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In Vietnam, the diagnosis rate of gallstones accounts for about 1/3 of all gallstone cases in general. In which, 10% of people with gallstones are generally cholesterol stones and most are detected too late, leading to the risk of cholecystectomy.
1. What are cholesterol stones in the gallbladder?
The normal gallbladder is a small sac that plays the role of condensing and storing bile from the liver secreted through the cystic duct, in the presence of fat in food, a hormonal reaction will cause gallbladder contractions. Bile is poured into the intestines. Cholesterol stones in the gallbladder are common stones formed because of the insolubility of cholesterol with bile due to the mechanism of saturation. The nature of the stones is usually yellow to dark yellow, each stone can be up to centimeters large causing filling of the gallbladder, very rarely there is only one individual cholesterol stone.
There are two main types of cholesterol stones, including:
Pure stones: are very hard cholesterol stones, large in size, usually spherical and have a yellow crystal structure Mixed stones: are stones composed of cholesterol combined with salt Bilirubin and calcium, stones are smaller in size but in a lot of quantity.
2. Mechanism of formation of cholesterol stones
Cholesterol is one of the products of fat metabolism in the liver, secreted by the liver into bile to remove excess cholesterol from the body. To transport this substance, cholesterol must be dissolved in bile. However, because of its fat nature, cholesterol requires additional bile acids and lecithin to dissolve in bile. Therefore, if the amount of cholesterol is too much in proportion to bile acids and lecithin, the insoluble cholesterol will remain in the gallbladder and stick together gradually forming stones. In addition, the mucus secreted to concentrate bile can also combine with cholesterol and calcium to create bile sludge - a precursor to gallstones. In addition to an excessive increase in cholesterol, a decrease in the contractility of the gallbladder also promotes cholesterol formation. At this point, the bile will stay longer than usual, giving enough time for the cholesterol to clump together. Thanks to this formation mechanism, the treatment of gallstones by reducing cholesterol synthesis in the liver and increasing gallbladder motility is being extensively developed.
Sỏi cholesterol trong túi mật là loại sỏi phổ biến được hình thành vì sự không tan của cholesterol
3. Risk factors for cholesterol gallstones
Risk factors that may increase the likelihood of cholesterol gallstones in patients include:
Female gender; Over 40 years old; Obesity, overweight; Diet high in cholesterol, low in fiber; Family history of gallstones; Diabetes ; Taking medications that contain estrogen, such as birth control pills or hormone therapy drugs.
4. How do gallstones manifest?
Small, small number of gallstones rarely cause recognizable symptoms and are usually detected only through physical examination or hepatobiliary ultrasound. However, cases of large stones causing biliary obstruction or obstructing gallbladder contraction can cause symptoms such as:
Sudden pain in the right upper quadrant, gradually increasing pain lasting several minutes to several hours; Severe, persistent abdominal pain may indicate acute pancreatitis, a surgical emergency; Nausea or vomiting; Fever usually occurs when the patient already has cholecystitis; Jaundice in cases of biliary obstruction.
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5. Treatment of gallbladder cholesterol stones
Cases of gallstones that do not cause symptoms do not need treatment for the most part. If there are symptoms caused by gallstones, medical or surgical treatment can be used:
Treatment of gallbladder cholesterol stones by medical methods:
Some drugs can be used to dissolve Small gallstones, of course, last a long time and have low effectiveness. This is mainly done to delay the growth and proliferation of stones. Drugs to treat gallstones are also not commonly used and are often indicated for cases where surgery is not possible. Treatment of gallbladder cholesterol stones by surgical methods:
Surgical treatment to remove the gallbladder to prevent gallstones from recurring, bile will flow directly from the liver to the small intestine instead of being stored in the gallbladder. The patient can lead a normal life without a gallbladder, but should consume less cholesterol or fat-containing foods; Open surgery or laparoscopic cholecystectomy depends on contraindications, technical skills and equipment of the performing unit. Other methods:
Percutaneous gallstone lithotripsy; Endoscopic retrograde cholangiopancreatography (ERCP); Percutaneous cholangiography (PTC). Diet for people with gallbladder cholesterol stones:
Eat right meals: skipping meals or fasting can increase the risk of gallstones, being too hungry or eating too full is also harmful; Add foods rich in fiber to help reduce the load on the digestive system and improve health; Reduce foods rich in cholesterol, fat, foods high in salt and sugar; Maintain a healthy weight; Lose weight slowly according to the schedule, up to a maximum of 0.5-1kg/week.
Các trường hợp sỏi túi mật không gây ra triệu chứng thì đa phần không cần phải điều trị
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