Bile duct strictureBile duct stricture; Biliary stricture
A bile duct stricture is an abnormal narrowing 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
- Damage or scarring after gallbladder removal
- Primary sclerosing cholangitis
- Abdominal pain on the upper right side of belly
- General feeling of discomfort
- Loss of appetite
- 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)
- 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.
- GGT enzyme level is higher than normal.
- Bilirubin level is higher than normal.
This condition may also alter the results of the following tests:
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 t...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
Call 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
Anstee QM, Jones DEJ. Hepatology. In: Ralston SH, Penman ID, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 23rd ed. Philadelphia, PA: Elsevier; 2018:chap 22.
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:chap 462-466.
Jackson PG, Evans SRT. Biliary system. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 54.
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: 5/27/2020
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.