"Doctor, I just have a stomachache, why do I need surgery?"
Mr. Dong is 35 years old this year, and he is usually in good health. However, recently, he has been experiencing abdominal pain. At first, he thought he had a stomach problem, so he went to the drugstore to buy medicine to treat it. Unconsciously, three days have passed, and Mr. Dong’s symptoms have not eased. In desperation, he went to the hospital for treatment.
After arriving at the hospital, the doctor carefully inquired about Dr. Dong’s situation and then prescribed a gallbladder ultrasound. After the examination results came out, it was suggested that gallbladder stones combined with cholecystitis . Later, the doctor told Mr. Dong that the diameter of his gallbladder stones was relatively large, and the best way to treat it was surgery. When Mr. Dong heard the doctor's explanation, he became confused, so he asked the doctor the question at the beginning of the article.
After listening to Mr. Dong’s question, the doctor explained: Your gallbladder stones are relatively large. If the stones stimulate your gallbladder for a long time, it will increase the risk of gallbladder cancer. Therefore, it is recommended that cholecystectomy be the first choice; of course, you can also choose Conservative treatment can save the gallbladder, but there is a risk of gallbladder cancer. After listening to the doctor’s explanation, Mr. Dong said he followed the doctor’s advice and chose cholecystectomy.
In real life, many people face the problem of gallbladder stones. In order to let everyone have more knowledge and understanding of gallbladder stones, today the doctor Good Words will talk to you about the relevant knowledge.
1.What is the function of the gallbladder? When does gallbladder need to be removed?
Objectively speaking, the gallbladder has two main functions, namely storing bile and concentrating bile. The specific summary is as follows:
❶ Storing bile:
Many people think that the gallbladder is an organ that secretes bile. In fact, this The point of view is wrong. The organ that actually secretes bile is the liver, and the gallbladder is just a "warehouse" for storing bile.
❷ Concentrated bile:
According to existing data, the amount of bile secreted by the liver every day is about 800 to 1200ml. About 500ml of bile enters the gallbladder every day, and the volume of the gallbladder is only about 40ml. So how can the gallbladder hold so much bile?
In fact, the gallbladder has a concentrating function. It can concentrate 500ml of bile into about 40ml, which can greatly relieve the pressure on the bile ducts.
❸ helps the human body digest food:
The gallbladder itself cannot help the human body digest food, but it can shrink the gallbladder with the help of cholecystokinin , so that the bile in the gallbladder will be discharged to help us digest food.
When we eat, food can stimulate the intestines to secrete a substance called cholecystokinin . This substance can promote the contraction of the gallbladder and then discharge bile from the gallbladder to aid digestion. If you don't eat, your body won't secrete cholecystokinin, so the bile in your gallbladder won't be discharged.
Through the above introduction, I think everyone should be able to see that the gallbladder is quite important to the human body. Therefore, the gallbladder should not be removed unless absolutely necessary. The situations that require cholecystectomy are mainly summarized as follows:
❶Calcification of the gallbladder wall or porcelain gallbladder;
❷Thickening of the gallbladder wall exceeding 3mm;
❸Gallbladder stones combined with gallbladder polyps;
❹There are a large number of gallbladder stones and the diameter of the stones is greater than 2cm;
❺The symptoms of gallbladder stones are obvious and affect normal life;
❻Gallbladder stones are complicated by complications (such as pancreatitis).
In fact, the reason why surgical treatment is needed in the first four points is mainly because in these four cases, the risk of gallbladder cancer is relatively high.
2. What are the sequelae after cholecystectomy?
Generally speaking, there are four main sequelae after cholecystectomy, among which the first three are more common. The specific summary is as follows:
❶ Indigestion:
Many friends will suffer from indigestion after the gallbladder is removed. , symptoms such as abdominal pain, bloating, and diarrhea occur.
The main reason why this happens is that the human body loses its ability to store concentrated bile. Even after the gallbladder is removed, bile is still secreted continuously. However, when a person eats a lot of food, a large amount of bile is needed in a short period of time to digest the food.
However, at this time, because the gallbladder has been removed, the human body cannot provide a sufficient amount of bile at once. After losing the gallbladder, the concentration of bile used for digestion is not high. This will prevent part of the food from being fully digested, causing indigestion.
For people who have had their gallbladder removed, they will experience abdominal discomfort after eating greasy food. Some people may feel disgusted even after seeing greasy food.
However, this situation will improve over time. This is mainly because after the gallbladder is removed, the bile duct wall will thicken compensatoryly to store more bile. Therefore, after cholecystectomy, you only need to pay attention to your diet, and most indigestion conditions can be improved.
❷ increases the risk of common bile duct stones :
To a certain extent, the gallbladder is equivalent to a tributary of the bile duct. The presence of the gallbladder can help relieve pressure on the bile ducts.
When a person has the gallbladder removed, the bile duct loses the "tributary" of the gallbladder. This will cause the pressure in the bile duct to increase, which will cause dilation of the common bile duct .
If the common bile duct is dilated, the inner diameter of the common bile duct will become larger, which will cause the bile to stay in the common bile duct longer. Prolonged bile retention increases the risk of common bile duct stones.
In addition, after cholecystectomy, the concentration of bile salt and bile acid will be reduced. In this way, the body's ability to dissolve cholesterol will also be reduced. The reduced ability to dissolve cholesterol will itself increase the risk of bile duct stones .
❸ Increases the risk of reflux gastritis:
When bile is discharged into the intestine, it may accumulate in the duodenum.
When bile accumulates to a certain extent, it may reflux into the stomach, causing reflux gastritis. Such patients may experience symptoms such as abdominal pain, bloating, nausea, and vomiting.
❹ increases the risk of bowel cancer :
Some surveys have found that those who have had their gallbladders removed have a significantly higher risk of bowel cancer than normal people.
Later research found that this was mainly because after losing the gallbladder, there was no place to store the bile secreted by the liver. This bile will be continuously discharged into the intestines.
Bile in the intestine will be decomposed into secondary bile acid under the action of intestinal bacteria, and secondary bile acid has certain carcinogenicity. If things go on like this, the risk of bowel cancer will increase.
One thing to note is that there is currently a lack of strong evidence as to whether gallbladder removal will increase the risk of bowel cancer. Let’s just take a look at it here.
