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

Written by Zhang Tao

Hepatobiliary Surgery

Updated on September 02, 2024

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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.

Other Voices

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Written by Liu Wu Cai

Hepatobiliary Surgery

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What to do about vomiting due to intrahepatic bile duct stones?

Patients with intrahepatic bile duct stones often have concomitant acute cholangitis, presenting with prominent right upper abdominal pain. Thus, they may experience clinical symptoms such as nausea, vomiting, chills, high fever, and jaundice. At this point, treatment should involve the use of antibiotics to combat the infection. Once the inflammation is controlled, the condition can be alleviated. Gastric protective drugs can also be used for symptomatic treatment to better relieve symptoms. However, for patients with symptomatic intrahepatic bile duct stones, the primary treatment is surgical, which is the only way to cure the condition completely. Conservative treatment can only alleviate symptoms. The surgical method mainly involves laparoscopic choledochotomy for stone removal, which can cure the condition by removing the stones.

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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

53sec

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Do people with intrahepatic bile duct stones experience weight loss?

Generally, patients with intrahepatic bile duct stones do not experience weight loss. If there is a significant weight decrease over a short period of time, resulting in weight loss or even cachexia, attention should be raised. It is necessary to complete relevant examinations to determine if there are malignant tumors. For patients with intrahepatic bile duct stones, although they may repeatedly experience upper abdominal pain and discomfort, along with nausea and vomiting, and sometimes concurrent cholangitis that results in jaundice, generally, it does not affect their weight. Of course, the condition of patients with intrahepatic bile duct stones should be actively managed. For treatment, typically, laparoscopic choledochotomy for stone removal is chosen, which can completely eliminate the stones and significantly improve the patients' quality of life.

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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

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.