What should I do if I always have back pain due to intrahepatic bile duct stones?

Written by Liu Wu Cai
Hepatobiliary Surgery
Updated on March 09, 2025
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If patients with intrahepatic bile duct stones repeatedly experience back pain, this should be taken seriously. Intrahepatic bile duct stones often coincide with acute cholangitis, which can cause discomfort and pain in the upper right abdomen. There might also be radiating pain in the right shoulder and scapular area, resulting in a sensation of soreness. At this time, antibiotic treatment should be used to fight the infection. Once the inflammation is under control, the condition can be alleviated. Of course, if the symptoms recur, surgical treatment should be carried out as soon as possible. Only surgery can achieve a complete cure, significantly improving the patient's quality of life and alleviating the condition more effectively.

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Written by Liu Wu Cai
Hepatobiliary Surgery
58sec home-news-image

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 Liu Wu Cai
Hepatobiliary Surgery
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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.

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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
Hepatobiliary Surgery
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How is intrahepatic bile duct stones treated?

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.

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Written by Zhang Tao
Hepatobiliary Surgery
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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.