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Bile duct stricture

Bile duct stricture; Biliary stricture

 

A bile duct stricture is an abnormal narrowing of the common bile duct, the tube that moves bile from the liver to the small intestine. Bile is a substance that helps with digestion.

Causes

 

A bile duct stricture is often caused by injury to the bile ducts during surgery. For example, it may occur after surgery to remove the gallbladder.

Other causes of this condition include:

  • Cancer of the bile duct, liver or pancreas
  • Damage and scarring due to a gallstone in the bile duct
  • Damage or scarring after gallbladder removal
  • Pancreatitis
  • Primary sclerosing cholangitis

 

Symptoms

 

Symptoms include:

  • Abdominal pain on the upper right side of belly
  • Chills
  • Fever
  • Itching
  • Jaundice
  • Nausea and vomiting
  • Pale or clay-colored stools

 

Exams and Tests

 

The following tests can help diagnose this condition:

  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Percutaneous transhepatic cholangiogram (PTC)
  • Magnetic resonance cholangiopancreatography (MRCP)

The following blood tests can help reveal a problem with the biliary system .

  • Alkaline phosphatase (ALP) is higher than normal.
  • Bilirubin level is higher than normal.

This condition may also alter the results of the following tests:

  • Amylase level
  • Lipase level
  • Urine bilirubin
  • Prothrombin time ( PT )

 

Treatment

 

The goal of treatment is to correct the narrowing so bile can flow from the liver into the intestine.

This may involve:

  • Surgery
  • Endoscopic or percutaneous dilation

If surgery is done, the stricture is removed. The common bile duct will be rejoined with the small intestine.

In some cases, a tiny metal or plastic mesh tube ( stent ) is placed across the bile duct stricture to keep it open.

 

Outlook (Prognosis)

 

Treatment is successful most of the time. Long-term success depends on the cause of the stricture.

 

Possible Complications

 

Inflammation and narrowing of the biliary duct may return in some people. There is a risk for infection above the narrowed area. Strictures that remain for a long period can lead to liver damage ( cirrhosis ).

 

When to Contact a Medical Professional

 

Call your health care provider if symptoms recur after pancreatitis, cholecystectomy , or other biliary surgery.

 

 

Open References

References

Anstee QM, Jones DEJ. Liver and biliary tract disease. In: Walker BR, Colledge NR, Ralston SH, Penman ID, eds. Davidson's Principles and Practice of Medicine . 22nd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 23.

Fogel EL, Sherman S. Diseases of the gallbladder and liver. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 155.

 
  • Bile pathway

    Bile pathway - illustration

    The biliary system is comprised of the organs and duct system that create, transport, store and release bile into the duodenum for digestion. Includes the liver, gallbladder and bile ducts (named the cystic, hepatic, common, and pancreatic duct).

    Bile pathway

    illustration

    • Bile pathway

      Bile pathway - illustration

      The biliary system is comprised of the organs and duct system that create, transport, store and release bile into the duodenum for digestion. Includes the liver, gallbladder and bile ducts (named the cystic, hepatic, common, and pancreatic duct).

      Bile pathway

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Bile duct stricture

         
           

          Review Date: 5/11/2016

          Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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