Middle-aged obesity “biliary tract” disease is high
Hong Kong’s famous actor “Fat Sister” Shen Dianxia had undergone biliary surgery and partial hepatectomy before he was transferred to a hospital. His condition was repeated.
Many people are very surprised: Why do bile surgery and liver surgery have to be carried out?
To this end, Professor Wang Jie, Dean of the Hepatobiliary Hospital of the Second Affiliated Hospital of Sun Yat-sen University, explained that the liver and gallbladder are the same, and the liver is cut for the gallbladder.
銆€銆€The characteristics of “Fat Sister” are in line with the high incidence of “biliary tract” disease Professor Wang Jie explained that many of the physical characteristics of “Fat Sister” are very similar to those of patients with cholelithiasis.
Her size, age, etc. put it at high risk.
Professor Wang introduced that cholelithiasis is the most common disease in biliary tract diseases. It occurs in obese women over 40 years old and has more children. Among them, women with a history of diabetes and above are more high-risk groups. Therefore, this type of middle-agedWomen should pay more attention to “protecting the gallbladder.”
銆€銆€”Fat sister” has carried out two gallbladder and liver operations, which made the public feel embarrassed. Professor Wang said that this is because the public does not understand the condition of “Fat Sister” and therefore cannot explain exactly why she has undergone biliary surgery and part of it.After the liver resection, it is necessary to continue treatment in the Intensive Care Unit (ICU).
However, in some cases, some patients have undergone laparoscopic gallstone surgery, resulting in bile duct erosion and hemorrhage due to residual stones. It is necessary to perform partial hepatectomy again, and after surgery, due to poor physical condition, it occurs.Local inflammation leads to the ICU.
Because the liver and bile duct system are closely related in physiological structure, the combination of two organs is not uncommon in medicine.
銆€銆€Obese middle-aged women are high-risk people with cholelithiasis “Fat sister” left the audience with the deepest impression of “obesity”. However, “obesity” and diabetes are high-risk factors that induce middle-aged women to suffer from cholelithiasis.
Middle-aged women themselves are prone to occur, and most people with diabetes are associated with hypercholesterolemia and high cholesterol levels. At the same time, most people with obesity also have high blood lipids, while cholesterol is mainly cholesterol and triglycerides.
銆€銆€Studies have found that in normal human bile, cholesterol remains dissolved, and it is not easy to form stones.
If for some reason this balance is destroyed, cholesterol is increased or bile salts, lecithin is reduced, cholesterol will gradually form a mass in the bile, forming cholesterol stones.
In addition, diabetes is prone to neuropathy, which makes the gallbladder motor dysfunction, gallbladder large and loose emptiness, and also provides space for the formation of gallstones.
銆€銆€”Hepatobiliary”, treatment of “biliary” and “liver” to protect “biliary” Professor Wang Jie, liver and gallbladder have an interdependent and mutually coordinated relationship in anatomical structure and physiological function, in which the liver is the largest digestion of the human body.And the detoxification organ; the bile duct system consists of the gallbladder and the biliary tract. The gallbladder is attached to the liver. It is a warehouse for bile. It stores, concentrates, discharges bile and directly participates in regulating the pressure of the biliary tract inside and outside the liver. The biliary tract usually includes intrahepatic biliary tract and extrahepatic.The two parts of the biliary tract, its role is to transport those bile secreted by the liver to the duodenum.
Therefore, once the liver and bile duct system suffer from the disease, they can get involved.
For example, suffering from gallstones, biliary mites or tumors can cause liver infection.
Conversely, the functional status of the liver also affects the gallbladder.
For this reason, in the treatment of part of liver disease or biliary tract disease, it is combined with another organ corresponding to it.
Resection of part of the liver to treat hepatolithiasis is a typical example.
銆€銆€Professor Wang said that long-term intrahepatic bile duct stones can cause hepatic bile duct obstruction and infection, resulting in necrosis, fibrosis, atrophy of the liver and gallbladder tissue, or complicated abscess and biliary tract bleeding. Therefore, hepatic resection is a treatment for intrahepatic bile duct.An important means of stone, it can not only remove stones, but also remove infected lesions and reduce the chance of stone recurrence.
However, the resection is not performed at will.
銆€銆€Today’s medical discovery found that the long-term excellent rate of hepatectomy for hepatolithiasis can reach more than 90%.
銆€銆€The cause of bile pigment stones According to Professor Wang, the primary intraductal calculus in China accounts for about 50% of gallstone cases.
Gallstones, which are the main components of bilirubin calcium, are closely related to biliary infection and biliary aphids.
The bilirubin excreted by the liver is called conjugated bilirubin, also known as water-soluble bilirubin, which is integrated with bile.
When biliary tract infection or biliary ascariasis, some bacteria, especially E. coli, release a 尾-glucuronidase, and the large release of this enzyme destroys the equilibrium relationship of glucose di-1,4-lactone.The combined bilirubin is hydrolyzed to free bilirubin, which is insoluble in water and combines with calcium in the bile to form insoluble bilirubin calcium particles.
The bilirubin calcium granules are mainly composed of exfoliated cells and parasitic eggs, and are continuously deposited to form stones under the help of mucin in bile.
銆€銆€”In addition, congenital abnormalities of the biliary system and bile flow disorders caused by anatomical variations of the bile duct system are likely to occur in this department.
It is worth noting that long-term malnutrition can affect the normal defense capacity of the biliary tract, and malnutrition is common in patients with pigment stones.
鈥濄€€銆€绯栧翱鐥呮偅鑰呮€ユ€х値鐥囧彂浣滄浜＄巼楂樸€€銆€濡傛灉娌℃湁鎮ｇ梾锛屽彧瑕佸湪骞虫椂娉ㄦ剰涓€涓嬭嚜宸辩殑鐢熸椿涔犳儻锛屽敖閲忚繙绂昏嚧鐥呯殑鍥犵礌锛屼害鍙繙绂荤柧鐥呯殑鍥版壈锛氥€€銆€绯栧翱鐥呰儐缁撶煶鐥呬汉蹇呴』娉ㄦ剰锛岀敱浜庣硸灏跨梾涓€鏃﹀苟鍙戞€ユ€nflammation is easy to evolve into a critical condition in a short period of time, and the mortality rate during emergency surgery is as high as 22%, and the postoperative complication rate is also high (51%). Therefore, patients with diabetes mellitus complicated with cholelithiasis, with or without symptoms, have symptoms.Laparoscopy or surgery should be performed as soon as possible to prevent the above-mentioned dangers.
銆€銆€Professor Wang suggested establishing healthy eating habits and a reasonable diet.
According to domestic and foreign data, in the population with low economic income and lack of protein and fat in the diet, the incidence of bile duct stones with bile pigment stones is high, while the wealthy urban residents and the population of economically developed countries are in the diet.More protein and fat, the incidence of cholesterol-based gallstones is high.
Therefore, the food should be mixed with meat, the protein and fat should be moderate, increase the fiber content of the food, mix the coarse and fine grains, do not eat or eat less food with high cholesterol content.
Advocate proper consumption of vegetable oil to facilitate gallbladder contraction and emptying.
銆€銆€Diabetic patients should be actively treated, regularly go to the hospital to review and check blood sugar, and control the development of the disease; “obese” patients should develop a moderate exercise plan, regular quantitative exercise, control the number and frequency of eating, and strive to reduce weight.