Multiple intrahepatic bile duct stones

Written by Liu Wu Cai
Hepatobiliary Surgery
Updated on September 17, 2024
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Multiple intrahepatic bile duct stones are a description used in imaging studies such as ultrasound and CT, meaning there are multiple stones within the intrahepatic bile ducts. Particularly in cases where there is recurrent upper right abdominal pain, the appearance of jaundice, chills, and high fever, it is important to pay attention and consider early surgical treatment. The main surgical approach is laparoscopic choledocholithotomy, which can completely treat the condition by removing the stones. Additionally, for patients with intrahepatic bile duct stones, it is also important to avoid spicy and irritating foods in their diet to reduce inflammatory irritation and better promote recovery from the condition. The diet should primarily consist of light meals, and eating fresh vegetables and fruits can better facilitate relief from the condition.

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Written by Li Hu Chen
Imaging Center
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Ultrasound presentation of intrahepatic bile duct stones

Intrahepatic bile duct stones can generally be detected via ultrasound, as they show up as strong echoes due to their solid nature which reflects sound waves back to the surface. However, the majority of these intrahepatic bile duct stones are asymptomatic. Since they rarely cause dilation of the intrahepatic bile ducts, and as long as the bile ducts do not appear dilated, thickened, or tortuous on the ultrasound, they usually do not have any significant impact. Therefore, most intrahepatic bile duct stones do not require treatment and can be managed through observation.

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Written by Zhang Tao
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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.

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Written by Shen Jiang Chao
Radiology
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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.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Are intrahepatic bile duct stones the same as gallstones?

Intrahepatic bile duct stones are a type of gallstone, and patients with intrahepatic bile duct stones often develop cholangitis. Thus, patients may exhibit symptoms such as chills, high fever, jaundice, and significant upper abdominal pain. They might also experience nausea and vomiting. In severe cases, the condition can lead to acute obstructive suppurative cholangitis, septic shock, and even result in death. Therefore, intrahepatic bile duct stones should be taken seriously. If significant symptoms occur, it is advisable to undergo surgery as soon as possible. The surgical method can be a laparoscopic choledochotomy to remove the stones, which can be curative. Gallstones also include gallbladder stones, which are a common type clinically. If symptoms occur, the treatment method is also surgical, involving the removal of the gallbladder to achieve a cure.

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Written by Zhang Tao
Hepatobiliary Surgery
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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.