Patient:Doctor, my gallstones have never hurt, do you want to **?
Doctor:This needs to be analyzed on a case-by-case basis!
Gallstones are a relatively common disease, with an incidence of about 10%, and the main incidence group is middle-aged and elderly people. However, many people may wonder if if their gallstones are still going to need to be done if they don't cause any symptoms or pain?
First, why do gallstones cause pain?
To be clear, not all gallstones trigger significant biliary colic. Many people accidentally find out that they have stones during a physical examination and do not feel any discomfort in their daily lives, or only have minor digestive problems or an aversion to greasy foods.
This is because whether gallstones cause symptoms is closely related to their shape, size, number and blockage of the cystic duct. The shape of gallstones varies, some are large, some are small, some are single, some are multiple, and some will even gradually increase.
In general, medium-sized stones (about 07-0.8cm) can easily get stuck in the cystic duct, causing acute cholecystitis. Larger gallstones, on the other hand, do not enter the cystic duct, so they do not cause blockages, are usually less symptomatic, and are often detected during a physical examination. Smaller gallstones or sediment-like gallstones tend to fall into the bile ducts, leading to more serious complications such as cholangitis and pancreatitis.
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For asymptomatic gallstones, is ** needed?
The general view in the medical community is that surgery is recommended for gallstones that are symptomatic or have complications**. For asymptomatic gallstones, the decision needs to be made on a case-by-case basis. In general, asymptomatic gallstones can be observed and followed. However, your doctor may recommend surgery if:
Stone diameter 3cm;
It happens that other laparotomy surgery is required;
with gallbladder polyps" 1cm (the possibility of progression to gallbladder cancer needs to be ruled out);
thickening of the gallbladder wall (to rule out progression to gallbladder cancer);
calcification of the gallbladder wall or porcelain gallbladder (the gallbladder no longer has the function of storing and releasing bile);
gallstones in children;
Diabetes mellitus (complicated to deal with in the event of a complication);
Have cardiopulmonary dysfunction (once complications occur, it is difficult to deal with them, it is recommended to deal with them when the condition is stable);
remote or under-trafficked areas, field workers (to prevent acute onset of biliary colic symptoms);
Gallstones have been found for more than 10 years.
These recommendations are based on the accumulation of clinical experience. If these conditions are present without early intervention, it can be more difficult to treat gallstones once they have caused symptoms. If the indication for chole-conserving surgery is met, the doctor will usually recommend chole-sparing surgery. If the above conditions do not exist, regular re-examinations should also be carried out, generally every six months to one year.
If gallstones are associated with gallbladder polyps and the polyps have certain "high-risk" features (eg, wide base, no pedicle, solitary, >1 cm, short-term or gradual enlargement, appearance after age 50, and gallstones or cholecystitis), there is an increased risk of gallbladder polyps malignant becoming gallbladder cancer. In this case, your doctor may recommend surgery as early as possible**.
Gallstones** The first choice is to take gallstones
In terms of cholelithotomy, cholelithotomy surgery is a technically mature and scientific method. This procedure removes stones while preserving a functioning gallbladder.
The gallbladder is an important digestive and immune organ in the human body and works every day for the proper functioning of the body. Therefore, removal of the gallbladder should be avoided as much as possible when possible. Removal of the gallbladder may cause a range of sequelae, such as diarrhoea, indigestion, reflux gastritis, and bile duct stones.
In addition, there are studies that show that the digestion and absorption of fat after gallbladder removal may be impaired, and long-term irritation of undigested fat to the mucosa may even lead to the occurrence of cancer. Therefore, the importance of preserving the gallbladder should be fully considered when choosing the best method.