What should I do if I always have back pain due to intrahepatic bile duct stones?

Written by Liu Wu Cai
Hepatobiliary Surgery
Updated on March 09, 2025
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If patients with intrahepatic bile duct stones repeatedly experience back pain, this should be taken seriously. Intrahepatic bile duct stones often coincide with acute cholangitis, which can cause discomfort and pain in the upper right abdomen. There might also be radiating pain in the right shoulder and scapular area, resulting in a sensation of soreness. At this time, antibiotic treatment should be used to fight the infection. Once the inflammation is under control, the condition can be alleviated. Of course, if the symptoms recur, surgical treatment should be carried out as soon as possible. Only surgery can achieve a complete cure, significantly improving the patient's quality of life and alleviating the condition more effectively.

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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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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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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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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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Does Jin Qian Cao expel gallstones from the liver's bile ducts?

This method cannot eliminate intrahepatic bile duct stones. The treatment for intrahepatic bile duct stones mainly depends on the symptoms. For patients with intrahepatic bile duct stones who do not have significant symptoms and whose stones are relatively small, no special treatment is required. Avoiding spicy and irritating foods in the diet can reduce inflammatory stimuli and better control the condition. Regular follow-up with ultrasonography is sufficient. However, for patients with larger intrahepatic bile duct stones, acute cholangitis may occur, presenting with significant upper abdominal pain. In such cases, proactive treatment is necessary. The treatment mainly involves surgery, which can significantly improve the prognosis and potentially cure the condition.