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 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.

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Written by Zhang Tao
Hepatobiliary Surgery
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Can people with intrahepatic bile duct stones eat sweet potatoes?

Intrahepatic bile duct stones can cause upper abdominal pain during acute episodes, which is generally closely related to the patient's careless diet. Sweet potatoes are a type of food that may induce gastric acid production. If a patient has intraheptic bile duct stones and consumes sweet potatoes, it may cause stomach discomfort. Therefore, it is recommended that patients generally avoid eating sweet potatoes or not eat them excessively.

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Hepatobiliary Surgery
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Symptoms of intrahepatic bile duct stones

Intrahepatic bile duct stones, depending on the duration and pathology, can present with various clinical manifestations. In the early stages, patients generally do not show obvious symptoms, with stones limited to a certain segment within the intrahepatic bile ducts. In later stages, stones can be found throughout the intra- and extrahepatic biliary system, and may even lead to biliary cirrhosis, liver atrophy, and liver abscesses. The clinical manifestations can include: first, pain in the upper abdomen; second, a long history of biliary tract diseases, with patients experiencing chills, fever, and jaundice; third, frequent pain and discomfort in the liver area on the affected side and the lower chest, which can radiate to the shoulder and back, etc.

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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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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.