Biliary stricture

Bile pathway — 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).

Also known as: Bile duct stricture

Definition

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

Causes, incidence, and risk factors

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

Other causes of this condition include:

Cancer of the bile duct
Damage and scarring due to a gallstone in the bile duct
Pancreatitis
Primary sclerosing cholangitis

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

Symptoms

Signs 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 abnormal function of 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:

Treatment

The goal of treatment is to correct the narrowing and help bile flow normally from the liver into the intestine. This may involve surgery or less invasive procedures (endoscopic or percutaneous dilation). Depending on the location, if surgery is done, the stricture may be removed and the common bile duct rejoined with the small intestine.

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

Expectations (prognosis)

Treatment is usually successful.

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.

Calling your health care provider

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

References

Ostroff JW, LaBerge JM. Endoscopic and radiologic treatment of biliary disease. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 67.

Disease

Otitis media with effusion

Otitis media with effusion (OME) is when there is thick or sticky fluid behind the eardrum in the middle ear, but there is no .
Disease

Gallstones

Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones may be as small as a grain of sand or as large as a golf ball. See also:
Symptoms

Earache

An earache can be a sharp, dull, or burning pain in one or both ears. The pain may be temporary or constant. See also:
Symptoms

Ear discharge

Ear discharge is drainage of blood, , pus, or fluid from the ear.
Disease

Cirrhosis

Cirrhosis is scarring of the liver and poor liver function. It is the final phase of chronic .
Disease

Sclerosing cholangitis

Sclerosing cholangitis refers to swelling (inflammation), scarring, and destruction of the ducts inside and outside of the liver.
Special Topic

Bile

Bile is a digestive fluid that is made and released by the liver and stored in the gallbladder. Bile helps break down into fatty acids, which can be taken into the body by the digestive tract. Bile contains mostly cholesterol, bile acids (also called bile salts), and bilirubin (a breakdown ...
Disease

Pancreatitis

Pancreatitis is inflammation of the pancreas. The pancreas is a gland located behind the stomach. It releases the hormones insulin and glucagon, as well as digestive enzymes that help you digest and absorb food.
Surgery

Gallbladder removal - open

Open gallbladder removal is surgery to remove the gallbladder.
Disease

Choledocholithiasis

Choledocholithiasis is the presence of a gallstone in the common bile duct. The stone may consist of pigments or calcium and cholesterol salts.
Surgery

Ear tube insertion

Ear tube insertion is the placement of tubes through the eardrums. It is done to help the fluid behind the eardrums to drain so that the ears can function normally, or to reduce the risk of recurrent ear infections. Note: While this article focuses on ear tube insertion in children, most of the ...
Disease

Otitis

Otitis is a general term for infection or inflammation of the ear.

Review date:: May 23, 2010
Reviewed by:: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.