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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What should not be eaten with gallstones?

Patients with gallstones should primarily avoid spicy and stimulating foods, such as chili peppers, barbecue, and garlic, to reduce inflammation. They should also avoid foods high in fats and cholesterol, such as animal organs and fatty meats. For patients with gallstones, the diet should mainly consist of light and mild foods, and include plenty of fresh vegetables and fruits to lessen the burden on the gallbladder and reduce the frequency of symptoms. If a patient with gallstones repeatedly experiences discomfort or pain in the upper right abdomen, it is necessary to consider surgical removal of the gallbladder at an early stage. Surgery is the only definitive treatment to improve the quality of life for these patients, and diet still needs to be carefully managed post-surgery.

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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 Liu Wu Cai
Hepatobiliary Surgery
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What is good to eat for gallstones?

Patients with gallbladder stones should primarily observe the following dietary guidelines: First, it is particularly important for patients with gallbladder stones to avoid spicy and stimulating foods such as chili peppers, barbecues, and garlic. A diet primarily composed of mild foods, supplemented by fresh vegetables and fruits, can better control the onset of the condition. Second, patients with gallbladder stones can also appropriately include protein-rich foods such as eggs, lean meats, and fish in their diet to enhance their immunity. Third, patients with gallbladder stones should avoid foods high in cholesterol and fats, such as animal offal and fatty meats. These foods might cause the stones to increase in size and lead to recurrent right upper abdominal pain and discomfort, thus requiring attention.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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How should gallstones be treated?

For the treatment of gallstones, the decision mainly depends on whether there are symptoms and the size of the stones. Patients with small gallstones generally do not exhibit clear symptoms and are often discovered only through ultrasound. They do not require special treatment; regular follow-up ultrasounds to dynamically observe any changes in size are sufficient. In daily diet, it is advised to avoid food high in cholesterol and fats, and to maintain a light diet, which can better control the condition. Patients with large gallstones often experience recurrent upper right abdominal pain and discomfort, which affects their quality of life. Treatment can include the use of antibiotics to manage infections. Once the inflammation is controlled, the condition can be alleviated, but recurrences are common, necessitating eventual surgical removal of the gallstones to achieve a better treatment outcome. Primarily, complete removal of the gallbladder through surgery can potentially cure the condition.

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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.