Porcelain gallbladder refers to extensive calcification of the gallbladder wall, also known as calcified gallbladder, porcelain bottle-like gallbladder, porcelain gallbladder, and porcelain gallbladder disease, etc. Some authors speculate that porcelain gallbladder may be a special and rare manifestation of chronic cholecystitis; others believe that porcelain gallbladder is one of the complications of gallstones.
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Porcelain gallbladder
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1. What are the etiologies of porcelain gallbladder?
2. What complications are porcelain gallbladder prone to cause?
3. What are the typical symptoms of porcelain gallbladder?
4. How should porcelain gallbladder be prevented?
5. What laboratory tests are needed for porcelain gallbladder?
6. Diet taboos for patients with porcelain gallbladder
7. Conventional methods of Western medicine for the treatment of porcelain gallbladder
1. What are the etiologies of porcelain gallbladder?
How is porcelain gallbladder caused? The following is a brief description:
1. Etiology
Brinzeu observed that porcelain gallbladder may exist three local pathogenic factors: chronic tendency to form calculi in the neck, which blocks the gallbladder duct; chronic inflammation of the gallbladder wall; and obstruction of the gallbladder artery, leading to ischemia of the entire gallbladder. Other possible causes of porcelain gallbladder include bleeding within the gallbladder wall during chronic cholecystitis and abnormal calcium metabolism. The above speculations can only explain the possibility of porcelain gallbladder formation from certain aspects.
2. Pathogenesis
The pathogenesis of porcelain gallbladder is not yet clear. Since the majority of porcelain gallbladders (60% to 95%) have concurrent cholecystitis, some authors speculate that porcelain gallbladder may be a special and rare manifestation of chronic cholecystitis; others believe that porcelain gallbladder is one of the complications of gallstones, and it is often filled with calcium carbonate in the resected gallbladder specimens. The obstruction of bile ducts may lead to the accumulation of calcium carbonate, which can promote calcification of the gallbladder wall. About 60% of porcelain gallbladders may also be accompanied by cholelithiasis; other complications of gallstones include pancreatitis, biliary-enteric fistula, hydronephrosis, calcareous bile, and gallbladder cancer, etc.
2. What complications can ceramic-like gallbladder easily lead to?
Because the clinical symptoms of patients with ceramic-like gallbladder are non-specific, when the disease occurs, the complications that appear are the same as those of cholecystitis and gallstones, which may include cholangiocarcinoma, bile duct stones, and secondary infection.
3. What are the typical symptoms of ceramic-like gallbladder?
The clinical symptoms of patients with ceramic-like gallbladder are non-specific, most presenting with symptoms of biliary colic and cholecystitis, about 1/3 of patients may have no clinical symptoms at all, and are only discovered incidentally during X-ray or ultrasound. It is common in people aged 50 to 60, with female patients being five times more than male patients. The clinical symptoms highly overlap with those of cholecystitis and gallstones, and diagnosis depends on various examinations such as ultrasound, CT, X-ray, and pathology.
4. How to prevent ceramic-like gallbladder?
How to prevent ceramic-like gallbladder? It is no more than the following points:
1, Engage in physical activities regularly to activate the metabolism of the whole body, especially for middle-aged people who are engaged in intellectual labor and always sit at work, they should consciously do more physical labor to prevent excessive obesity, as obesity is an important cause of cholecystitis or gallstones.
2, Pay attention to dietary hygiene, avoid overeating and excessive intake of fatty foods. Because after eating fatty foods, the gallbladder will contract reflexively, and once the contraction is too strong, it will lead to an acute attack of biliary colic.
3, After the autumn cool, pay attention to keeping warm, especially cover the quilt well when sleeping to prevent the abdomen from being cold, because after the abdomen is cold, it will stimulate the vagus nerve, causing the gallbladder to contract strongly.
4, People who have been proven to have gallstones should be treated in a timely manner to avoid causing cholecystitis.
5, When there are intestinal worms (mainly ascaris), apply vermifuges in a timely manner, and the dosage should be sufficient to prevent insufficient medication, as ascaris are active and easy to penetrate into the bile duct, causing obstruction and leading to cholecystitis.
6, When inflammation occurs, apply effective antibiotics in a timely manner.
7, Some traditional Chinese medicine can be taken, and the effect is also good.
5. What laboratory tests should be done for a ceramic-like gallbladder?
What examinations should be done for a ceramic-like gallbladder? Briefly described as follows:
Ultrasound and abdominal X-ray are routine examinations. CT can exclude certain tumors. Oral gallbladder imaging is simple to perform and can simultaneously display gallstones and gallbladder function, but only 60% of patients can achieve satisfactory results with a single imaging. Intrahepatic cholangiography can overcome gastrointestinal effects and can be used when oral double-dose contrast agent is still not visible. In cases with jaundice and when tumors are not excluded, endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) can be directly used to shorten the examination time. Fine needle aspiration biopsy (EUS and FNA) guided by endoscopic ultrasound has minimal trauma and can be considered for patients suspected of having tumors. For those with ERCP indications but unable to undergo ERCP or those with failed EPCP, magnetic resonance cholangiopancreatography (MRCP) examination can be performed.
6. Dietary Recommendations and Taboos for Ceramic Gallbladder Patients
Patients with ceramic gallbladder should eat less high-fat, high-cholesterol foods such as egg yolks, fish roe, animal liver, brain and intestines. The increase in cholesterol in bile is prone to form cholesterol stones. Vegetable oils can not only reduce cholesterol but also promote the conversion of cholesterol into bile acids, preventing the formation of gallstones, so it is advisable to use vegetable oils as the main source. Fried and fried foods should be avoided to prevent the induction of biliary colic. Cooking should be as light and low in oil as possible, preference should be given to steaming and boiling, and frying and frying should be avoided. Eat more foods rich in vitamin A, such as carrots, tomatoes, and other yellow and red fruits and vegetables. Since vitamin A can maintain the integrity of the gallbladder wall epithelium, it can also reduce the formation of cholesterol stones. Radishes, fruit juices, shepherd's purse, hawthorn, and other foods have the effects of promoting bile and soothing the liver, and can be eaten regularly. Increase the proportion of protein and carbohydrates in food to ensure heat requirements and promote the formation of glycogen. Reducing the fiber content and low-fiber diet can also reduce the stimulation to the gastrointestinal tract.
7. Conventional Western Treatment Methods for Ceramic Gallbladder
Currently, most experts still believe that cholecystectomy should be performed for ceramic gallbladders, especially for non-'true' ceramic gallbladders. Laparoscopic surgery or cholecystoscopy can be considered. Since very few gallbladder cancers can be diagnosed before surgery, full preparation should be made before and during surgery.
Patients with 'true' ceramic gallbladders often have concurrent bile duct stone disease, and the gallbladder function is generally lost. Whether to perform cholecystectomy mainly depends on the patient's symptoms. For patients with selective gallbladder wall calcification, the opportunity for concurrent gallbladder malignant tumors is significantly increased, and such ceramic gallbladders should consider early prophylactic surgical resection.
Currently, there are few reports on the diagnosis and treatment of this disease in China, and there is a lack of accurate statistical data. Overall, based on foreign data, there is a certain possibility of carcinogenesis in ceramic gallbladders, but most authors still advocate for prophylactic surgical resection of ceramic gallbladders.
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