Can intrahepatic bile duct stones be shattered?

Written by Zhang Tao

Hepatobiliary Surgery

Updated on September 01, 2024

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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

54sec

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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 Liu Wu Cai

Hepatobiliary Surgery

55sec

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What are the sequelae of liver resection for intrahepatic bile duct stones?

Patients with intrahepatic bile duct stones do not have significant sequelae after liver resection because the area of the liver removed during the surgery is relatively small, generally not causing significant effects. Furthermore, for patients with intrahepatic bile duct stones, the main treatment involves making an incision in the bile duct to remove the stones, which can completely cure the condition, and patients can typically recover within about seven days after the surgery. Since the procedure is mainly performed using laparoscopy, it has the advantages of smaller incisions, less damage, and faster recovery. Therefore, postoperative recovery is relatively good. At this time, patients can also avoid spicy and irritating foods in their diet to reduce inflammatory irritation, better promoting recovery from the condition. There are no significant sequelae after the resection.

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Written by Liu Wu Cai

Hepatobiliary Surgery

49sec

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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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Written by Liu Wu Cai

Hepatobiliary Surgery

57sec

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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.