Patient: Hello! I had an operation for gallstones in February 1994, and as a result, my common bile duct was damaged high up near the hepatic portal. After the operation, a bile leak occurred. In July 1994, I started to have biliary tract infection. The upper abdomen was painful with high fever and chills, and the bile flow was white and green. In January 1995, he underwent a second surgery to perform a “jejunostomy with left and right hepatic ducts”. The jejunum was left 60cm. Three weeks after the operation, I had a high fever again, and so the biliary tract infection has been with me since then. In 1997, ultrasound detected intrahepatic hepatic duct stones, which were only one at first, but now there are many. The pain in the liver area is often high. In the beginning, biliary tract infections occurred once a week, sometimes twice a month or once a month. When it happens, I go to the hospital for an injection, but when it is mild, I stay home and take oral antibacterials. Since I got sick, I have never stopped taking the medicine. Choline tablets. Bile vitamins. Since last year, I have been taking herbal medicine. But I still have frequent attacks. Ultrasound shows that the bile ducts are dilated and the right hepatic duct is full of sediment-like stones. I don’t know if I can still cure this disease, I’m really too painful! Hepatobiliary Surgery Department, Hepatobiliary Hospital: It seems that the situation is really complicated. In general, the only way to solve the problem is to operate again, but there are some objective prerequisites for re-operation, so we suggest that you come to the hospital for a comprehensive examination first, and then consider whether there are conditions and necessities for re-operation. Patient: Thank you, Professor Zhang! I appreciate your prompt reply. I have checked your schedule for the specialist clinic. It is every Wednesday afternoon, can I get a number? Is there a regular line? Or online? Liver and gallbladder hospital hepatobiliary surgery: online should be able to register, queue to come to the hospital very early. Patient: I see. Thank you very much! Patient: Hello! I had a test at your hospital. Radiological findings: irregular liver morphology, widened liver fissure. The right intrahepatic bile duct is significantly dilated with multiple granular TlWI high signal and low signal images. The enlarged spleen is not obvious. There is no significant abnormality in the pancreas and both kidneys in the slice. MRCP: After cholecystectomy + hepatic duct jejunostomy, the right intrahepatic bile duct is significantly dilated with multiple granular low signal filling defects; the hilar region is not clearly visible; the following extrahepatic bile ducts are not dilated; the gallbladder is absent; the pancreatic duct is not dilated. Radiological diagnosis: post cholecystectomy + hepatic duct jejunostomy Multiple stones in the right intrahepatic bile duct. Do I have to have surgery? If I am taking Chinese medicine now. The cholangitis is less frequent than before, and the symptoms are less severe. I can recover in 2 or 3 days. I can’t tell I’m a patient if I don’t have an attack. My quality of life is also better than before, and I participate in the South Wind Drum Team and perform regularly. When I get sick, I feel very uncomfortable. Now is the liver area often discomfort vague pain. Is it really necessary to operate immediately in a case like mine? I hope I can get some advice from Professor Zhang. Thank you! Hepatobiliary Surgery Department, Hepatobiliary Hospital: I think it’s the same lady who saw my film a few days ago (Professor Renji has operated on her)! You do seem to be in good condition, but the presence of right hepatic bile duct stenosis, multiple stones in the right intrahepatic bile duct, and right hepatic atrophy are indisputable facts, and the frequent attacks are the objective manifestations of the above intrinsic causes. In order to solve the existing problems, another surgery is the only option. It is understandable to be afraid of surgery, but if we wait until the condition is so serious that we need emergency surgery or other bile duct lesions (bile duct stones can lead to bile duct cancer!) However, if we wait until the condition is so severe that we need emergency surgery or other bile duct lesions (bile duct stones can lead to bile duct cancer!), it will be more risky, more difficult and more uncertain! We recommend comprehensive consideration and timely intervention. Patient: Thank you very much, Professor Zhang, for giving me a timely reply in your busy schedule. You have a good memory, I am the lady. I am the woman who has undergone two biliary surgeries. I am really afraid of having to operate again. The first surgery in ’94 was supposed to be a simple cholecystectomy for gallstones, but I never thought it would cause damage to the upper end of the bile duct. Now I am afraid to operate again and this time to cut my liver. When a stone was found in the intrahepatic bile duct in 1997, I wrote to President Wu Mengchao, who recommended Professor Qian Guangsang, and I asked Professor Qian to see me twice, saying that I could not operate. Your answer was “Nowadays, some cancers can be cured because they can be operated on as long as they have not metastasized. But you can’t be cured because you can’t operate, there’s no way.” Your answer was like a death sentence for me. Of course, in those first few years, I went to Shanghai hospitals and saw many specialists, but the answer was the same: “There is no way to operate”. I remember Ruijin Hospital admitted me for two times, but I was afraid to operate, so I had to be discharged. At that time my quality of life was not good and I wanted to operate but no one dared to do so, now my quality of life is quite good and you said that another operation is the only option. To be honest, I’m really scared. I don’t know what the success rate of this is? Since I met you online I really appreciate you! I think you are a good doctor who is passionate and responsible for his patients. I will take your advice into consideration. Thank you again! Hepatobiliary Surgery Department of Hepatobiliary Hospital: I really appreciate you helping me to relive the history that has disappeared from my memory, and your experience once again confirms the objective law that everything has a historical limitation. More than a decade has passed and there has been a lot of updating of knowledge and concepts about the disease, and there has been a great improvement in technology. Therefore, at this moment I suggest you should receive surgery in time to eliminate future problems.