Bile duct stricture

Definition

Biliary stricture is an abnormal narrowing of the biliary duct, the tube that moves bile (a chemical used in digestion) from the liver to the small intestine.

Alternative Names

Causes

Biliary strictures are often caused by surgical injury to the bile ducts, for example, after surgery to remove the gallbladder (cholecystectomy).

Other causes of this condition are pancreatitis, breakdown of the duct by a gallstone in the bile duct, primary sclerosing cholangitis, and cancer of the bile duct.

Risk factors include previous biliary surgery, pancreatitis, cholelithiasis, or injury to the intestine.

Symptoms

• Abdominal pain
• Fever
• Chills
• Jaundice
• Pale or clay-colored stools
• Nausea and vomiting
• Itching

Exams and Tests

Tests that show stricture in the bile duct:

• ERCP (endoscopic retrograde cholangiopancreatography)
• PTC (percutaneous transhepatic cholangiogram)
• MRCP (magnetic resonance cholangiopancreatography)

Blood tests that indicate abnormal function of biliary system:

• Bilirubin level is higher than normal
• ALP (alkaline phosphatase) is higher than normal

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

• Fecal fat
• Urine bilirubin
• Prothrombin time (PT)
• Amylase
• Lipase

Treatment

Surgery (endoscopic or percutaneous dilation) is needed to correct the narrowing. The goal of surgery is to re-establish the flow of bile from the liver into the intestine. Depending on the location, the stricture may be surgically removed and the biliary duct rejoined with the small intestine or the hepatic duct.

For some patients, a stent is placed across the bile duct stricture to keep it open.

Outlook (Prognosis)

Treatment is usually successful.

Possible Complications

Recurrent inflammation of the biliary duct and stricture can occur in some patients. Patients are at risk for infection developing above the stricture. Long-standing strictures can lead to cirrhosis.

When to Contact a Medical Professional

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

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