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.

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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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How to deal with inflammation and pain caused by intrahepatic bile duct stones?

For patients with intrahepatic bile duct stones, acute cholangitis may occur, which can cause fever and significant upper abdominal pain. At this time, antibiotic treatment should be used to control the infection, and the condition can be alleviated once the inflammation is under control. Moreover, if the condition recurs repeatedly, surgical treatment should be chosen. Only by surgically removing the stones can the symptoms be completely cured. Patients with intrahepatic bile duct stones should also be careful with their diet. They should avoid spicy and irritating foods to reduce inflammation, and eat more fresh vegetables and fruits that are rich in vitamins to better promote recovery. Patients who have undergone surgery should also have regular ultrasound check-ups to dynamically observe changes in their condition.

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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 Liu Wu Cai
Hepatobiliary Surgery
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Multiple intrahepatic bile duct stones

Multiple intrahepatic bile duct stones are a description used in imaging studies such as ultrasound and CT, meaning there are multiple stones within the intrahepatic bile ducts. Particularly in cases where there is recurrent upper right abdominal pain, the appearance of jaundice, chills, and high fever, it is important to pay attention and consider early surgical treatment. The main surgical approach is laparoscopic choledocholithotomy, which can completely treat the condition by removing the stones. Additionally, for patients with intrahepatic bile duct stones, it is also important to avoid spicy and irritating foods in their diet to reduce inflammatory irritation and better promote recovery from the condition. The diet should primarily consist of light meals, and eating fresh vegetables and fruits can better facilitate relief from the condition.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Is the incidence of intrahepatic bile duct stones high?

Intrahepatic bile duct stones have a relatively low incidence rate. They are a type of gallstone, and compared to gallbladder stones, their occurrence is less frequent. Patients with intrahepatic bile duct stones often experience concurrent cholangitis, leading to symptoms such as upper abdominal pain, significant nausea, and vomiting, along with other gastrointestinal symptoms. Therefore, for patients with intrahepatic bile duct stones, when significant symptoms occur, not only is the use of antibiotics necessary to treat the infection and control the inflammation, but surgery is also required to achieve therapeutic effects. The primary surgical method is choledochotomy for stone removal, which can lead to better treatment outcomes after the stones are extracted.