【Common Diseases】Gallstones
Gallstones: A Breakdown of Treatments in Hong Kong | Causes, Symptoms, Surgical Options, and Recurrence Risk
Hello everyone, after researching various Hong Kong and international medical websites, I've discovered that gallstones are not uncommon in Hong Kong. Middle-aged women, obese individuals, diabetics, and those who consume a high-fat diet are particularly at risk. Many people assume surgery is essential when they hear the word "gallstones." However, there are many treatment options, and not everyone needs surgery immediately. I've compiled a super detailed guide for your reference.
What are gallstones?
Gallstones are solid particles of cholesterol, bile pigments, or calcium salts that crystallize in the gallbladder or bile ducts . They vary in size, from as small as a grain of sand to as large as a ping-pong ball. In most cases, gallstones may not cause obvious symptoms in the early stages. However, once they become lodged in the bile duct, they can cause severe pain (commonly known as "biliary colic"), which may be accompanied by fever and jaundice.
Common Causes of Gallstones in Hong Kong
According to the Hong Kong Hospital Authority and private doctors, common causes include:
- High cholesterol : The cholesterol concentration in bile is too high, causing it to precipitate and form stones.
- Poor bile emptying : For example, long-term low food intake or rapid weight loss can lead to reduced gallbladder contraction and bile retention.
- Blood disorders , such as hemolytic anemia, increase the risk of pigment stones.
- Female hormones : Estrogen can increase cholesterol secretion, so women, especially those who are pregnant or taking birth control pills, are at higher risk.
Gallstone symptoms
Some patients may be unaware of their gallstones for years (called "asymptomatic gallstones"). However, once symptoms develop, common symptoms include:
- Severe pain in the right upper abdomen or stomach, which may extend to the back or right shoulder
- Attacks after meals, especially greasy foods
- Nausea and vomiting
- Fever and chills (possibly cholecystitis or cholangitis)
- Yellowing of the skin and the whites of the eyes (jaundice)
⚠️ If accompanied by fever and jaundice, it is a dangerous signal and requires immediate hospitalization.
Gallstone treatment in Hong Kong
1. Observation and lifestyle management (applicable to asymptomatic patients)
- Principle : If gallstones are not causing symptoms, your doctor may recommend regular observation rather than immediate surgery.
- Dietary adjustments : low-fat diet, weight control, and avoid overeating.
- Risks : Although most asymptomatic people can live peacefully for a long time, a small number of them will suddenly develop an attack.
2. Medical litholysis therapy
- Principle : Ursodeoxycholic acid (UDCA) is taken orally to help dissolve cholesterol gallstones.
- Limitations : It is only suitable for small pure cholesterol stones and requires long-term use (six months to two years). There is a risk of recurrence after discontinuation of the drug.
- Situation in Hong Kong : It is provided in private clinics and some public hospitals, but it is not a routine treatment.
3. Endoscopic treatment (ERCP)
- Applicable situations : Stones stuck in the common bile duct, causing jaundice or cholangitis.
- Procedure : An endoscope is inserted through the mouth into the duodenum, and the bile duct is opened to remove the stone.
- Advantages : Minimally invasive, no need for gallbladder removal.
- Disadvantages : It cannot prevent the regeneration of gallstones in the gallbladder and may recur in the future.
4. Laparoscopic Cholecystectomy
- The most common treatment method in Hong Kong : This is the standard treatment for symptomatic gallstones in both public and private medical institutions.
- Procedure : Under general anesthesia, the gallbladder is removed endoscopically through several small incisions in the abdomen.
- Advantages : less trauma, faster recovery, and shorter hospital stay (usually 1-3 days).
- Disadvantages : After gallbladder removal, some people may experience mild indigestion or diarrhea.
5. Open Cholecystectomy
- Applicable situations : severe cholecystitis, abdominal adhesions or laparoscopy is not possible.
- Disadvantages : Large wound and long recovery period.
Post-operative precautions (commonly recommended by Hong Kong doctors)
- Diet : Avoid high-fat and spicy foods in the early stages and gradually resume a normal diet.
- Life : Avoid strenuous exercise in the short term and keep the wound clean.
- Risk of recurrence : After cholecystectomy, gallstones generally will not recur, but bile duct stones may still develop, so regular follow-up visits are necessary.
Editor's Tips
Although gallstones are a common condition in Hong Kong, each person's condition, constitution, and lifestyle vary. Treatment options aren't one-size-fits-all; your doctor should tailor the most appropriate plan based on clinical examination, ultrasound, or CT scan results. In many cases, doctors may not recommend immediate surgery if there are no symptoms. However, if severe pain, fever, or jaundice occur, it's important to seek medical attention immediately to avoid serious complications such as gallbladder perforation and acute pancreatitis.
This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles
