胆结石

迹象 & 症状

Many people do not experience any 症状 and are said to have "silent gallstones." Often the gallstones are found when a test is performed to evaluate some other problem. Treatment is only recommended if a person actually experiences 症状 of the condition.

A severe and steady pain in the upper abdomen or right side is the most common symptom of gallstones. 的痛苦, 这也可能影响肩胛骨或右肩, 持续时间从几分钟到几小时不等. 此外，你可能会出汗或呕吐.

在更高级和更严重的阶段, 胆结石可引起胆囊长期疼痛和感染. 结石进入胆管通常会引起疼痛, 发烧和黄疸, 哪一种是眼睛和皮肤的黄色变色.

诊断

Your doctor will first ask about your medical history and perform a physical examination. 此外，他或她可以要求进行以下检查:

• 计算机断层扫描(CT). An X-ray that uses a computer to provide an image of the inside of the abdomen.
• 磁共振成像(MRI)扫描. 这个测试使用电磁波来创建一个图像.
• 超声波. This test uses high-frequency sound waves that echo off the body to create a picture.
• 内镜逆行胰胆管造影(ERCP). During an ERCP, a flexible tube is inserted down the throat and into the stomach and small intestine. By injecting dye into the drainage tube of the pancreas, your doctor can see the area more clearly.
• 内镜超声(EUS). EUS包括通过一个薄层, flexible tube called an endoscope through the mouth or the anus to exam the lining and walls of the upper and lower gastrointestinal tract and nearby organs such as the pancreas and gall bladder. The endoscope is equipped with a small ultrasound transducer that produces sounds waves that create a viewable image of the digestive track. 结合细针抽吸, EUS成为最先进的, minimally invasive alternative to exploratory surgery to remove tissue samples from abdominal and other organs. It also may be used to determine the cause of 症状 such as abdominal pain, 评估一个增长, 诊断胰腺疾病, bile duct and gall bladder when other tests are inconclusive and to determine the extent of certain cancers of the lungs or digestive tract.
• 经皮经肝胆管造影(PTC). By injecting dye into the bile duct through a thin needle inserted into the liver, 在x射线上可以看到阻塞.
• 胆管活检和细针穿刺. A tiny sample of the bile duct fluid or tissue is removed and examined under a microscope.

治疗

胆结石可以通过手术和药物治疗.

手术

如果需要手术，可以使用以下程序:

• 胆囊切除术. 胆囊切除胆囊的外科手术, 一种叫做胆囊切除术的手术, 胆结石最常用的治疗方法是什么, 虽然这个手术现在大多是腹腔镜下进行的. 尽管在某些情况下, 由于感染或其他手术, 这是一种传统的胆囊切除术. Four or five days of hospitalization are generally required for this procedure. 病人 often do well after surgery and have no difficulty with digesting food.
• 腹腔镜胆囊切除术. UCSF Medical Center also offers a less-invasive procedure called laparoscopic cholecystectomy. 在这个过程中, the surgeon makes several incisions in the abdomen through which a tiny video camera and surgical instruments are passed. 视频画面在手术室的电视屏幕上播放, and the gallbladder can be removed by manipulating the surgical instruments. Because the abdominal muscles are not cut there is less postoperative pain, 更快的康复, 更好的美容效果. You can usually go home from the hospital within a day and resume normal activities within a few days.
• 内镜逆行胰胆管造影(ERCP). ERCP can be used to find stones in the bile duct, as described in the diagnosis section. 当检测到结石时, the doctor can widen the bile duct opening and pull the stones into the intestine. This is commonly done when the gallbladder is being removed laparoscopically or when a stone is found in the duct long after gallbladder surgery. 如果病人太虚弱不能做胆囊手术, 它也可用于缓解胆管结石的症状, 即使胆囊中存在其他结石.

药物

特殊的化学物质, 可提供药丸形式, 可以用来溶解某些胆结石吗, 比如那些由胆固醇组成的. 然而, 因为缺乏医学研究, 这些药物的疗效尚未得到证实.