Treatment Methods for Hepatobiliary Duct Stones

The primary treatment options include medical (conservative) management and surgical intervention. For asymptomatic intrahepatic bile duct stones located proximal to the tertiary bile ducts—without localized intrahepatic bile duct dilation—no specific treatment is required; however, oral anti-inflammatory and choleretic medications may be administered, along with regular follow-up examinations. In contrast, hepatobiliary stones associated with recurrent cholangitis necessitate surgical intervention. The fundamental surgical principles are complete stone removal, excision of diseased tissue, establishment of adequate biliary drainage, and prevention of recurrence.

Depending on the stone location, presence or absence of concomitant biliary stricture, and degree of hepatic atrophy, various surgical approaches may be employed—including hepatectomy, choledochojejunostomy, choledocholithotomy, and, in select cases, liver transplantation.