Gallbladder is an important digestive organ of human body. It has the functions of storing bile, concentrating bile, excreting bile and helping digestion, especially playing an important role in lipid metabolism. At the same time, it may have the function of secreting and regulating bile duct pressure.
Gallbladder stones generally coexist with cholecystitis. If the pain symptoms are obvious, or the gallbladder has lost its function, surgery may be needed. Many people have their gallbladder removed because of gallbladder disease, so what are the sequelae after cholecystectomy? Might as well follow the doctor to find out.
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case sharing
Brother Zhang is 53 years old this year. He has been a sales director in this company for decades. Because the May Day holiday is long, there is a lot of work before the holiday. Because the work needed to be completed on time and handed over to the leader, he was too busy to go out for dinner, so he asked his assistant to order a takeaway for himself and then went back to work.
For a long time, Zhang Ge had a dull pain in his stomach after eating. However, because of my busy work recently, I didn't take it to heart. He thought it was an old stomach trouble, and he usually took stomach medicine to relieve it.
Last week, the company organized a physical examination for all employees. During the physical examination, Zhang Dage told the doctor that his abdomen was often unwell recently. The doctor suggested that Lao Wang have a CT examination for his symptoms. After getting the checklist, I found that Brother Zhang had gallstones. I was surprised to hear the doctor's diagnosis.
However, the doctor said: Zhang Dage's gallstones are only two centimeters at present. As long as he is examined and treated regularly in the later period, there will be no major problems.
Most patients don't know much about gallstones. Many times, they want to cure the disease by removing the gallbladder. But in fact, in the eyes of doctors, the brain is the digestive organ needed by the human body and plays a very important role in the human body, so the gallbladder cannot be removed at will.
When the patient chooses to remove the gallbladder, the body will lose the function of bile storage and concentration, and the function of digesting food will also be reduced.
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Under what circumstances do you need to remove the gallbladder?
Surgery first has two purposes. The first is to alleviate the pain and danger caused by cholecystitis.
Second, both gallstones and gallbladder polyps will cause chronic cholecystitis over time. Chronic cholecystitis can lead to inflammation of gallbladder mucosa and become precancerous lesion. The second purpose of the operation is to prevent gallbladder cancer.
Under what circumstances do you need cholecystectomy?
1, patients with recurrent acute cholecystitis;
2. Patients with acute biliary pancreatitis caused by gallstones;
3. Patients with large stones such as stones exceeding 2cm;
4, the gallbladder is filled with stones, and the gallbladder has no storage function;
5. The cystic duct is blocked or adhered, and the bile pigment in the gallbladder has been absorbed by the gallbladder mucosa and secreted a lot of mucus to form white bile;
6. Gallbladder stones grow on the cystic duct, which affects gallbladder emptying;
7. Gallbladder stones oppress the common hepatic duct or the common bile duct, causing jaundice or bile duct leakage;
8. Patients with acute cholecystitis undergoing cholecystostomy;
9. Patients with gallstones and gallbladder polyps;
10 gallbladder polyp/patients above kloc-0/cm (the malignant rate of gallbladder polyp of 1cm is 10%, that of gallbladder polyp of 2cm is 20-30%, and that of gallbladder polyp of 3cm is almost all malignant);
1 1, patients with gallbladder polyps less than 1cm but growing too fast;
12, patients with broad-based gallbladder polyps;
13, local thickening of gallbladder wall is suspected to be malignant;
14. Although there are many stones, there may be no typical symptoms, but the stones exist for a long time (more than 10 to 15 years). All these patients need cholecystectomy.
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After cholecystectomy, the following three outcomes can easily affect people's normal life.
1, dyspepsia, abdominal distension and diarrhea
Because the gallbladder has the function of regulating bile, there are certain standards for how much it exists, when it is discharged and how much it is discharged. Once the gallbladder is surgically removed, this human valve no longer exists.
Bile still exists, because it can't be adjusted in time, so it can't be discharged quickly after every meal, and the normal digestion and absorption of food will be affected to some extent, resulting in indigestion symptoms.
Moreover, patients will feel disgusted with greasy food because they can't digest it as soon as possible, so patients will have symptoms such as abdominal pain, bloating and nausea. With the passage of time, the bile duct wall will be compensated and thickened due to cholecystectomy. If the operation is properly adjusted, the symptoms of indigestion can be well eliminated.
2, it will increase cholesterol.
Because gallbladder has the function of concentrating bile, and concentrated bile has a good effect on the decomposition of cholesterol in the body, which can help dissolve cholesterol.
Once the gallbladder is removed, bile can not be concentrated, cholesterol can not be dissolved well, and excessive cholesterol will be accumulated, forming a series of cholesterol diseases.
Most patients will not have much influence after cholecystectomy, but some patients will have bile secreted by the liver continuously discharged from the intestine after cholecystectomy because there is no way to store it, thus stimulating the intestine and causing a series of symptoms. Most of these symptoms will gradually disappear after 6 months.
3. Increase the risk of colon cancer.
We need to pay attention to the healthy maintenance of gallbladder in our daily life. If there are health problems in the gallbladder, it is necessary to remove the gallbladder knot, which is likely to increase the risk of some cancer diseases.
Because after people lose their gallbladder, the liver can't secrete enough bile at this time, and the bile secretion is insufficient, and the digestive ability of the body will be limited.
Moreover, some bile will directly flow into human intestines, and under the action of intestinal bacteria decomposition, bile acids that affect health will be produced. This substance will cause damage to human intestinal mucosa, which may increase the risk of intestinal diseases and even lead to an increase in the prevalence of colon cancer. Therefore, we should pay attention to the healthy maintenance of the gallbladder.
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Doctor's suggestion: Some patients can "protect the gallbladder and remove the stone"
"Protecting gallbladder and removing stones" means removing stones without cholecystectomy. Generally speaking, the following situations can be considered:
1, no discomfort or mild symptoms;
2. The contractile function of gallbladder is still in good condition;
3. The length and diameter of the gallbladder are between 6-8cm, neither too large nor too small, and there can be no separation in the capsule;
4. No history of acute inflammation such as open surgery and perforation of upper abdomen;
5. Under ultrasonic examination, the sound transmission in gallbladder bile is good, the gallbladder mucosa is smooth, and the gallbladder wall is within 3±4mm; There are single stones and many stones, with regular shapes and strong fluidity.
Generally speaking, which method is suitable depends on the patient's situation. I suggest you go to a regular hospital, and the doctor will make a plan suitable for you.
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Extended reading-Is ESWL harmful?
Extracorporeal shock wave lithotripsy (ESWL) is a safe and effective method to treat stones. Its purpose is to crush stones by using stress effect and cavitation effect of shock wave.
At present, the commonly used shock wave lithotripsy in the world mainly includes hydraulic, electromagnetic and piezoelectric methods. But it may have some side effects on the body, that is, some harm.
For example, extracorporeal shock wave lithotripsy is prone to visceral minimally invasive, hematuria, renal colic, urinary tract obstruction, and may also cause edema of tissues around stones and gross hematuria.
The hazards of multiple extracorporeal shock wave lithotripsy mainly include the following aspects. Generally, the same site should not be crushed for more than three times, and continuous shock wave treatment is not recommended, and the time interval should not be too close. Patients should try to reduce the number of lithotripsy.