Bile is a pile of stone crystals in the gallbladder or in the bile duct. Stones found in the gallbladder is called cholelitiasis, while stones in the bile ducts called koledokolitiasis.
Gallstones were more common in women and risk factors are:
- Obesity (Obesity)
- High-fat diet
The major components of gallstones is cholesterol, a small portion of other forms of calcium salt. Bile contains large amounts of cholesterol that usually remains as a liquid. If the bile becomes saturated because of cholesterol, so cholesterol can become insoluble and precipitate out to form bile.
Most gallstones form inside the gallbladder and the majority of stones in the bile ducts from the gallbladder. Gallstones can form inside the bile duct if the bile experiencing backflow due to narrowing of the canal or after the removal of gall bladder.
Gallstones in the bile ducts can cause severe infection of the bile ducts (cholangitis), infection of the pancreas (pancreatitis) or liver infection. If the bile duct is blocked, then the bacteria will grow quickly and cause infection in the channel. Bacteria can spread through the bloodstream and cause infections in other body parts.
The majority of gallstones in a long time does not cause symptoms, especially when settling in the gall-bladder stones. Sometimes large stones will gradually erode the gallbladder wall and into the small intestine or large intestine, causing intestinal obstruction (gallstone ileus).
What more often happens is out of gallstones and gallbladder into the bile duct. Of the bile duct, gallstones can enter the small intestine or remain in the bile ducts without causing disturbances or symptoms of bile flow.
If gallstones block the sudden bile duct, then the patient will feel pain. Pain tends to disappear, arise and are known as colic pain. Pain arises slowly and reached a peak, then decreased gradually. Pain is sharp and the missing-occur, could last up to several hours. Location of pain varies, but most felt in the upper right abdomen and can spread to the right shoulder.
Sufferers often feel nauseated and vomiting. If infection occurs in conjunction with a blocked duct, it will have a fever, chills and jaundice (jaundice). Usually the blockage is temporary and rare infections. Pain due to blockage of the channel can not be distinguished from pain caused by blockage of the gallbladder.
Persist in the cystic duct obstruction caused gallbladder inflammation (acute cholecystitis). Gallstones blocking the pancreatic duct causing inflammation of the pancreas (pancreatitis), pain, jaundice and may also be infected. Sometimes the pain is gone-recurrence arising after gall bladder removed, pain may be caused by gallstones in the main bile duct.
To find the best examination of gallstones is by ultrasound and kolesistografi. In kolesistografi, x-rays will show the path of the contrast agent that has been swallowed radioopak, absorbed in the intestine, thrown into the bile and stored in the gallbladder. If the gallbladder is not functioning, the contrast agent will not be visible in the gallbladder. If the gall bladder function, then the outer boundary of the gall bladder will be visible on x-rays.
Diagnosis of bile duct stones in upheld on the basis of abdominal pain, jaundice, chills and fever. Results of blood tests usually show a pattern of abnormal liver function, which may indicate blockage of bile ducts. Several other tests can provide additional information to make a definite diagnosis is:
- CT scan
- Various techniques using x-ray contrast substances radioopak to describe the bile duct.
If not found symptoms, hence require no treatment. Missing pain-arising can be avoided or reduced by avoiding or reducing fatty foods.
Gall Bladder Stone
If emped bladder stones cause repeated pain attacks have been carried out despite dietary changes, then it is advisable to undergo gallbladder removal (cholecystectomy). Appointment of the gall bladder does not cause nutrient deficiency and after surgery, food restriction is not necessary. Approximately 1-5 of every 1000 people who underwent kolesistektom died.
Laparoscopic cholecystectomy was introduced in 1990 and is currently about 90% done in laparoscopic cholecystectomy. Gallbladder removed through a tube that is inserted through a small incision in the abdominal wall.
This type of surgery has the following advantages:
- Reducing post-surgical discomfort
- Shortening the period of hospitalization.
Other techniques to remove gall bladder stones are:
- Dissolution with methyl-butyl-ether
- Split with sound waves (lithotripsy)
- Dissolution with chronic bile acid treatment (acid and acid kenodiol ursodeoksikolik).
Gall Stone Line
Bile duct stones can cause serious problems, because it must be removed either surgically or through the abdomen, a procedure called endoscopic retrograde cholangiopancreatography (ERCP).
In ERCP, an endoscope is inserted through the mouth, esophagus, stomach and into the small intestine. Radioopak contrast substance into the bile duct through a tube in the sphincter Oddi. In sfingterotomi, rather wide open sphincter muscles so that gallstones are blocking the channel will move to the small intestine.
ERCP and sfingterotomi has been successfully performed on 90% of cases. Less than four of every 1,000 patients who died and 3-7% had complications, so that this procedure is safer than abdominal surgery.
Complications that may soon occur are:
- Inflammation of the pancreas (pancreatitis)
- Perforation or biliary tract infection.
In 2-6% of patients, shrinking the channel back and gall stones appear again. Gallbladder stones can not be removed via ERCP procedures. ERCP is usually effective only in patients with bile duct stones are older, the bladder bile has been lifted.
Because the largest composition of gallstones are cholesterol, high cholesterol should avoid foods that are generally derived from animal fats.