The secretion of bile is an important function of the liver. Due to various harmful factors, the secretion and excretion of bile can become impaired, leading to bile stasis. When the lesion occurs within the liver, it is called intrahepatic bile stasis, and when it occurs outside the liver, it is called extrahepatic bile stasis.

bubble_chart Diagnosis

1. Medical History and Symptoms

This disease is characterized by obstructive jaundice without visible intrahepatic or extrahepatic biliary obstruction. It can be caused by various diseases such as drugs, viral hepatitis, alcoholism, pregnancy, familial factors, etc. Clinically, it may manifest as jaundice, pruritus, loss of appetite, lack of strength, and other symptoms. During inquiry, attention should be paid to identifying the predisposing factors of the patient's illness and distinguishing it from obstructive jaundice caused by hepatobiliary obstruction.

2. Physical Examination Findings

Jaundice, scratch marks due to pruritus, and hepatomegaly.

3. Auxiliary Examinations

Elevated serum bilirubin, with conjugated bilirubin accounting for more than 50%; positive urinary bilirubin; increased blood cholesterol, alkaline phosphatase (AKP), γ-glutamyl transpeptidase (GGT), with GGT/AKP = 12.2.

4. Imaging Examinations

B-mode ultrasound and ERCP can be used for the differential diagnosis of intrahepatic and extrahepatic obstruction.

bubble_chart Treatment Measures

In one-third of cases, the cause of intrahepatic gall bladder stasis is unknown, but in more than half of cases, the cause can be identified. Therefore, actively eliminating the cause has a positive effect on alleviating gall bladder stasis. For cases with unknown causes, symptomatic treatment is applied. Phenobarbital 30–180 mg/day. Cholestyramine 6–10 mg/day. If there are obvious toxic symptoms, especially those accompanied by allergic reactions, prednisone 40 μg/day can be administered continuously for one week, with bilirubin levels decreasing by 50% in most cases. Once bilirubin levels normalize, the dosage should be gradually reduced to 10 mg and maintained for 1–2 months to prevent rebound. However, if bilirubin does not show significant improvement after one week, the medication should be discontinued to avoid side effects. The Chinese herbal medicine Virgate Wormwood Decoction has a certain effect on relieving bile stasis.