Why do asymptomatic gallstones need to be removed?

　　Gallbladder stones are a common and frequently-occurring disease. The incidence of women in the general population is significantly higher than that of men. With age, the incidence of men and women is on the rise.

　　With the popularity of physical examinations, it is very common to find gallbladder stones on ultrasound during physical examinations.

For asymptomatic gallbladder stones found in these physical examinations, not all need to be treated, but they need to be treated differently according to the number, size, thickness of the gallbladder wall, polyps or adenomyosis, and other accompanying diseases.

　　What kind of gallbladder stones need surgery?

Patients who have had cholecystitis or biliary colic need surgery to remove their gallbladder.

In addition, for asymptomatic gallbladder stones, surgical removal of the gallbladder is recommended when the following conditions exist:

　　The gallbladder fills the gallbladder, causing the fluid dark area of ​​the gallbladder to disappear and lose its function; gallbladder stones with thickening of the gallbladder wall more than 5mm; gallbladder stones with common bile duct stones; gallbladder stones with polyps and polyps greater than 5mm; gallbladder stones compress the common hepatic duct or common bile duct; yes Patients with unexplained history of acute pancreatitis and gallbladder stones; those with stones exceeding 3 cm; those with stones with a history of more than 10 years or women with stones over 65 years of age; and those with diabetes or coronary heart disease who have gallbladder stones.

　　Can gallbladder stones that do not require surgery be treated with medication?

For patients who do not have the above indications for surgery, it is recommended to review regularly.

If there is a willingness to treat with medicine, especially those who have stones less than 1cm and have no calcification, you can try to take ursodeoxycholic acid, compound azimide and Chinese patent medicines for choleretics. Some patients may get obvious stone-dissolving effects.

　　What should patients with gallbladder stones usually pay attention to?

After the gallbladder stones are found, you can work and live normally. You should pay attention to eating three meals a day on time, avoid frequent skipping breakfast or dinner; eat less high cholesterol and high fat diets appropriately.

But by no means can't eat. A balanced diet is necessary to meet the needs of the body. Long-term non-intake of cholesterol and lipids can lead to malnutrition.

And diet is not the most important factor in the occurrence and development of stones and inducing biliary colic. Therefore, it is impossible to blindly listen to the false statement that stone patients cannot eat foods such as eggs and meat.

　　What happens if gallbladder stones are not treated?

Through the previous description, I think everyone should know that most of the gallbladder stones found in the physical examination do not need to be treated, so what might happen to these patients?

　　① I have no symptoms throughout my life and do not need treatment.

　　② Intermittent discomfort such as dull pain and abdominal distension in the upper right abdomen need to be differentiated from gastrointestinal diseases. If it is confirmed that it is caused by gallbladder stones, surgical treatment should be considered.

　　③ During the follow-up observation, it was found that the gallbladder was filled with stones, the gallbladder wall thickened more than 5mm, the occurrence of biliary colic or cholecystitis, the stones fell into the bile duct and even caused cholangitis or pancreatitis. There are indications for the operation of cholecystectomy and should be considered. operation treatment.

　　Given that the gallbladder has the functions of concentrating, storing bile, and expelling bile into the bile duct and then into the intestinal tract after eating, it helps the digestion and absorption of food.

Therefore, when asymptomatic gallbladder stones are found on physical examination and the gallbladder is functional, it is recommended not to rush to deal with it, and to review regularly. During the observation process, if the disease progresses to the indications for cholecystectomy, active consideration should be given to receiving laparoscopic cholecystectomy. .

　　By Gao Pengji (Beijing Jishuitan Hospital)