Cholecystectomy in immigration physical examination

A few days ago, among the fans, a friend asked:

"Please help me out of an idea! Last month, I was diagnosed as pancreatitis induced by gallstones and bile duct nipple stenosis, and I had ERCP. The doctor said to have a cholecystectomy in 45 days. It is still 45 days, and the gallbladder is a little inflamed, which is very painful. I feel much better after taking the medicine. Do you want to have surgery or not! "

Everyone has put forward suggestions:

-"although there are gallstones, if the function is still normal, it is not recommended to do cholecystectomy too early! Conservative treatment and reasonable diet are recommended, especially for young patients. It is important to maintain a functional gallbladder! "

-"it's time to cut it. I've had my gallbladder removed for almost 20 years, and I don't feel anything. I usually eat everything, and my taste and digestion are good, even better than those who have the courage. "

-"Is there a way to treat gallstones without removing the gallbladder?"

-"I have been removed from office for twelve years, and I feel much less courageous than before. I don't know if courage has anything to do with bravery, haha. "

Gallstones have long been a common disease of modern people, and when it comes to the treatment of gallstones, we have to mention the problem of cholecystectomy. When do you have gallstones? When should they be removed and treated conservatively?

Needless to say, you may not know that the incidence of gallstones in China is very high, and it has soared in recent years, reaching 9%- 10%. In addition, it has two sets of data that are very scary: gallstones are a high risk factor for inducing gallbladder cancer, and more than 70% patients with gallbladder cancer are complicated with gallstones; If gallstones are not treated in time, the probability of developing gallbladder cancer is about 30 times higher than that of ordinary people.

Diet is closely related to gallstones and must not be ignored. For example, if you don't eat breakfast for a long time, bile will accumulate in the gallbladder, and cholesterol solid substances will precipitate to form stones; Long-term high-oil and high-carbon water diet and excessive intake of sugar and oil will also increase the incidence of gallstones; Rapid weight loss and extreme vegetarianism can reduce gallbladder contraction, lead to supersaturation of bile concentration and form gallstones.

Therefore, in order to prevent gallstones, we must get rid of some bad habits and be alert to symptoms such as indigestion, loss of appetite, swelling and pain in the right upper abdomen, and colic. Once diagnosed, it must be solved in time.

Laparoscopic cholecystectomy is the first choice for patients with gallstone diameter of 3cm, recurrent chronic gallstone cholecystitis, gallbladder wall thickening and calcification, gallbladder polyp, diabetes, cardiopulmonary dysfunction and children with gallstone.

Although this is a minor operation, it may still damage and stimulate the bile duct, leading to post-cholecystectomy syndrome (PCS), that is, the postoperative symptoms of patients reappear, including abdominal pain, discomfort, postprandial fullness, diarrhea, indigestion, biliary tract infection, biliary tract obstruction and so on.

However, patients need not worry too much. The gallbladder is not an indispensable organ, and the main function of the diseased gallbladder has been lost. If left unchecked, it may lead to other complications.

Clinically, some patients do have postoperative sequelae, and the following two are common:

Mostly because gallbladder function is not completely lost. After resection, bile flows directly into the intestine, which accelerates the movement of the intestine and causes diarrhea, which generally improves and recovers quickly.

Probably because patients are accompanied by chronic pancreatitis, chronic gastritis and other diseases in addition to gallstones, it is necessary to check the cause in time and then solve it in a targeted manner.

Generally speaking, as long as the patient meets the surgical indications, surgery is recommended. Some patients may have some uncomfortable symptoms after operation, and feel uncomfortable for a short time, but most of them can relieve themselves without worrying too much.

"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.

Pay more attention to diet after cholecystectomy. Yao Yong, director of Ward 5 of Digestive Center of Central Hospital, reminded patients to avoid eating foods with high cholesterol content after operation, such as heart, liver, brain, intestine and egg yolk of animals.

In addition, light and digestible foods are mainly used in 1 month to reduce the irritation to biliary tract; 1 month later, the gastrointestinal function recovered almost, and then gradually returned to normal diet, increasing the variety and quantity of food, but the amount of food eaten per meal should not be too much, so it is better to be full. After 3 months, the body basically recovered, so we should start to develop good eating habits.

The incidence of gallstones is high and there is a certain chance of canceration. Be sure to treat it in time after finding out, do a good job of diet management after operation, and recover as soon as possible!

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