How is intrahepatic bile duct stones treated?

Written by Zhang Tao
Hepatobiliary Surgery
Updated on September 13, 2024
00:00
00:00

Intrahepatic bile duct stones refer to stones located in the branches of the bile duct above the junction of the left and right hepatic ducts. Surgical treatment is currently the main method of treatment. Treatment should be based on the number and distribution of stones within the bile ducts, the location and extent of hepatic and biliary strictures, pathological changes in the liver, the state of liver function, and the patient's overall symptoms. Appropriate surgical approaches should be adopted, including hepatectomy, high position bile ductotomy for stone removal, transhepatic choledochotomy for stone removal, biliary-intestinal internal drainage, liver transplantation, etc.

Other Voices

doctor image
home-news-image
Written by Zhang Tao
Hepatobiliary Surgery
48sec home-news-image

Symptoms of intrahepatic bile duct stones

Intrahepatic bile duct stones, depending on the duration and pathology, can present with various clinical manifestations. In the early stages, patients generally do not show obvious symptoms, with stones limited to a certain segment within the intrahepatic bile ducts. In later stages, stones can be found throughout the intra- and extrahepatic biliary system, and may even lead to biliary cirrhosis, liver atrophy, and liver abscesses. The clinical manifestations can include: first, pain in the upper abdomen; second, a long history of biliary tract diseases, with patients experiencing chills, fever, and jaundice; third, frequent pain and discomfort in the liver area on the affected side and the lower chest, which can radiate to the shoulder and back, etc.

doctor image
home-news-image
Written by Liu Wu Cai
Hepatobiliary Surgery
49sec home-news-image

Is the incidence of intrahepatic bile duct stones high?

Intrahepatic bile duct stones have a relatively low incidence rate. They are a type of gallstone, and compared to gallbladder stones, their occurrence is less frequent. Patients with intrahepatic bile duct stones often experience concurrent cholangitis, leading to symptoms such as upper abdominal pain, significant nausea, and vomiting, along with other gastrointestinal symptoms. Therefore, for patients with intrahepatic bile duct stones, when significant symptoms occur, not only is the use of antibiotics necessary to treat the infection and control the inflammation, but surgery is also required to achieve therapeutic effects. The primary surgical method is choledochotomy for stone removal, which can lead to better treatment outcomes after the stones are extracted.

doctor image
home-news-image
Written by Liu Wu Cai
Hepatobiliary Surgery
57sec home-news-image

Can MRCP detect intrahepatic bile duct stones?

Patients with intrahepatic bile duct stones can undergo MRCP examination. For patients with intrahepatic bile duct stones, in addition to being noticeable in ultrasound, CT, and MRI examinations, MRCP can also be performed, and it is also a method of treatment. Moreover, whether treatment is needed for patients with intrahepatic bile duct stones mainly depends on the symptoms. For asymptomatic patients with intrahepatic bile duct stones, if the stones are relatively small in size, no special treatment is necessary. Avoiding spicy and irritating foods in the diet to reduce inflammatory stimuli can help manage the condition. However, for patients with larger intrahepatic bile duct stones, acute cholangitis may occur, presenting as significant upper abdominal pain. In such cases, early surgical intervention should be considered for treatment.

doctor image
home-news-image
Written by Liu Wu Cai
Hepatobiliary Surgery
1min 1sec home-news-image

Do intrahepatic bile duct stones fear cold?

Patients with intrahepatic bile duct stones can possibly experience chills. This is because patients with intrahepatic bile duct stones often have concurrent cholangitis, which manifests as chills, high fever, prominent upper abdominal pain, and jaundice. In severe cases, it can even lead to acute suppurative cholangitis, septic shock, and death. Therefore, for patients with intrahepatic bile duct stones presenting with significant symptoms, early surgical treatment is advised. Surgery involves opening the bile duct to remove the stones, which can be curative. Post-surgery, it is still necessary to avoid spicy and irritating foods, such as peppers, barbecues, and garlic, and to mainly consume a bland diet with plenty of fresh vegetables and fruits to facilitate recovery. After recovery, patients generally do not experience significant discomfort.

doctor image
home-news-image
Written by Liu Wu Cai
Hepatobiliary Surgery
50sec home-news-image

Can liver intrahepatic bile duct stones be detected by ultrasound?

Patients with intrahepatic bile duct stones can be detected via ultrasound examination, where the stones are clearly visible, especially for those with larger stones. These patients may also experience recurrent right upper abdominal pain, nausea, and vomiting. For patients with intrahepatic bile duct stones who exhibit significant symptoms, it is advisable to undergo surgical treatment as soon as possible. Only by surgically opening the bile duct and removing the stones can a cure be achieved. However, if the stones are relatively small and asymptomatic, they might not be detected during an ultrasound examination, and no special treatment is required at that time. If small gallstones are observed, it is recommended to regularly recheck with an ultrasound to monitor changes in size.