Bile duct strictureBile duct stricture; Biliary stricture
A bile duct stricture is an abnormal narrowing, most often of the common bile duct. This is a tube that moves bile from the liver to the small intestine. Bile is a substance that helps with digestion.
Bile is a fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acid...Read Article Now Book Mark Article
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
Gallstone in the bile duct
Choledocholithiasis is the presence of at least one gallstone in the common bile duct. The stone may be made up of bile pigments or calcium and chol...Read Article Now Book Mark Article
- Damage or scarring after gallbladder removal
- Primary sclerosing cholangitis
Primary sclerosing cholangitis
Sclerosing cholangitis refers to swelling (inflammation), scarring, and destruction of the bile ducts inside and outside of the liver.Read Article Now Book Mark Article
- Abdominal pain
on the upper right side of belly
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.Read Article Now Book Mark Article
Chills refers to feeling cold after being in a cold environment. The word can also refer to an episode of shivering along with paleness and feeling ...Read Article Now Book Mark Article
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...Read Article Now Book Mark Article
Itching is a tingling or irritation of the skin that makes you want to scratch the area. Itching may occur all over the body or only in one location...Read Article Now Book Mark Article
- General feeling of discomfort
- Loss of appetite
- Nausea and vomiting
- Pale or clay-colored stools
Pale or clay-colored stools
Stools that are pale, clay, or putty-colored may be due to problems in the biliary system. The biliary system is the drainage system of the gallblad...Read Article Now Book Mark Article
Exams and Tests
The following tests can help diagnose this condition:
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Percutaneous transhepatic cholangiogram (PTC)
Percutaneous transhepatic cholangiogram
A percutaneous transhepatic cholangiogram (PTC) is an x-ray of the bile ducts. These are the tubes that carry bile from the liver to the gallbladder...Read Article Now Book Mark Article
- Magnetic resonance cholangiopancreatography (MRCP)
- Endoscopic ultrasound (EUS)
The following blood tests can help reveal a problem with the biliary system.
The biliary system creates, moves, stores, and releases bile into the duodenum. This helps the body digest food. It also assists in transporting wa...Read Article Now Book Mark Article
- Alkaline phosphatase (ALP) is higher than normal.
Alkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. A blo...Read Article Now Book Mark Article
- GGT enzyme level is higher than normal.
- Bilirubin level is higher than normal.
The bilirubin blood test measures the level of bilirubin in the blood. Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. Bi...Read Article Now Book Mark Article
This condition may also alter the results of the following tests:
- Amylase level
Amylase is an enzyme that helps digest carbohydrates. It is made in the pancreas and the glands that make saliva. When the pancreas is diseased or ...Read Article Now Book Mark Article
- Lipase level
Lipase is a protein (enzyme) released by the pancreas into the small intestine. It helps the body absorb fat. This test is used to measure the amou...Read Article Now Book Mark Article
- Urine bilirubin
Bilirubin is a yellowish pigment found in bile, which is a fluid produced by the liver and stored in the gallbladder. This article is about a lab tes...Read Article Now Book Mark Article
- Prothrombin time (PT)
Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot. A related blood test is ...Read Article Now Book Mark Article
The goal of treatment is to correct the narrowing. This will allow bile to flow from the liver into the intestine.
This may involve:
- Endoscopic or percutaneous dilation or insertion of stents through the stricture
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.
A stent is a tiny tube placed into a hollow structure in your body. This structure can be an artery, a vein, or another structure, such as the tube ...Read Article Now Book Mark Article
Treatment is successful most of the time. Long-term success depends on the cause of the stricture.
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).
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.Read Article Now Book Mark Article
When to Contact a Medical Professional
Contact your health care provider if symptoms recur after pancreatitis, cholecystectomy, or other biliary surgery.
Open gallbladder removal is surgery to remove the gallbladder through a large cut in your abdomen. The gallbladder is an organ that sits below the li...Read Article Now Book Mark Article
Dudeja V, Ferrantella A, Fong Y. The liver. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 54.
Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.
Ibrahim-zada I, Ahrendt SA. Management of benign biliary strictures. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:462-466.
Williams MJ, Gordon-Walker TT. Hepatology. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 24.
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).
Review Date: 5/4/2022
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.