Are intrahepatic bile duct stones the same as gallstones?

Written by Liu Wu Cai
Hepatobiliary Surgery
Updated on September 27, 2024
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Intrahepatic bile duct stones are a type of gallstone, and patients with intrahepatic bile duct stones often develop cholangitis. Thus, patients may exhibit symptoms such as chills, high fever, jaundice, and significant upper abdominal pain. They might also experience nausea and vomiting. In severe cases, the condition can lead to acute obstructive suppurative cholangitis, septic shock, and even result in death. Therefore, intrahepatic bile duct stones should be taken seriously. If significant symptoms occur, it is advisable to undergo surgery as soon as possible. The surgical method can be a laparoscopic choledochotomy to remove the stones, which can be curative. Gallstones also include gallbladder stones, which are a common type clinically. If symptoms occur, the treatment method is also surgical, involving the removal of the gallbladder to achieve a cure.

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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 Zhang Tao
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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Will intrahepatic bile duct stones cause a bluish complexion?

Patients with intrahepatic bile duct stones, if experiencing an episode, may exhibit symptoms such as sharp pain in the upper right abdomen, often accompanied by nausea, vomiting, abdominal bloating, and diarrhea. These patients are prone to acute cholangitis. Additionally, this condition is a type of biliary colic, thus the pain is significant and may even manifest as a bluish complexion. Therefore, patients with prominent symptoms should undergo surgery as soon as possible. Surgery is the only definitive treatment. Although the use of antibiotics for infection control can alleviate the inflammation and improve the condition temporarily, recurrence is common.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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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.

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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.