540 cases of clinical analysis of cholelithiasis complications: varying degrees of damage to the bile duct and capillary bile duct mucosal barrier, extensive purulent inflammatory changes in liver tissue nearby, formation of multiple abscesses, some fused into larger abscesses, ulceration reaching the diaphragm or bronchi, and formation of bronchial fistulas. Some form glass-like structures leading to abdominal cavity collapse and peritonitis. When bile duct stones are impacted at the bottom of the bile duct, apart from ordinary expansion outside the bile duct, the gallbladder also increases due to local inflammation, edema, and tissue necrosis, causing biliary perforation, resulting in bile peritonitis. The oppression of some bile duct stones on duct openings causes gallstone pancreatitis. Due to long-term stone oppression, local tissue necrosis and blood flow obstruction can wear through adjacent tissues or organs, resulting in biliary fistulas. Stones can also travel with the fistula through the sphincter into the duodenum or jejunum, causing gallstone ileus.
Due to biliary pressure or repeated episodes of lymphoid bile leakage around human liver cells or sinusoidal tracts, there is infiltration of inflammatory cells, fibrosis, liver tissue degeneration and necrosis, nodular hyperplasia of liver cells, and formation of biliary cirrhosis. Fibrous tissue and regeneration of liver cells in the portal vein lead to secondary portal hypertension. Repeated stimulation of stones and inflammation leads to proliferation of the bile duct mucosa, resulting in cancer, leading to bile duct or gallbladder cancer. Recurrent stones cause intrahepatic and extrahepatic bile duct wall thickening and hyperplasia, eventually resulting in benign bile duct stricture, increasing biliary obstruction and biliary tract infections, and also increasing processing difficulty.
Clinical features of powerful horse stone complications when cholelithiasis produces gallstone complications often present critical conditions that are difficult to treat, with high mortality rates.
A. Critical condition: mere cholelithiasis may have no obvious clinical symptoms, some as painless cholelithiasis. Even if there are symptoms, they are more ambiguous, such as abdominal distention after eating, fatigue, indigestion. If combined with gallstone complications, they often worsen the condition. Severe acute cholangitis is one of the serious complications of cholelithiasis, with rapid onset, rapid changes in condition, and high mortality.
B. Increase the difficulty of processing: simple cholelithiasis may be cured by non-surgical or elective surgery. Combined gallstone complications generally require surgery, and some even need emergency surgery. However, in critical conditions, liver damage, jaundice, water, and electrolyte disturbances only allow for simple surgical procedures to save lives, often requiring a second surgery in the future. Difficulties arise due to adhesion from the first surgery during the second surgery. Although some do not require emergency surgery, complex conditions like cirrhosis, portal vein disease, and stenosis, especially high bile duct stricture, are difficult to handle.
C. High mortality: cholelithiasis has a high number of hospitalizations after general surgery, with its fatality rate being the highest in general surgery. In China, out of 1195 hospitalized cases of cholelithiasis, 114 died, with a mortality rate of 9.5%. Among them, 101 cases of cholelithiasis complications died, accounting for 86.788.6% of deaths, mainly due to toxic shock and sepsis in this group of 815 cases, with a case fatality rate of 10.5%, consistent with domestic reports. 77 cases of gallstone concurrent recover from illness to death are shown in table 3. Qiu 377 cases of gallstone complications resulted in death due to gallbladder complications, including acute pancreatitis, biliary perforation, peritoneum involvement, hepatorenal syndrome, bile cirrhosis, portal hypertension, and bile heart swept Taiwan framed cholangiocarcinoma. To reduce the occurrence of cholelithiasis and mortality and improve the cure rate of cholelithiasis, early diagnosis and treatment must be achieved.
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