The treatment of small intrahepatic bile duct stones includes regular observation and follow-up, choledochotomy, bile-intestinal anastomosis, partial hepatectomy and so on.
1. Observation and follow-up: For patients with small stones that do not cause obvious symptoms, intrahepatic bile duct stones can be left untreated for the time being, and only need to be followed up regularly to observe the changes in their conditions.
2. Choledochotomy for stone extraction: Intrahepatic bile duct stones close to the hepatic hilum can be extracted by choledochotomy, in which the narrowed bile ducts or embedded stones are cut as much as possible, and the stones are removed through choledochoscope.
3. Bile-enteric anastomosis: For patients with dilated intrahepatic bile ducts and stones cannot be removed, or patients with loss of sphincter function with dilated intrahepatic bile ducts without stenosis, hepatic-jejunoileal anastomosis can be performed.
4. Partial hepatectomy: partial hepatectomy can be considered for intrahepatic bile duct stones combined with recurrent infections, hepatic segment atrophy, fibrosis, abscess or fistula formation, biliary hemorrhage, difficult to retrieve high-grade stones, or even intrahepatic bile duct cancer.
Patients with small intrahepatic bile duct stones are advised to go to the hospital as soon as possible to have their condition evaluated by a professional doctor to decide on the next treatment plan.