How to treat gallstones?

Written by Liu Wu Cai
Hepatobiliary Surgery
Updated on September 14, 2024
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For the treatment of gallbladder stones, the approach mainly depends on whether there are symptoms or not. For patients with asymptomatic gallstones, which are relatively small in size, they are often found during ultrasonography and do not require special treatment. Regular follow-up ultrasonography is conducted to dynamically observe changes in size. Of course, diet should also avoid spicy and stimulating foods to reduce inflammatory stimulation and avoid foods high in cholesterol and fats, focusing on a light diet, which can alleviate symptom flare-ups and control the condition. For patients with larger gallstones who often experience discomfort and pain in the upper right abdomen, early surgical treatment should be pursued, as surgery is the only way to achieve a cure and can significantly improve the patient's quality of life.

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Can ERCP remove gallbladder stones?

ERCP is currently being explored by some hospitals in China for the removal of gallstones. It involves inserting a tube through the lower part of the gallbladder to remove the gallstones. However, we generally do not recommend using ERCP for gallstone removal because if it becomes necessary to remove the stones, the gallbladder must be cut open, which can easily lead to complications such as suppurative cholecystitis. Currently, the most common method for removing gallstones is laparoscopic cholecystectomy, which, of course, requires mature surgical skills and relatively has fewer complications.

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What should I do if gallstones cause my complexion to turn yellow?

If a patient with gallstones presents with yellowing of the skin, jaundice has occurred. When jaundice appears, it is often a secondary obstructive jaundice. In such cases, the patient will display symptoms such as lighter stool color, darker urine color, and yellowing of the skin and mucous membranes due to jaundice. Therefore, at this point, the only treatment for the patient is surgery, which typically involves laparoscopic cholecystectomy. By removing the gallbladder, a definitive cure can often be achieved. In severe cases, some cholesterol-lowering medications may be used for symptomatic treatment, but generally, symptoms can be alleviated after surgical removal.

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Gallbladder stones and gallbladder polyps differentiation

Gallbladder stones and gallbladder polyps are common diseases in the digestive system and are usually benign. Both gallbladder stones and gallbladder polyps can cause chronic inflammation of the gallbladder, leading to chronic cholecystitis. Some patients may experience acute episodes of pain in the upper right abdomen, leading to an acute cholecystitis attack. Both conditions typically require laboratory tests and diagnostic imaging to confirm diagnosis. Clinically, they are mainly identified through color Doppler ultrasound; gallbladder stones are formed by the deposition of bile salts within the gallbladder, while gallbladder polyps are protrusions growing from the gallbladder wall into the cavity, which can be clearly distinguished by ultrasound.

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Gallbladder stones CT manifestations

Gallstones typically display characteristic features on a CT scan. Depending on the calcium content and the chemical composition of the stones, they can appear as high-density, isodense, or low-density stones. High-density stones present as multiple areas of increased density within the gallbladder, though they can also be solitary. A solitary high-density stone generally appears as a concentric circle with low central density surrounded by high density. Isodense stones have the same density as bile, which sometimes makes them difficult to distinguish. Low-density stones, which are primarily cholesterol stones, can sometimes contain gas, appearing as low-density shadows. CT is not the first choice for diagnosing gallstones; abdominal ultrasound is generally preferred.

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How should gallstones be treated?

The treatment of gallstones primarily depends on whether symptoms are present. For patients with relatively small gallstones, they usually do not experience significant discomfort and do not require special treatment. Regular ultrasonic re-examinations to monitor changes in size are recommended. Daily dietary intake should avoid spicy and stimulating foods, and foods high in cholesterol. For patients with larger gallstones, recurrent right upper abdominal pain and biliary colic may occur, so early surgical intervention is advised. Only through surgical removal of the gallbladder can a complete cure be achieved, with laparoscopic cholecystectomy being the main method of surgery.