Is surgery necessary for bile duct stones?

The presence of stones in the bile duct will seriously affect daily life and work, and once the bile duct stones occur, the pain caused is usually difficult for normal people to bear. There are many methods for treating gallstones, but when treating, you must choose a regular and professional hospital, try to maintain a balanced diet, and eat less spicy and irritating foods.

Is surgery necessary for bile duct stones?

Biliary stones do not necessarily require surgery. The need for surgery is mainly determined by the location, number and size of the stones. Another major reason for deciding whether surgery is necessary is to see whether the stones are accompanied by other complications such as bile duct infection, cancer, etc. If the bile duct infection is caused and combined with cancer, it must be surgically removed. If the bile duct stones are in a dormant period and do not cause corresponding clinical changes and have no clinical symptoms, we can observe them appropriately.

Of course, there is another major reason, which is the location of the stone. If the location of the stone causes obstruction of the bile duct, although there is no temporary clinical manifestation, then in order to prevent the corresponding complications caused by the gallstones, we may perform some surgical resections. For example, if the gallbladder stone is larger than one centimeter, foreign literature reports that it is two centimeters. Then, although the common bile duct stone has no clinical symptoms, we will also perform surgical resection to prevent it from causing suppurative cholangitis.

Clinical manifestations

1. Extrahepatic bile duct stones

The typical symptoms are biliary colic at the beginning, often accompanied by nausea and vomiting. Patients with biliary tract infection have chills and high fever. Then jaundice appears clinically, and the typical Charcot triad appears, namely abdominal pain, chills, high fever and jaundice.

(1) Abdominal pain is mostly located under the xiphoid process or in the right upper abdomen, and is paroxysmal or continuous pain that worsens paroxysmically and often radiates to the right shoulder and back.

(2) Chills and high fever often occur after severe abdominal pain, presenting as a remittent fever, with body temperature reaching 39°C to 40°C.

(3) Jaundice: About 70% of patients with bile duct disease may develop jaundice 12 to 24 hours after experiencing upper abdominal colic, chills, and high fever. Jaundice is accompanied by itchy skin, dark tea-colored urine, lighter or clay-colored stools. Jaundice may fluctuate in most patients and improve in about a week.

2. Intrahepatic bile duct stones

There may be no symptoms or there may be deep and persistent pain in the liver area, chest and back, which affects sleep. When acute obstructive suppurative cholangitis occurs, there may be chills, fever, hepatomegaly, tenderness, and no or mild jaundice. Sepsis and shock may occur in the late stage.