Bile duct stones

Introduction to bile duct stones Bile duct stones refer to the formation of stones in the bile ducts inside and outside the liver, which is the most common biliary system disease. Stones block the bile duct and cause bile stasis, which is followed by bacterial infection and causes acute cholangitis. Repeated inflammation of the bile duct can cause local wall thickening or scarring stenosis, and bile duct inflammation and stenosis can promote the formation of stones. basic knowledge The proportion of sickness: 0.8% Susceptible people: no special people Mode of infection: non-infectious Complications: acute suppurative cholangitis, liver abscess

Causes of bile duct stones

Hormone factor (15%):

The majority of patients with gallstones are due to the high level of estrogen in the female body, which affects the formation of glucuronide in the liver and increases the unconjugated bilirubin; estrogen affects the emptying of the gallbladder, causing The biliary stasis is so easy to form stones. After the use of estrogen after menopause, the incidence of gallstones increased.

Disease factors (15%):

The incidence of gallstones in patients with cirrhosis is significantly higher than that in normal people. This is associated with decreased estrogen inactivation in patients with cirrhosis, higher estrogen levels, chronic hemolysis, lower gallbladder contraction, and empty gallbladder emptying. Chang, biliary varices, elevated blood bilirubin and other factors. Aphid-infected people do not pay attention to food hygiene and infection of tsutsugamushi. When mites flow back to the biliary tract to lay eggs or die, they will become the core of the stone and produce stones.

Obesity factor (10%):

If the body weight exceeds 15% of the normal standard, the incidence of gallstones is five times higher than that of normal people. Obese people mostly consume too much fat and cholesterol, and most people with obesity have less activity and are prone to gallstones.

Dietary factors (25%):

Diet favors sweet people, their fat and cholesterol intake, easy to form cholesterol stones; too much sweet food and promote insulin secretion, will accelerate cholesterol deposition; often do not eat breakfast will reduce bile acid content, bile concentration, conducive to stone formation .

Genetic factors (17%):

In addition, genetic factors affect the occurrence of gallstones. Therefore, the immediate family members of the family, such as parents, siblings or children with gallstones, are also high-risk.

Bile duct stone prevention

The occurrence of stones is due to the stone formation of bile, but the key is the patency of bile drainage. Therefore, regular diet should be taken regularly, and B-ultrasound should be reviewed regularly to understand the compensatory expansion of the intrahepatic and extrahepatic biliary tract. If necessary, you can eat some. A choleretic agent that promotes the excretion of bile. These may be helpful for your prevention.

Bile duct complication Complications Acute suppurative cholangitis Liver abscess

Complications of bile duct stones:

(1) Acute suppurative cholangitis. Hepatolithiasis is complicated by acute obstructive.

In purulent cholangitis, regardless of where the stones are blocked, toxemia and septic shock can occur, leading to multiple organ failures such as liver, kidney, lung, heart, and brain.

(2) Liver abscess and bronchial biliary fistula. Liver abscess can be formed on the basis of recurrent acute obstructive suppurative cholangitis, and its clinical symptoms are similar to acute suppurative cholangitis. When the abscess penetrates into the lungs, it forms bronchial biliary fistula, and the clinical manifestation is cough and pus. At this time, the symptoms of severe infection will be quickly relieved.

(3) Biliary hemorrhage. Biliary hemorrhage can occur when repeated inflammatory corrosion causes the bile duct to communicate with adjacent blood vessels. Clinical manifestations include periodic gastrointestinal bleeding, abdominal pain, and fever.

(4) The hepatic bile duct is small. Hepatobiliary stones often lead to repeated inflammatory damage and repair of the bile duct wall, and ultimately make the bile duct fibrosis narrow.

(5) Biliary cirrhosis and portal hypertension. Diffuse intrahepatic bile duct stones can gradually lead to biliary cirrhosis and further cause portal hypertension.

Bile duct stones symptoms common symptoms abdominal pain high fever chills bile duct obstruction jaundice

The pathological changes of extrahepatic bile duct stones in extrahepatic bile duct stones are:

1 bile duct obstruction: generally incomplete obstruction, the proximal side has different degrees of expansion and wall thickening, often accompanied by bile stasis, easy to cause secondary infection.

2 secondary infection, bile long-term tissue congestion, edema can increase the degree of bile duct obstruction, resulting in incomplete obstruction, can form obstructive or suppurative cholangitis, further increase in bile duct pressure, purulent bile (including bacteria and berry ), can flow back into the blood through the capillary tube, and sepsis can also cause the bile duct wall to smash and collapse, so that the formation of bile duct hepatic artery and portal vein contracture lead to biliary bleeding.

3 obstruction and infection lead to liver cell damage, and even liver cell necrosis and biliary liver abscess can occur. Repeated attacks of bile duct inflammation can also cause bile cirrhosis.

Bile duct stone examination

1. Leukocytes rise, the nucleus moves to the left, and serum bilirubin measurement suggests obstructive jaundice.

2. B-ultrasound has stones in the bile duct.

3. Oral gallbladder angiography without gallbladder is not developed, PTC, ERCP examination see intrahepatic bile duct dilatation, bile duct obstruction and so on.

4. CT examination has bile duct dilatation or stone presence.

5. Magnetic resonance cholangiography (MRICP) can show biliary and bile duct lesions.

Diagnosis and diagnosis of bile duct stones

Inspection diagnosis

The diagnosis of intrahepatic bile duct stones for patients with simple bile duct stones without infection or other comorbidities, especially in the "quiescent period" is easily misdiagnosed as hepatitis, stomach disease, etc., should be noted for identification. Imaging studies are helpful for diagnosis and differential diagnosis. B-ultrasound and PTC examination can show the distribution of intrahepatic bile duct stones and the stenosis and dilation of hepatobiliary ducts, which are important for the diagnosis and guidance of treatment.

The X-ray features of PTC are:

1 The common hepatic duct or left and right hepatic duct fistula has a ring stenosis, and the proximal biliary duct is dilated, and the stone shadow is visible.

2 left hepatic duct or some part of the bile duct in the liver is not developed.

3 The left and right hepatic bile ducts were asymmetrical, localized, spindle-shaped or dumbbell-shaped. CT also has important diagnostic value, especially for those with concurrent biliary cirrhosis and cancer.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.