Gallbladder stones CT manifestations

Written by Shen Jiang Chao
Radiology
Updated on September 19, 2024
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Gallstones typically display characteristic features on a CT scan. Depending on the calcium content and the chemical composition of the stones, they can appear as high-density, isodense, or low-density stones. High-density stones present as multiple areas of increased density within the gallbladder, though they can also be solitary. A solitary high-density stone generally appears as a concentric circle with low central density surrounded by high density. Isodense stones have the same density as bile, which sometimes makes them difficult to distinguish. Low-density stones, which are primarily cholesterol stones, can sometimes contain gas, appearing as low-density shadows. CT is not the first choice for diagnosing gallstones; abdominal ultrasound is generally preferred.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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How to treat gallstones?

For the treatment of gallbladder stones, the approach mainly depends on whether there are symptoms or not. For patients with asymptomatic gallstones, which are relatively small in size, they are often found during ultrasonography and do not require special treatment. Regular follow-up ultrasonography is conducted to dynamically observe changes in size. Of course, diet should also avoid spicy and stimulating foods to reduce inflammatory stimulation and avoid foods high in cholesterol and fats, focusing on a light diet, which can alleviate symptom flare-ups and control the condition. For patients with larger gallstones who often experience discomfort and pain in the upper right abdomen, early surgical treatment should be pursued, as surgery is the only way to achieve a cure and can significantly improve the patient's quality of life.

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Written by Zhang Tao
Hepatobiliary Surgery
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How many days are needed for minimally invasive gallbladder stone surgery?

Gallbladder stones clinically often require surgical treatment. There are two types of minimally invasive surgery for gallbladder stones. The first type is laparoscopic cholecystectomy, and the other type is laparoscopic gallbladder-preserving stone removal. If the patient undergoes minimally invasive gallbladder-preserving stone removal, they can generally move around within three to five hours after surgery, resume a liquid diet after half a day, be discharged three days postoperatively, and fully recover within a week without affecting their normal life and work. If the patient undergoes a laparoscopic cholecystectomy, and if they are relatively young, it is recommended that they can resume eating on the evening of the surgery, get out of bed the next day, and be discharged within two to three days. Even in some large clinical medical centers, the cholecystectomy can be performed as a day surgery, where the patient may be admitted in the morning, undergo surgery in the afternoon, and handle discharge procedures after completing post-surgery intravenous fluid therapy in the evening.

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Written by Zhang Tao
Hepatobiliary Surgery
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Gallbladder stones and gallbladder polyps differentiation

Gallbladder stones and gallbladder polyps are common diseases in the digestive system and are usually benign. Both gallbladder stones and gallbladder polyps can cause chronic inflammation of the gallbladder, leading to chronic cholecystitis. Some patients may experience acute episodes of pain in the upper right abdomen, leading to an acute cholecystitis attack. Both conditions typically require laboratory tests and diagnostic imaging to confirm diagnosis. Clinically, they are mainly identified through color Doppler ultrasound; gallbladder stones are formed by the deposition of bile salts within the gallbladder, while gallbladder polyps are protrusions growing from the gallbladder wall into the cavity, which can be clearly distinguished by ultrasound.

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Written by Jiang Zhen Hui
Hepatobiliary Surgery
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Can ERCP remove gallbladder stones?

ERCP is currently being explored by some hospitals in China for the removal of gallstones. It involves inserting a tube through the lower part of the gallbladder to remove the gallstones. However, we generally do not recommend using ERCP for gallstone removal because if it becomes necessary to remove the stones, the gallbladder must be cut open, which can easily lead to complications such as suppurative cholecystitis. Currently, the most common method for removing gallstones is laparoscopic cholecystectomy, which, of course, requires mature surgical skills and relatively has fewer complications.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Is it normal to feel nauseous with gallstones?

Patients with gallstones experiencing nausea and vomiting is normal, as gallstones often cause acute cholecystitis, leading to pain and discomfort in the upper right abdomen. At this time, it may also affect the stomach causing nausea and vomiting, so it is advisable to use antibiotics for anti-infection treatment as soon as possible. Once the inflammation is controlled, the condition can be alleviated. When nausea and vomiting occur, it is also advisable to fast for gastrointestinal decompression, which can better alleviate the condition. Additionally, after returning to a normal diet, one should avoid spicy and irritating foods to reduce inflammation and aid in the relief of the condition. If symptoms do not improve with conservative treatment, surgery should be considered as soon as possible.