Gallbladder Disease: Causes, Complications And Treatment

One of the most common hepatobiliary conditions is cholangiolithiasis, which is characterized by obstruction of the bile ducts because of gallstones in the common bile duct causing many symptoms.
Gallstone stones is what disease?
Gallstones are a condition in which the stones in the bile duct pass from the liver and gallbladder to the duodenum.
Bile stone stones can be classified into two main types based on their composition:
Cholesterol stones
Pigment stones
Bile duct stones have a number and size that vary from person to person. In addition to stones in the bile duct, the patient also appears stones in other locations such as the gallbladder, the biliary tract in the liver.
Symptoms of gallstones gallstones
Typical symptoms of bile duct stones include: right flank pain, fever and jaundice:
Right flank pain: Occurs after 1-2 hours or occurs at any time of the day, the level of pain is prolonged and widespread, pain spreads to the chest or to the back, can last up to 2-3 hours

. The pain is caused by the movement of stones or by increased bile duct contractility, increased gallbladder motility and increased bile pressure.
Fever: Patients with bacterial fever develop when the bile fluid is stagnant, the bacteria will produce endotoxins leading to high fever of 39 - 40 ° C with chills, sweating. High fever usually appears after 2-3 hours of painful cramps
Jaundice: Causes jaundice due to obstructed bile fluid and stagnation in the liver, bilirubin in bile fluid into the blood causing jaundice, yellowing of eye mucosa.




Some other symptoms may occur such as vomiting, nausea, itching, yellow eyes, dark yellow urine, fecal stools.
Causes of gallstones stones
Bacterial and parasitic infections: When the bile fluid becomes stagnant, the bacteria grow, causing damage to the biliary tract, causing ulcerative cells to slough into the bile, causing precipitation of some components of the bile fluid. bile acids, bile salts) lead to the formation of stones in the bile ducts. There are also cases where worms carry eggs or worms to bury the bile duct and become a place for pigmented bile deposits to deposit, gradually forming stones.
Because stones from the bile ducts in the liver or gallbladder move down the bile ducts
Risk factors for biliary tract stones
The risk of gallstones stones is higher in people with a history of gallstones, gallbladder disease and even those who have their gallbladder removed. The following are factors that increase your chances of developing gallstones.
Fat
Low in fiber, high in calories, high in fat diet
Pregnant
Vegetarian for a long time
Lose weight fast
Lack of physical activity
The risk factors you cannot change include:
Age: Older adults are often at higher risk for gallstones
Gender: women are more likely to have gallstones
Family history: genetics may play a role
Complications of bile duct stones
Acute complications
Peritoneal infiltration: the obstruction of the bile duct appears stagnant bile, permeates through the bile duct into the abdominal cavity
Bile peritonitis: Bile and bacteria discharge into the abdomen due to gallbladder rupture or bile duct perforation causing peritoneal infection
Cholangitis and biliary abscess: cholangitis due to bile stagnation and infection: cloudy bile fluid, odor and pus.



Cholangitis leads to the formation of small abscesses in the liver, manifested by high fever, chills, enlarged and painful liver ...
Bleeding of the bile ducts: The wall of the bile ducts is ulcerated by stones and abscesses, which causes the bile duct to be connected to blood vessels in the liver. Symptoms of vomiting or bloody stools, bleeding often lasts, persistent and intermittent
Acute pancreatitis caused by gallstones: stones that appear at the end of the bile duct or stones that attach to the Oddi muscle; When examining the lumbar ribs feeling pain, blood and urine amylase increased.
Acute gallstones nephritis (liver and kidney syndrome): symptoms of low urination, anuria, increased jaundice, elevated urea and blood creatinine. This is a serious complication that can be fatal.
Septic shock: patients with biliary obstruction syndrome, high fever fluctuating, small pulse faster than 120 times / minute, blood pressure drops, blood cultures with bacteria, mainly gram (-).



Complications cause high mortality rates
Chronic complications
Cholangitis
Chronic pancreatitis
Biliary cirrhosis
Cholangitis is a dangerous complication of bile duct stones
Methods of diagnosis of bile duct stones
If the frequency and severity of symptoms appear, the patient goes to the medical facility to conduct a number of tests to accurately diagnose the disease and have appropriate and timely treatment.
Blood biochemical test
Urine test
X-ray of abdominal cavity, biliary tract
Endoscopic ultrasound
Magnetic resonance imaging (MRCP)
CT - Scan
Methods of treatment of biliary tract stones
Medical
Set bile duct
Rehydration and intravenous electrolytes
Antibiotics kill Gram-negative and anaerobic bacteria
Pain relief
Vitamin K, frozen plasma if there is a coagulation disorder
Surgery
The principle of treatment of biliary stones is to remove all stones and ensure good bile circulation, the methods of treatment include:
Endoscopic retrograde cholangiopancreas (ERCP)
Bile drainage through the skin
Open OMC surgery for classic stones
Some other methods of drainage of the bile ducts: Create Oddi sphincter, connecting OMC - duodenum
Measures to prevent gallstones stones.

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