incidence in women than in men, and the incidence of gallbladder stones will continue to increase with age. Gallstones are mainly composed of cholesterol. There are many causes of gallbladder stones. After the disease occurs, symptoms such as biliary colic and dull pain in the right upper abdomen will appear, which are very harmful. So, how to treat gallbladder stones?

Causes

Gallstones are related to many factors. Any factor that changes the ratio of cholesterol to bile acid concentrations and causes bile stasis can lead to stone formation. Residents of certain regions and ethnic groups, female hormones, obesity, pregnancy, high-fat diet, long-term parenteral nutrition, diabetes, hyperlipidemia, after gastrectomy or gastrointestinal anastomosis, terminal ileal disease and after ileal resection, cirrhosis, hemolytic anemia and other factors can all cause gallstones. The incidence of gallstones in the northwest region of my country is relatively high, which may be related to dietary habits.

1. Laparoscopic cholecystectomy is the first choice for treatment

It causes less damage than classic open cholecystectomy and has a more definite therapeutic effect. Asymptomatic gallstones generally do not require active surgical treatment and can be observed and followed up. However, surgical treatment should be considered in the following situations:

(1) Stone diameter ≥ 3 cm;

(2) Combined with surgery requiring laparotomy;

(3) With gallbladder polyps > 1 cm;

(4) Thickening of the gallbladder wall;

(5) Calcification of gallbladder wall or porcelain gallbladder;

(6) Gallstones in children;

(7) Combined with diabetes;

(8) Cardiopulmonary dysfunction;

(9) Workers in remote or underdeveloped areas or in the field;

(10) Gallstones have been detected for more than 10 years.

2. During cholecystectomy, common bile duct exploration should be performed in the following situations:

(1) Preoperative medical history, clinical manifestations or imaging examinations confirm or highly suspect common bile duct obstruction, including obstructive jaundice, common bile duct stones, recurrent biliary colic, cholangitis, and pancreatitis.

(2) The common bile duct is confirmed to have lesions during surgery, such as stones, ascariasis, or masses found in the common bile duct as confirmed or palpable by intraoperative cholangiography, dilatation of the common bile duct with a diameter exceeding 1 cm, significant thickening of the bile duct wall, and the presence of pancreatitis or a tumor in the head of the pancreas. Bile duct puncture extracts purulent, bloody bile or muddy bile pigment particles.

(3) If the gallstones are small, they may enter the common bile duct through the cystic duct. To avoid blind bile duct exploration and unnecessary complications, choledochography or choledochoscopy can be performed during surgery. After exploration of the common bile duct, T-tube drainage is usually required, which may cause certain complications.