Hepatic and Biliary Duct Stones

Patient's question:

Hepatic and Biliary Duct Stones 1.2 Occasionally have pain at night this year

Doctor's answer:

Gallstones refer to stones that occur in any part of the hepatobiliary system, including gallstones, common bile duct stones, hepatic duct stones, intrahepatic bile duct stones, and complex location stones. Based on their chemical composition, gallstones are classified as cholesterol stones, pigment stones, and mixed stones. This condition is a common and frequently occurring disease, with its incidence rate showing a progressive upward trend as age increases.
Medical Advice: Surgical treatment is the primary method for treating intrahepatic bile duct stones. The surgical approach can be selected based on the current condition and the location of the stones. Options include bile duct incision and stone removal, bile duct-enteric anastomosis with drainage, and partial hepatectomy. Oral dissolution or expulsive drugs have limited therapeutic effects on stones, especially when the stones have already caused biliary obstruction. Continuing to use dissolution and expulsive drugs in such cases may delay the condition. The method of injecting various stone solvents into the bile duct during surgery is rarely used in clinical practice due to the potential for various complications.
Sometimes, even after surgery when a T-tube is still retained, stones may still be found in the bile duct, or the stones may be located in deeper parts of the liver. In such cases, endoscopic retrograde cholangiopancreatography (ERCP) can be used to remove the stones under direct visualization using stone retrieval forceps or baskets.
Intrahepatic bile duct stones often cause persistent in the affected liver region and chest-back area, along with fever and jaundice. If purulent inflammation occurs in the bile duct, symptoms such as fever, chills, sepsis, and shock may develop. If the obstruction caused by stones in the bile duct is not relieved promptly, it may lead to bacterial infection and complications such as intrahepatic abscesses. In advanced stages, bile accumulation in the liver may result in liver cirrhosis.
During physical examinations, significant tenderness and percussion pain are often found in the right upper abdomen. Localization diagnosis can rely on ultrasound (B), computed tomography (CT), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP).