Are gallstones and bile duct stones serious?

Generally, the severity of hepatobiliary calculi needs to be determined based on the location and size of the stones, as well as whether they have caused complications.

Asymptomatic hepatobiliary stones are usually not severe, but if the stones lead to secondary infections, biliary obstruction, or malignancy, the condition may worsen. Gallbladder stones without symptoms generally carry a low risk; however, if the stones are large or repeatedly cause inflammation, they may become lodged and obstruct the cystic duct, leading to acute cholecystitis, empyema of the gallbladder, gangrene, or even perforation, which can be life-threatening in severe cases. Intrahepatic bile duct stones may not cause obvious symptoms in the early stages, but as the stones grow, they may cause biliary obstruction and bile stasis, leading to atrophy of the drained liver segments, infection, or malignant transformation of the bile duct. If the stones pass into the extrahepatic bile duct, they may block the common bile duct or pancreatic duct orifice, inducing acute obstructive suppurative cholangitis or biliary pancreatitis, potentially resulting in shock or even death.

The severity of hepatobiliary stones mainly depends on their risk of complications. Patients without symptoms require regular monitoring, while those experiencing pain, jaundice, fever, or other symptoms should seek timely medical evaluation. Gallbladder stones without symptoms can usually be managed conservatively; however, common bile duct stones require high vigilance, as they may cause obstructive jaundice, biliary infection, or pancreatitis, necessitating early intervention. In addition, long-term presence of stones may increase the risk of malignancy, particularly intrahepatic bile duct stones, which are more closely associated with cholangiocarcinoma.

Regarding treatment, asymptomatic small stones can be managed through observation and monitoring, while symptomatic stones require specific treatment options such as medication, endoscopic therapy, or surgery based on individual circumstances. For example, common bile duct stones can be removed via ERCP, while laparoscopic cholecystectomy is a common choice for recurrent gallbladder stones. For prevention, maintaining a healthy diet, controlling body weight, and regular作息 (作息 should be replaced with an appropriate English term like "rest patterns" or "lifestyle habits") are recommended to reduce the risk of stone formation.