What medicine should be taken for intrahepatic bile duct stones?

Written by Zhang Tao
Hepatobiliary Surgery
Updated on September 10, 2024
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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.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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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.

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Hepatobiliary Surgery
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"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.

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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 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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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.