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Bile duct obstruction

Biliary obstruction

Bile duct obstruction is a blockage in the tubes that carry bile from the liver to the gallbladder and small intestine.

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Digestive system
Endocrine glands
Bile pathway

Presentation

Biliary obstruction - series - Normal anatomy

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Causes

Bile is a liquid released by the liver. It contains cholesterol, bile salts, and waste products such as bilirubin. Bile salts help your body break down (digest) fats. Bile passes out of the liver through the bile ducts and is stored in the gallbladder. After a meal, it is released into the small intestine.

When the bile ducts become blocked, bile builds up in the liver, and jaundice (yellow color of the skin) develops due to the increasing level of bilirubin in the blood.

The possible causes of a blocked bile duct include:

The risk factors for a blocked bile duct include:

The blockage can also be caused by infections. This is more common in people with weakened immune systems.

Symptoms

Symptoms may include:

Exams and Tests

Your health care provider will examine you and feel your belly.

The following blood test results could be due to a possible blockage:

The following tests may be used to investigate a possible blocked bile duct:

A blocked bile duct may also alter the results of the following tests:

Treatment

The goal of treatment is to relieve the blockage. Stones may be removed using an endoscope during an ERCP.

In some cases, surgery is required to bypass the blockage. The gallbladder will usually be surgically removed if the blockage is caused by gallstones. Your provider may prescribe antibiotics if an infection is suspected.

If the blockage is caused by cancer, the duct may need to be widened. This procedure is called endoscopic or percutaneous (through the skin next to the liver) dilation. A tube may need to be placed to allow drainage.

Outlook (Prognosis)

If the blockage is not corrected, it can lead to life-threatening infection and a dangerous buildup of bilirubin.

If the blockage lasts a long time, chronic liver disease can result. Most obstructions can be treated with endoscopy or surgery. Obstructions caused by cancer often have a worse outcome.

Possible Complications

Left untreated, the possible complications include infections, sepsis, and liver disease, such as biliary cirrhosis.

When to Contact a Medical Professional

Contact your provider if you:

Prevention

Be aware of any risk factors you have, so that you can get prompt diagnosis and treatment if a bile duct becomes blocked. The blockage itself may not be preventable.

Related Information

Bile
Bilirubin blood test
Gallstones
Biliary system
Chronic pancreatitis
Pancreatic cancer
Open gallbladder removal
Cholangiocarcinoma
Sepsis
Cirrhosis

References

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.

Lidofsky SD. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 21.

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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.

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