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Bile Duct Stones

- Jul 27, 2018 -

Bile duct stones are a kind of clinical cholelithiasis. According to the location of the stones, they are divided into extrahepatic bile duct stones and intrahepatic bile duct stones. The stones located at the lower end of the common bile duct are called extrahepatic bile duct stones; and the stones distributed in the bile duct of the liver lobe are called intrahepatic bile duct stones. In addition, the stones formed in the bile duct are collectively referred to as primary bile duct stones, and those with gallstones discharged to the common bile duct for various reasons are called secondary bile duct stones. The most common clinical symptoms are upper abdominal pain, which can be painful or cramping, and some patients have fever. When the hepatic duct is obstructed, the jaundice can be produced.


Primary bile duct stones are associated with intrahepatic infection, cholestasis, and biliary aphids, with bile pigment stones or mixed stones. Secondary bile duct stones are mainly caused by gallstone stones and stay in the bile duct. They can also be caused by intrahepatic bile duct stones discharged into the common bile duct. Therefore, they are mostly cholesterol stones or bile pigment stones.

Clinical manifestation

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 clinically appear jaundice, typical Charcot triad, ie abdominal pain, chills, fever and jaundice.

(1) Abdominal pain is mostly located under the xiphoid or upper right abdomen colic, showing paroxysmal or persistent pain paroxysmal, often radiating to the right shoulder and back.

(2) chills, high fever often appear after severe abdominal pain, showing relaxation heat, body temperature can be as high as 39 ° C ~ 40 ° C.

(3) About 70% of patients with jaundice can develop jaundice in 12 to 24 hours after upper abdominal cramps, chills, and high fever. Astragalus is accompanied by itchy skin, urine is thick brown, stool color is light or terracotta color, most patients with jaundice can be volatile, relieved in about 1 week.

2. Intrahepatic bile duct stones

It can be asymptomatic or has deep and persistent pain in the liver area and chest and back, affecting sleep. When acute obstructive suppurative cholangitis occurs, there may be chills, fever, hepatomegaly, tenderness, jaundice may be no or lighter, and sepsis and shock may occur in the advanced stage.



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