Cholelithiasis, a disease in which stones occur in the biliary system such as the gallbladder and bile ducts, is a common disease of the digestive system, and at present, the incidence is rising, and, with a trend of rejuvenation, about 1 in every 10 adults suffer from cholelithiasis. However, about 75% of patients with cholelithiasis may have no symptoms for life, but only occasionally detect cholelithiasis during a physical examination. The remaining 25% develop symptoms, and some patients develop serious complications such as acute cholecystitis or acute biliary pancreatitis. As a result, patients with cholelithiasis will fall into entanglement, wondering in their hearts, should they cut off the gallbladder early and cut off cholelithiasis from then on? Is there a conservative treatment plan without cutting a scalpel? Let's combine the relevant scientific research conclusions now to analyze and support for everyone.
Cholelithiasis, the cause is not very clear, the current academic community believes that it is genetic, nutritional metabolic factors, gastrointestinal diseases, infections and other factors caused, in layman's terms, cholelithiasis and diet-related, but not eaten diseases. A decrease in bile acids and lecithin in the bile, and excessive cholesterol levels increase the risk of cholelithiasis. Gallbladder and gallstones and bile ducts can be divided into 3 types according to chemical composition, the first is a simple cholesterol stone with a cholesterol content of more than 98%, which is soap white or yellow. The second type is a brownish-green mixed stone with a pattern and a cholesterol content of about 60%. The third type is bilirubin stones, which are reddish-brown or black-brown stones with a cholesterol content of less than 45%. Usually, most of the cholesterol stones that occur in the gallbladder are cholesterol stones, and the bilirubin stones or mixed stones that occur in the bile ducts are the main ones.
Cholelithiasis, according to the symptoms and manifestations, can be divided into 3 stages, asymptomatic stage, symptomatic stage, complication stage. Most patients with cholelithiasis can have no symptoms for a long time. However, cholelithiasis can cause inflammation, edema, infection, and even perforation of the gallbladder, and stones irritating the gallbladder may cause the gallbladder to atrophy, affect normal function, and increase the risk of cancer. If stones enter the common bile duct, forming a blockage and the bile cannot be drained effectively, it can lead to acute cholecystitis. In this way, it seems that the earlier the gallbladder is removed, the better, but clinical studies have shown that after cholecystectomy, bloating, diarrhea, indigestion, reflux gastritis, epigastric pain and other problems may occur.
For cholelithiasis in the asymptomatic stage, the previous view was that surgery should be performed as early as possible if the stone is more than 3 cm in diameter, the patient is over 50 years of age, has a cardiovascular or metabolic disease, and requires long-term outdoor work. Because, larger stones, the risk of developing gallbladder cancer, is more than 9 times that of patients with stones less than 1 cm in diameter. If the patient develops biliary colic, antispasmodic medications may be given first. If fever, jaundice, hypotension, clay-like stools and other manifestations appear, it is a sign of complications, and it is necessary to seek medical treatment in time, confirm the condition, and undergo surgical treatment.
There are 4 types of methods for coping with cholelithiasis, in general. The first is the use of drugs such as ursodeoxycholic acid, which is only effective for simple cholesterol stones, requires long-term medication, and has a recurrence rate of more than 50%. The second type is biliary stone removal surgery, there are currently a variety of minimally invasive surgical methods to choose from, which can preserve the function of the gallbladder, but has a certain recurrence rate. The third is the exoplasmic lithotripsy, which has the risk of liver damage and has been less used. The fourth type is cholecystectomy. This method may seem thorough, but the reality is that after the removal of the gallbladder, the liver continues to secrete bile, and bile duct stones may still occur. Therefore, the pros and cons need to be weighed before a treatment plan can be decided.
At present, the latest advance in the study of cholelithiasis in the international academic community is to change the chemical composition of the gallbladder and the bile that forms stones by activating the androgene receptors in the liver and small intestine, and at the same time, increasing the amount of cholesterol converted into bile acids and increasing the reabsorption of bile acids. Achieve a balance of cholesterol, bile acids, and triglycerides, so as to achieve the effect of preventing and treating cholelithiasis. This method is still in the clinical verification stage, and the prevention will design specific drugs according to the relevant mechanisms and targets in the future.
Ordinary people face cholelithiasis, need to pay attention to, must not mistake cholelithiasis as a stomach disease to treat. Similar manifestations between gallbladder disease and stomach disease, such as abdominal pain or indigestion, should be carefully differentiated. For example, cholelithiasis is caused by pain in the right abdomen, and the pain in stomach disease is concentrated in the middle of the upper abdomen. Cholelithiasis mainly causes persistent vague pain, the pain of stomach disease is related to eating, duodenal ulcer is manifested as hunger pain, gastric ulcer is manifested as postprandial pain, and accompanied by symptoms such as acid reflux and heartburn. Patients with cholelithiasis may take stomach medicine, which may alleviate symptoms, but it will also cover up the condition, laying hidden dangers for acute cholecystitis or gallbladder stone incarceration, therefore, when abdominal pain or indigestion and other symptoms occur, they should pass B ultrasound and gastroscopy examination in time to confirm the cause, and it is not advisable to blindly take medicine.
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