Does gallstone need to be removed?

Gallstones are a common gallbladder disease in daily life, also known as cholelithiasis. Its occurrence is often related to age, obesity, diet and other factors. The incidence rate in women is usually much higher than in men, so female friends should do a better job of prevention. So when people suffer from gallstones, do they have to have their gallbladder removed to treat it?

1. Do I need to remove my gallbladder if I have gallstones?

Gallstones do not necessarily require gallbladder removal, but cholelithiasis with concurrent cholecystitis (clinical symptoms or imaging findings of inflammation) should undergo gallbladder removal. Cholecystitis is divided into acute and chronic types. In principle, the gallbladder should be removed surgically. However, with the popularization of minimally invasive surgery, laparoscopic cholecystectomy has replaced traditional open cholecystectomy and become the preferred procedure for the treatment of cholecystitis. During an acute cholecystitis attack, there is swelling and adhesion around the gallbladder, and the anatomical layers are not clear, which increases the difficulty and risk of laparoscopic surgery. Therefore, most people do not advocate cholecystectomy in the acute phase. Instead, they adopt conservative treatment methods to help patients get through the acute inflammatory period, and then perform laparoscopic cholecystectomy after the inflammation completely subsides (about 1 month after the acute attack). For special cases where conservative treatment fails to provide relief, open cholecystectomy is the only option.

Of course, experienced surgeons can selectively perform laparoscopic cholecystectomy in the acute phase, but the corresponding surgical risks will be significantly increased. The clinical manifestations of patients with chronic cholecystitis or gallstones after an acute attack are not serious, so many people are willing to take the chance and be unwilling to have their gallbladder removed. Little do they know that doing so is equivalent to burying a "time bomb" in their body. Recurrent cholecystitis itself increases the incidence of gallbladder cancer, and the cancer rate increases sharply with age. On the other hand, the mortality rate and difficulty of treatment of acute cholecystitis in the elderly are greatly increased, and a benign disease that is easy to treat may be fatal in the elderly. Therefore, it is wise to choose the appropriate time to undergo cholecystectomy for patients with symptomatic gallstones (especially those with recurrent acute cholecystitis), gallbladder wall thickening on imaging, and gallbladder atrophy.

2. What should you pay attention to after gallbladder removal?

The function of the gallbladder is to store, concentrate and excrete bile to help the digestion and absorption of fatty foods. The above functions will definitely be affected after gallbladder removal, mainly manifested in diarrhea after eating a lot of fatty foods. However, as time goes by, the body will dilate the bile duct to partially compensate for the gallbladder function, and generally the body will be able to digest and absorb food normally after 2 to 3 months. Therefore, after cholecystectomy, you should pay attention to a low-fat diet, eat less greasy, fatty meat, egg yolks and other foods, avoid overeating, and develop good dining habits.