Subscribe
Hepatolithiasis
What medicine should be taken for intrahepatic bile duct stones?
The treatment of intrahepatic bile duct stones currently does not have specific medications. Traditional Chinese medicine treatments primarily focus on clearing the liver and facilitating bile flow, and have certain clinical effects. Western medicine often uses deoxycholic acid, ursodeoxycholic acid, and chenodeoxycholic acid, which can somewhat prevent the formation of bile duct stones. It is also recommended that patients change poor lifestyle habits, adjust their life rhythms, and eat three meals a day at regular times, especially breakfast. Specific medications should be used under the guidance of a doctor.
Can gallstones within the liver that don't cause pain be ignored?
For patients with intrahepatic bile duct stones who do not experience any discomfort, abdominal pain, or jaundice, it is possible to temporarily observe without special treatment. However, special attention should be paid to the diet. It is advisable to avoid spicy and stimulating foods such as chili peppers, barbecue, and garlic, as these inflammatory irritants may cause local inflammation and even lead to acute cholecystitis and cholangitis. Additionally, the diet should also avoid foods high in cholesterol and fats, such as animal offal and fatty meats, as these foods can exacerbate symptoms. Therefore, although patients with intrahepatic bile duct stones may not exhibit any symptoms, it is still important to pay attention to daily life.
What should be noted for intrahepatic bile duct stones?
Patients with intrahepatic bile duct stones should pay attention to the following: First, try to reduce the intake of fats, especially animal fats; second, the formation of a considerable number of intrahepatic bile duct stones is related to high cholesterol levels and metabolic disorders in the body, so it is necessary to limit foods high in cholesterol, such as eggs and the organs of various meat animals; third, food should be prepared by steaming, boiling, or stewing; fourth, increase the supply of fish, lean meats, soy products, and fresh fruits and vegetables.
Do people with intrahepatic bile duct stones experience weight loss?
Generally, patients with intrahepatic bile duct stones do not experience weight loss. If there is a significant weight decrease over a short period of time, resulting in weight loss or even cachexia, attention should be raised. It is necessary to complete relevant examinations to determine if there are malignant tumors. For patients with intrahepatic bile duct stones, although they may repeatedly experience upper abdominal pain and discomfort, along with nausea and vomiting, and sometimes concurrent cholangitis that results in jaundice, generally, it does not affect their weight. Of course, the condition of patients with intrahepatic bile duct stones should be actively managed. For treatment, typically, laparoscopic choledochotomy for stone removal is chosen, which can completely eliminate the stones and significantly improve the patients' quality of life.
"Intrahepatic bile duct stones"
Intrahepatic bile duct stones, as the name implies, are stones located within the bile ducts inside the liver. The biliary tract is divided into extrahepatic and intrahepatic bile ducts. The intrahepatic bile ducts refer to the left and right hepatic ducts and their related branches. The intrahepatic bile ducts evolve from the left and right hepatic ducts into the common hepatic duct, common bile duct, and gallbladder, which are part of what we commonly refer to as the extrahepatic bile ducts. The symptoms of intrahepatic bile duct stones are not as apparent as those of common bile duct stones, but most intrahepatic bile duct stones cause upper abdominal pain in patients; generally, jaundice does not occur.
Do you need to cut the liver for intrahepatic bile duct stones?
The treatment of intrahepatic bile duct stones primarily requires surgery to remove the stones, relieve obstruction, and correct deformities. Generally, there is no need to remove the liver. However, if the liver has a tumor, or if intrahepatic bile duct stones are accompanied by liver fibrosis or even liver atrophy, partial liver lobe resection can be considered. For asymptomatic patients with intrahepatic bile duct stones, temporary observation and follow-up are feasible.
Is the likelihood of malignant transformation of intrahepatic bile duct stones high?
Intrahepatic bile duct stones have a relatively low probability of becoming cancerous. Patients with intrahepatic bile duct stones may develop acute cholangitis, presenting with symptoms like severe pain in the upper right abdomen, nausea, vomiting, jaundice, and systemic infectious symptoms such as chills and high fever, but generally, these stones do not become cancerous. When patients with intrahepatic bile duct stones exhibit significant symptoms, it is important to take them seriously and perform timely surgical treatment to achieve a radical cure. The main surgical approach is laparoscopic salpingotomy for stone removal, which can lead to better treatment outcomes. Additionally, dietary adjustments should include avoiding spicy and irritating foods to reduce inflammatory stimuli and better prevent exacerbation of the condition.
Surgical treatment methods for intrahepatic bile duct stones
Asymptomatic intrahepatic bile duct stones do not require treatment; regular follow-up examinations are recommended. Surgical treatment should be considered for those with recurring clinical symptoms. The principle of surgical treatment is to remove the stones as much as possible, identify and address bile duct strictures and obstructions, remove infected areas and the sites of stones to restore and establish unobstructed bile drainage, and prevent recurrence of the stones. Surgical methods include choledochotomy for stone removal, bilioenteric anastomosis, and hepatectomy.
Intrahepatic bile duct stones B-ultrasound manifestations
Intrahepatic bile duct stones show typical sonographic changes on ultrasound, appearing as punctate or mass-like strong echoes within the liver, accompanied by acoustic shadows. These strong echoes are distributed along the intrahepatic bile ducts. The bile duct proximal to the stone may exhibit varying degrees of dilation, and the dilated intrahepatic bile duct, along with the accompanying portal vein, forms a parallel tube sign. Around the strong echoes of the stones, a narrow anechoic region can be seen encircling them, and the stones generally do not move with changes in body position. Intrahepatic bile duct stones can also cause thickening of hepatic parenchyma echoes and internal echo heterogeneity.
Can intrahepatic bile duct stones be shattered?
Asymptomatic intrahepatic bile duct stones generally do not require treatment. Currently, most hepatobiliary surgeons believe that if patients undergo shock wave lithotripsy, the stones may migrate to the extrahepatic bile duct, forming common bile duct stones, and the patient will experience obvious abdominal pain, jaundice, and other symptoms, causing great trouble. Therefore, they oppose extracorporeal shock wave treatment for intrahepatic bile duct stones and suggest regular follow-up with ultrasound or CT, adopting more reasonable methods for treatment.