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 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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Do you need to cut the liver for intrahepatic bile duct stones?

The treatment of intrahepatic bile duct stones primarily requires surgery to remove the stones, relieve obstruction, and correct deformities. Generally, there is no need to remove the liver. However, if the liver has a tumor, or if intrahepatic bile duct stones are accompanied by liver fibrosis or even liver atrophy, partial liver lobe resection can be considered. For asymptomatic patients with intrahepatic bile duct stones, temporary observation and follow-up are feasible.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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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 Li Fei Rong
General Surgery
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Surgical treatment methods for intrahepatic bile duct stones

Asymptomatic intrahepatic bile duct stones do not require treatment; regular follow-up examinations are recommended. Surgical treatment should be considered for those with recurring clinical symptoms. The principle of surgical treatment is to remove the stones as much as possible, identify and address bile duct strictures and obstructions, remove infected areas and the sites of stones to restore and establish unobstructed bile drainage, and prevent recurrence of the stones. Surgical methods include choledochotomy for stone removal, bilioenteric anastomosis, and hepatectomy.

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Written by Zhang Tao
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.