NTU Hospital Superintendent Huang Kuan-tang "Hong Chun-pei Culture and Education Foundation" Public Welfare Lecture

(Taiwan Business News) Last Sunday, Taiwan Business News and the Hong Chun-pei Culture and Education Foundation invited NTU Hospital Superintendent Huang Kuan-tang to give a lecture at the Sun Yat-sen Memorial Hall on "Liver and Gallbladder Health, Happy Life," sharing his experience from many years of medical practice and research in liver disease, from which the public benefited greatly. Huang Kuan-tang holds a doctorate from the Graduate Institute of Clinical Medicine at National Taiwan University and is an authority on hepatology in Taiwan, China. He has rich clinical experience and cares deeply about patients; often, before the resident physicians have even arrived at the ward, he has already gone to check on them.

The largest organ in the human body is the liver. The liver shoulders many important functions, but among us Orientals, especially Chinese people, the incidence of liver disease is also the highest. In Taiwan, China, hepatobiliary and gastrointestinal diseases are the national diseases that people most commonly suffer from. Through health checkups, one can correctly understand whether one's digestive organs are normal, so correctly interpreting health checkup results is especially important.

NTU Hospital Superintendent Huang Kuan-tang Public Welfare Lecture: The Silent Organ - Be Careful About Liver and Gallbladder Health

The liver is located at the lower right diaphragm. It weighs about 1.5 kilograms. Its main functions are producing proteins and producing anticoagulant factors, and it is also the largest immune organ in the human body. The liver also has the function of producing proteins and storing vitamins. Our immune globulins and many various proteins are all stored in the liver.

Our liver shoulders the task of human health. Once it is damaged and its functions are affected, it will cause abnormal metabolism in the body and thereby trigger diseases and serious problems such as hepatitis, jaundice, fatty liver, cirrhosis, cholecystitis, indigestion, and drug poisoning.

Because the liver has no nerves, even if one suffers from liver disease, there will be no sensation of pain, and early-stage liver disease also has no symptoms, so patients are not easily discovered in the early stage of illness. To maintain a healthy liver, one needs to regularly undergo liver function tests, high-risk groups should receive hepatitis vaccinations, avoid casually taking artificial drugs, avoid overeating and excessive drinking, pay attention to food hygiene, try not to smoke, try to avoid processed foods, avoid contact with other people's blood, and avoid staying up late and overworking.

The liver has a detoxification function and secretes a lot of bile. Bile is produced by the liver. Bile flows back from the hepatic duct into the gallbladder. After food enters the stomach, a message is fed back to the gallbladder, and the gallbladder contracts to produce bile, which enters the duodenum, then flows from the duodenum to the small intestine and large intestine. Throughout the entire digestive process, bile mainly helps with the digestion and absorption of fats.

People who have had their gallbladder removed are more prone to diarrhea, because their bile flows out continuously as usual. Without regulation by the gallbladder, it keeps flowing into our intestines, so when eating, its concentration is not particularly high, which causes indigestion.

There are usually three more common types of hepatitis: one is alcoholic hepatitis, one is drug-induced hepatitis, and one is viral hepatitis. Alcoholic hepatitis is very easily contracted by drinkers, because alcohol is harmful to the liver, described as a burning kind of damage. Drinking a small cup of spirits every day, after thirteen months, a liver biopsy can reveal early signs of cirrhosis. So alcohol really does harm the liver.

In fact, the liver has no way to metabolize alcohol. Where is alcohol metabolized? It is slowly broken down in the bloodstream; it is not metabolized by the liver. Why do people's faces turn red when they drink? It is because alcohol dilates blood vessels in the human body. During the decomposition process, it produces many substances that dilate blood vessels, so the face turns red. This is completely contrary to our common belief that a red face after drinking means one's liver is very capable and has metabolized the alcohol, but the result is not like that at all. That is to say, whether or not your face turns red has absolutely nothing to do with your liver's detoxification function. The key to whether your face turns red is that a person has an alcohol-decomposing enzyme. This decomposing enzyme is innate, and its concentration is determined from birth, related to genetics. So some people's fathers can drink, and the sons can drink very well too; in fact, it is just that their faces do not turn red, but the damage caused to the liver is exactly the same.

Alcohol in our bodies is slowly broken down by enzymes within our body, not personally broken down by the liver. When the liver breaks down alcohol, in fact, it uses the lives of liver cells in exchange for breaking down the alcohol. We know that although the liver has regenerative capacity, once liver cells die, what replaces them is a kind of fiber cell, fibroblasts. Fibroblasts will cause the liver to harden, and the hardened part of the liver cannot carry out regenerative functions. Once the liver has hardened, it actually cannot regenerate. A liver that has been cut can regenerate, but the hardened part does not easily regenerate.

When the liver is inflamed, the patient's GOT and GPT will first rise, and then bilirubin will rise and the patient will develop jaundice. When the patient enters the recovery period, GOT and GPT will first fall, and then bilirubin will fall and the jaundice will disappear. As for patients with cirrhosis, when liver function deteriorates and cannot bear the body's needs, bilirubin may remain unable to fall to the normal range.

Gallstones are the most common lesion seen on gallbladder ultrasound. Under ultrasound, a bright white lesion can be seen, sometimes with a dark tail trailing behind it, like a comet. According to research, people with a family history of gallstones, high cholesterol, obesity, women who have been pregnant multiple times, middle-aged women, and people who are fond of high-cholesterol foods, greasy foods, and sweet foods are more likely to suffer from gallstones.

In terms of treatment, gallstones in Chinese people have low cholesterol content, so using ultrasound to break them up or drugs to dissolve them is currently unrealistic. It is recommended that patients with recurrent biliary colic or acute cholecystitis attacks should be arranged for surgical treatment. Currently, 75% of patients can undergo laparoscopic surgical removal, which is fast and convenient.

Gallbladder polyps may be mucosal hyperplasia, adenomas, cholesterol polyps, or inflammatory polyps, and in a very small number of cases they are malignant lesions. Under ultrasound, they look like a polyp stuck to the gallbladder wall, and the vast majority of patients have no symptoms.

Which gallbladder polyps carry potential danger, and which ones need surgical removal of the gallbladder? If a gallbladder polyp is symptomatic, regardless of size, surgical removal is recommended in all cases. If an asymptomatic gallbladder polyp has a diameter greater than one centimeter, removal is relatively safer; for lesions with a diameter less than one centimeter, careful observation and follow-up are required, and if there are complications or symptoms, surgery should also be accepted. After an interval of six months to one year, ultrasound examination can be done to observe changes. If there are no changes after two or three years, the frequency of examinations can gradually be reduced. There is no absolute way to prevent gallbladder polyps, but basically it is still best to avoid a high-cholesterol diet and to supplement enough water.

Hong Chun-pei Culture and Education Foundation 103rd Year Public Welfare Lecture