Is surgery necessary for cholecystitis with gallstones?

Written by Li Ying
Gastroenterology
Updated on September 09, 2024
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Gallstone cholecystitis primarily has several treatment methods, targeted towards symptomatic and asymptomatic treatments. These include medical treatment and surgical treatment. Not all cases of cholecystitis require surgery. For some asymptomatic gallbladder stones, treatments can be managed through dietary therapy, symptomatic treatment, and preventive treatment for those at high risk, including dietary adjustments or treatments that promote bile flow. Preventive gallbladder removal may be considered for those at high risk of gallbladder cancer. For symptomatic cases, the main goal is to control symptoms and primarily reduce inflammation. For chronic cholecystitis and gallstones, if there is no significant improvement with medical treatment, then surgical treatment may be considered.

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Written by Liu Wu Cai
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Diet after relief of acute cholecystitis

After the relief of acute cholecystitis, he still needs to pay attention to his diet: First, he should avoid spicy and irritating foods, such as chili peppers, barbecue, garlic, etc., avoid hard-to-digest foods, and avoid foods high in fat to reduce the burden on the gallbladder, such as fatty animal organs. Second, although the symptoms of acute cholecystitis have recovered, it is still necessary to maintain a light diet, eat more fresh vegetables and fruits, which are rich in vitamins and trace elements, to keep the bowels open and prevent other complications. Third, after the symptoms of acute cholecystitis have recovered, it is also appropriate to supplement some foods high in protein, which can enhance the patient's resistance and facilitate the recovery of the condition.

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Written by Wu Hai Wu
Gastroenterology
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Do you need to fast and hold your urine for a gallbladder inflammation B-ultrasound?

When undergoing an ultrasound for cholecystitis, fasting is required, but there is no need to hold urine. However, if the examination involves the adnexa of the uterus, bladder, prostate, and other areas, it requires holding urine to perform the test, allowing the prostate, adnexa, etc., to sufficiently distend. This helps in more clearly observing pathological changes. Patients with cholecystitis need to fast before an ultrasound. If food is consumed before the scan, the gallbladder contracts more quickly, making it difficult to accurately identify lesions. Patients with cholecystitis may experience chills, fever, right upper abdominal pain, jaundice, yellowing skin, dark urine, etc. In severe cases, patients may develop septic shock and require active treatment measures.

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Written by Wu Hai Wu
Gastroenterology
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What are the symptoms when there are problems with the gallbladder?

Gallbladder issues, specifically symptoms of cholecystitis, mainly include chills, fever, persistent dull pain in the upper right quadrant of the abdomen, episodic colic pain that radiates to the right shoulder and back, and may also be accompanied by jaundice, dark urine, nausea, vomiting, and constipation. Patients with cholecystitis often experience sudden pain at night, typically due to overeating or consuming greasy foods. Once cholecystitis occurs, it is advised to seek medical attention at a regular hospital as soon as possible, complete the relevant diagnostic tests, such as imaging studies of the abdomen, consider surgical treatment, and engage in active anti-infection treatment.

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Written by Zhang Jun Jun
Endocrinology
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How to Diagnose Cholecystitis

The definitive diagnosis of cholecystitis mainly involves the following aspects: First, clinical manifestations are crucial. The most common symptoms include nausea, vomiting, abdominal distension, and loss of appetite. Regarding physical examination, there is typically pain in the lower right abdomen and mid-lower right abdomen, with tenderness upon palpation. Furthermore, the onset of cholecystitis is characterized by postprandial pain, particularly after consuming fatty foods or feeling overly full. If these symptoms are present, further examination such as gallbladder ultrasound can be conducted to check for thickening of the gallbladder wall. Additionally, blood tests for inflammatory markers like complete blood count and CRP (C-reactive protein) can be performed. The diagnosis of cholecystitis can be confirmed by combining these symptoms and test results.

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Written by Wu Hai Wu
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Why is there nothing wrong with the B-ultrasound for cholecystitis?

As for why cholecystitis appears normal in an ultrasound, there are two possible reasons. One possibility is that the medical practitioner conducting the ultrasound may lack sufficient clinical experience to identify an inflamed gallbladder. Another reason could be limitations in the ultrasound equipment itself, which might fail to detect an inflamed gallbladder. There are very few cases where cholecystitis appears normal under ultrasound. The main ultrasound features of cholecystitis include gallbladder wall edema, roughness, and an enlarged gallbladder among other radiological changes. Once cholecystitis is diagnosed, it is crucial to undertake active treatment measures, such as aggressive anti-infection treatment, spasmodic pain relief, etc.