Tokushukai Medical Group

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Digestive System Surgery: Cholelithiasis, Bile Duct Inflammation

Bile stone ownership ratio is increasing tendency among Japanese.

Bile is a brownish yellow colored digestive liquid which mainly helps fat digestion and absorption taken by meal. It is produced about 500ml a day by liver organ. The path where bile flows through is called as biliary tract. Biliary tract is divided into intrahepatic biliary tract, extrahepatic biliary tract, and gallbladder.

Gallbladder works as the storage of bile. When taking a meal, bile which is condensed inside of gallbladder send out to extrahepatic biliary tract by gallbladder is shrinking, and flows out in duodenum to help digesting.

Cholelithiasis is a general name of the disease which develops gallstone in biliary tract. Depend on the location of gallstone, they are grouped as intrahepatic stone, biliary tract stone, and gallbladder stone. Because of westernized eating habit and aging society, gallstone ownership ratio is increasing. By gender, female ratio is high compared with male ratio.

Causes are life-style habit, and so on.

Causes of the disease is depending upon the building block of gallstone. Typical causes of gallstone are; obesity, hyperlipemia, diabetes, or initiated by bacteria infection into bile.

Abdominal pain may appear in bile duct calculus.

Symptom appearance is also depending on where is gallstone developed.

Gallbladder stone
Even though there is stone inside of gallbladder, there appears no symptom most of the case. In case stone stuck on the exit of gallbladder, symptoms may appear suddenly. Periodical pain on upper belly or right hypochondrium, or pains on back or right shoulder may appear. Or, in case stone has stuck at exit of gallbladder, bile flow inside of gallbladder is stagnated then if bacteria infect on this, disease may transit to acute gallbladder inflammation stage, so that continuous abdominal pain, high fever, or blood poisoning are developed. Generally speaking, high level jaundice recognition is uncommon by gallbladder stone or gallbladder inflammation.
Biliary tract stone
Bile flow to duodenum is interfered by stone in biliary tract, abdominal pain comes up. And, bile stands up in biliary tract is adversary flew and jaundice may appear. Bile in biliary tract is infected, high fever, shaking is developed. Occasionally, shock status (blood pressure down) may come up. This status is called as acute obstructive suppurative cholangitis. This is a serious disease which has a possibility of more serious condition although appropriate treatment has conducted.

Detection rate is high at Ultrasonic exam.

For the detection of stone, image diagnosis is useful. Common exam conducted at first time is ultrasonic exam. It is simple and easy, no need to prepare injection and no radiation is applied, so that it is a high safety exam. In ultrasonic exam, Detection of gallbladder stone is high, but regarding common duct stone, there may be a case which is undetected.

CT exam is good for viewing the status of entire abdominal, gallbladder, or biliary tract surrounding region, but , it is not so high for the detection of stone.

One kind of MRI exam, MRCP, is very good in drawing up gallbladder to biliary tract run and stone inside of it. Duration of Exam takes relatively longer. Or, blood drawing is also useful to diagnose gallbladder inflammation or biliary tract inflammation.

No problem even cut-off entire gallbladder.

Regarding Gallbladder stone, if it has no symptom at all, follow-up is one of the measures. Person with some symptom or person who has symptom history before are basically subject to the treatment.

First selection of gallbladder stone is the surgery (gallbladder extirpate). Nowadays, Laparoscopic surgery becomes a standard treatment and it can take gallbladder out through small scur. But depend on the situation, abdominal surgery may be selected.

Person may have a query like why gallbladder is taken out for just a surgery for gallstone. However, to take only stone is more difficult surgery than taking entire gallbladder, also, because of gallbladder itself is a cause of disease with developing stone, gallbladder extirpate is to be considered as permanent cure treatment for gallbladder stone.

Also, there is a person who worries about the post-effect in taking gallbladder out. But, for most of the people, normal daily life will not be affected. In some cases, Diarrhea may occasionally occur after having much fatty meals but taking anti-flatulent may work for this.

Common bile duct stone is fundamentary subject to all cases treatment adaptation. First selection is ERCP (Endoscopic retrograde cholangiopancreatography). It becomes a test and treatment that camera like stomach camera is inserted from mouth, then, insert tube or process materials into bile duct reversed form duodenum which is an exit of biliary duct. In case of ERCP, there no need to cut abdominal part off, and it can say it’s relatively gentle treatment. Depend on the case, abdominal surgery or laparoscopic surgery may be selected.

For gallbladder stone and common bile duct stone, in case when bacterial infection is complicated, anti-bacteria agent administration is necessary.

Care for balanced meal and appropriate exercise.

Although there are no assured preventive measures, it can be listed that care for taking balanced meals, maintain adequate exercise or appropriate body weights.