Speaker: Wang Dong, Chief Physician, Department of Hepatobiliary Surgery, Peking University People's Hospital December 26, 2017
Biliary system attached to the liver and intestine, but also hung a fragile gallbladder, in the human body belongs to 'high incidence of road accident', it is worth our vigilance and attention.
Four symptoms alert biliary disease
Normal adult liver can secrete about 600 to 1000 ml daily bile can excretion of a variety of liver metabolites, to help digest food in the fat, promote the absorption of cholesterol and various fat-soluble vitamins, but also in the stomach and stimulate Peristalsis and so on.
The biliary system is the 'traffic arteries' of the bile from the liver to the intestine, including the gallbladder, the common hepatic duct, the common bile duct, etc. The bile secreted by hepatocytes flows into the gallbladder for storage and concentration.The gallbladder is a pear-shaped pouch Organs. Fasting, the gallbladder storage bile; meal, the gallbladder contraction, bile thus discharged into the duodenum, to play the digestive function.
Biliary tract is the only way to transport bile, any part of the problem, can lead to poor drainage of bile caused disease. Common biliary system diseases are gallstones, cholecystitis, cholangitis and biliary system tumors, etc. Some of the following symptoms can help We judge whether we have biliary system diseases.
1. Bile colic This is the most common symptom of biliary disease Typical biliary colic manifestations of severe, paroxysmal right upper quadrant colic and may involve the back of the right shoulder pain often occurs after eating greasy food, Drinking or physical strenuous exercise, after a bumpy 2. digestive system symptoms. Gallbladder in the chronic phase of inflammation, the patient will show a series of gastrointestinal symptoms, such as bloating, belching, tired of oil, nausea, vomiting, many patients are perennial Misdiagnosed as stomach cramps or gastritis, delayed treatment. 3. Chills. Acute suppurative cholecystitis seizures often combined with chills, fever, then often dangerous, need emergency medical treatment. 4. Skin, the size of the second will change if the stones block the biliary Cause poor bile discharge, the patient will appear yellow sclera or skin sclera, accompanied by itchy skin; urine darker, stool gray.
In the event of the above symptoms, patients should seek medical attention in time to do the necessary tests to confirm.
Gallstone treatment of the four errors
Gallbladder has concentrated, the role of bile storage, if its own function, bile composition problems, or in some chronic diseases, drugs, the formation of abnormal bile abnormal precipitation or crystallization, and slowly lead to stones.
The specific causes of gallstones are not fully understood, middle-aged and elderly women are high incidence of the population, the incidence of young people are also gradually increased.The predisposing factors include high-fat diet, excessive dieting, drinking less; obesity and physical activity decreased; female hormone Balance; diabetes, nephritis, hypothyroidism, hemolytic disease, chronic liver disease, chronic medication; mental stress and so on.
Gallstones are common, but they are generally misunderstood by the general public. For example:
1. That gallstones are common disease, nothing big difference with the same gallstone, some people no major problem for life, it was because of gallstone incarceration gallbladder perforation, secondary bile duct stones, purulent cholangitis, severe pancreatitis , Biliary tract malignancies and other life-threatening, so patients can not ignore regardless of stones, to actively treat and care to prevent aggravating.
2. That gallstones can be gravel and row of stone. Full name of the gravel for extracorporeal shock wave lithotripsy, has been used for gallstone treatment, but because of side effects and was eliminated. Currently the main treatment for gravel in vivo surgery is not easy to remove the bile duct stones Can not be used to treat gallstones. Row of stones treatment is chaos on the chaos .When the stones discharged from the gallbladder within the bile duct, ailments will become serious illness .And some non-formal medical institutions to 'row of stone, gravel' As a signboard, to exaggerate the efficacy of some non-formal treatment methods, the general population without medical knowledge, but also hold once or twice can cure the illusion of illness, it is easy to be fooled.
3 that suffering from gallstones will completely bid farewell to oil c .. Many patients with gallstones due to fear of pain episodes, only vegetarian, a long time there will be malnutrition leading to the onset of gallstones symptoms of food is mainly high in fat, high cholesterol, Irritating foods, in the outbreak of the disease really want to avoid .But in symptomatic remission or asymptomatic populations, usually can still choose high-quality diet or low-fat foods, such as lean meat, low-fat milk, soy products, eggs Qing, etc., in order to maintain normal physiological needs.
4 that gallbladder surgery is the best choice .Cargo gallbladder surgery can be simply understood as 'only take the stone, not cut gall.' Currently there is much controversy over the preservation of gallbladder surgery, the vast majority of doctors disagree. Of the clinical research can not confirm the efficacy and safety of clinical gallbladder surgery is better than the classic cholecystectomy.Moreover, the sick gallbladder not only easy to recurrent stones, patients had to accept the second surgery, what is more, because the gallbladder long-term In chronic inflammation, it is easy to develop into cancer.
Patients with mild symptoms should be regularly reviewed
The treatment of gallstones should be sub-conditions: Asymptomatic patients, you can long-term observation of the disease, do not need surgery; frequent biliary colic attacks, symptoms of serious impact on life, surgery should be considered; acute suppurative cholecystitis, bile duct stones, Inflammation, biliary pancreatitis and other complications of patients should be as soon as possible surgery.
Most patients with mild or moderate gallbladder dysfunction, in addition to regular review and adjustment of dietary habits, but also with the drug treatment. Oral ursodeoxycholic acid can not only improve the symptoms, but also have a role in the dissolution of cholesterol, but the time is generally Long: less than 0.5 cm of stone completely dissolved for 6 months, 0.5 ~ 1.0 cm stones need 12 months, more than 1.5 cm stones need 2 years, and the overall success rate of low soluble stone.If the symptoms worsen during drug treatment or Gallbladder function loss, should be timely surgery.
Gallbladder polyp to distinguish between true and false
Another common disease of the biliary system is gallbladder polyps, and many people are scared to panic when they see a report of 'gallbladder polypoid lesions' on the medical report, and they also say that polyps tend to become cancerous and that polyps should be operated as soon as possible. Lost.
'Gallbladder polypoid lesions' refers to the gallbladder wall polypoid growth of all non-stone lesions, also known as gallbladder hyperplasia lesions which are divided into three categories: First, cholesterol polyp, also known as pseudo polyp, the vast majority Of the gallbladder polyps belong to this type; the second is inflammatory polyps, gallbladder or gallbladder patients with recurrent seizures in the formation of local tissue hyperplasia; third is adenomatous polyps, also known as true polyps, less than 5% of the gallbladder Polyps belong to this type, which increases to a certain extent may have cancer.
Clinically, the so-called 'gallbladder polypoid lesions', most of which are not true polyps, especially when accidentally discovered on the physical examination even less need to worry too much about, because it is only deposited on the gallbladder wall cholesterol crystals need to be alert is the gallbladder Polyps and long-standing chronic gall bladder inflammation.
If the gallbladder polyps no obvious symptoms, polyps, the size of about 5 mm and the patient is young, mostly cholesterol polyps, without surgery, but need to regularly review and improve the diet, rest habits if the polyps more than 1 cm or Short-term rapid growth should be promptly checked to the hospital to clarify the nature of polyps, if the gallbladder adenomatous polyps, it is recommended to take timely surgical treatment.
