Chronic cholecystitis complicated with gallstones

Chronic cholecystitis complicated with gallstones refers to the presence of gallstones with chronic inflammatory changes in the gallbladder wall. It is often caused by long-term stimulation of the gallbladder mucosa by stones, and some cases are sequelae of acute cholecystitis. Gallstones can repeatedly block the cystic duct or repeatedly stimulate the gallbladder wall, causing recurrent acute cholecystitis. Over time, it may transform into chronic cholecystitis. Of course, the presence of gallstones does not necessarily mean the presence of cholecystitis.
This disease is more common in developed countries such as Europe and the United States, with a higher incidence rate among women, with a ratio of 2-3:1 female to male. The etiology is diverse and complex, including age, gender, race, dietary habits, obesity, genetics, biliary tract infection, bile stasis, and pancreaticobiliary reflux, among many other factors, and is often the result of the combined effects of various factors. With the improvement of living standards and health conditions among the Chinese people in recent years, the incidence rate of chronic cholecystitis complicated with gallstones has been increasing day by day, especially in major cities, which is more obvious. According to statistics, it accounts for about 70% of all cholelithiasis. In recent years, with the advent of laparoscopic technology, satisfactory results have been achieved in the treatment of this disease.

　　During the remission period, there may be no signs or deep tenderness in the gallbladder area. During the acute attack period, there are signs of acute cholecystitis. Patients with chronic cholecystitis complicated by gallstones may develop complications such as gallbladder effusion or abscess, acute cholelithiasis pancreatitis, bile duct stones or cholangitis.

1. Symptoms are atypical, often with right upper quadrant discomfort or dull pain, aversion to greasy foods, bloating, diarrhea, and other symptoms of dyspepsia, which may recur repeatedly and last for decades.
2. Most patients have a history of acute cholecystitis attacks.
3. During the remission period, there may be no signs or deep tenderness in the gallbladder area. During the acute attack period, there are signs of acute cholecystitis.

　　Chronic cholecystitis complicated by gallstones is often caused by long-term stimulation of the gallbladder mucosa by stones, resulting in inflammation. The main attention for chronic cholecystitis complicated by gallstones is diet and drinking more water, and there is no special preventive method.

1. Ultrasound examination shows thickening of the gallbladder wall and light spots with echoes inside.
2. Abdominal X-ray films show positive gallstone shadows in the gallbladder area. Oral cholecystography shows poor gallbladder concentration and contraction function, and positive or negative gallstones can be seen.
3. CT or MRI shows gallstones.

　　Patients with chronic cholecystitis complicated by gallstones should have a light diet, eat more vegetables and fruits, and eat vegetables rich in vitamin A or vitamin K. High-fat, greasy, spicy and刺激性 foods should be avoided. Patients should also pay attention to drinking more water.

　　For patients with chronic cholecystitis complicated by gallstones, if asymptomatic, the operation and timing can be determined according to the size and number of the stones, and the changes in the gallbladder wall. Elective cholecystectomy should be performed, and laparoscopic cholecystectomy should be performed in hospitals with conditions. Open method or laparoscopic method should be used for symptomatic gallstones.