นิ่วในถุงน้ำดีและระบบน้ำดี (Gallstones and Biliary System)

Gallstones and Biliary System is a common condition that can affect health if not properly treated. Let&#8217;s understand more about gallstones and the biliary system.
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<h2>Gallstones</h2>
Gallstones are hard lumps that form in the gallbladder, a small organ under the liver that stores bile produced by the liver to help digest fats. Gallstones can be divided into two main types:
<ul>
<li style="font-weight: 400;">Cholesterol stones: The most common type, caused by high cholesterol in the bile.</li>
<li style="font-weight: 400;">Pigment stones: Caused by high bilirubin in the bile, often found in patients with hemolytic conditions or cirrhosis.</li>
</ul>
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<h3>Causes and Risk Factors of Gallstones</h3>
<ul>
<li style="font-weight: 400;">High cholesterol: Having high cholesterol in bile can lead to cholesterol stones.</li>
<li style="font-weight: 400;">Obesity: Increases the risk of gallstones.</li>
<li style="font-weight: 400;">Rapid weight loss: May cause the body to produce more cholesterol.</li>
<li style="font-weight: 400;">Age and gender: Women and the elderly have a higher risk.</li>
<li style="font-weight: 400;">Genetics: A family history of gallstones may increase risk.</li>
</ul>
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<h2>Symptoms of Gallstones</h2>
Gallstones may be asymptomatic (silent gallstones), but if symptoms occur, they may include:
<ul>
<li style="font-weight: 400;">Pain in the upper right abdomen, epigastric area, or mid-abdomen, which may radiate to the right shoulder or mid-back.</li>
<li style="font-weight: 400;">Bloating, fullness, excessive gas, often after meals, especially dinner, usually at night. Sometimes severe, requiring sitting in a curled position for more than 20 minutes or hours.</li>
<li style="font-weight: 400;">Nausea and vomiting.</li>
<li style="font-weight: 400;">Jaundice (yellowing of skin and eyes), dark urine, pale stools, hepatitis if stones block the bile ducts.</li>
<li style="font-weight: 400;">Fever, chills, and abdominal tenderness if infection occurs.</li>
</ul>
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<h3>Complications</h3>
<ul>
<li style="font-weight: 400;">Cholecystitis: Inflammation of the gallbladder.</li>
<li style="font-weight: 400;">Bile duct obstruction: Stones may move to block the bile duct, causing jaundice or pancreatitis.</li>
<li style="font-weight: 400;">Pancreatitis: Caused by stones blocking the common channel between the bile duct and pancreatic duct.</li>
</ul>
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<h3>Diagnosis</h3>
<ul>
<li style="font-weight: 400;">Ultrasound: The primary method to detect gallstones.</li>
<li style="font-weight: 400;">CT scan or MRI: Sometimes used to examine further details, such as combined bile duct stones or inflammation separate from other conditions.</li>
<li style="font-weight: 400;">Detection of bile duct stones found in 10-15% of cases with gallstones, such as blood tests, magnetic resonance cholangiopancreatography (MRCP), intraoperative cholangiogram (IOC), or endoscopic ultrasound (EUS).</li>
<li style="font-weight: 400;">Blood tests: To assess liver function and detect infection.</li>
</ul>
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<h3>Treatment</h3>
<ul>
<li style="font-weight: 400;">Cholecystectomy: The main treatment for symptomatic gallstones, which can be performed by open surgery or laparoscopically.</li>
<li style="font-weight: 400;">Medication: In some cases, medications to dissolve stones may be used, but treatment takes a long time and stones may recur.</li>
<li style="font-weight: 400;">Endoscopic retrograde cholangiopancreatography (ERCP): Used when stones block the bile duct or for diagnosis and treatment of other bile duct diseases.</li>
</ul>
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<h2>Prevention</h2>
<ul>
<li style="font-weight: 400;">Maintain a normal weight.</li>
<li style="font-weight: 400;">Avoid rapid weight loss.</li>
<li style="font-weight: 400;">Eat a low-fat, high-fiber diet.</li>
<li style="font-weight: 400;">Have an annual upper abdominal ultrasound.</li>
<li style="font-weight: 400;">Monitor for symptoms such as epigastric or right upper abdominal pain, bloating after meals, excessive gas, and abnormal yellowing of skin and eyes.</li>
</ul>
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If you suspect you may have gallstones or biliary system issues, consult a doctor promptly for proper diagnosis and treatment. This can prevent complications, reduce health risks, and lower emergency treatment costs, minimizing complications during unprepared times.
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Dr. Benjaporn Nantasanti
Advanced Surgical Interventional Technologies (ASIT) Center
Phyathai 3 Hospital
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Gallstones and Biliary System are common conditions that can affect health if not properly treated. Let's understand more about gallstones and the biliary system.

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