Bile duct stricture

Bile duct stricture can be caused by several conditions. Our specialists in gastroenterology will determine your diagnosis and provide the latest treatments.

What is a bile duct stricture?

A stricture of the bile duct happens when a bile duct becomes blocked or narrowed so that bile (a digestive fluid) can’t flow through the duct. This condition is sometimes called bile duct stenosis, biliary stricture or common bile duct stricture.

Bile ducts are thin tubes that carry bile from the gallbladder to the small intestines where it aids in the digestion of food. Bile is made in the liver and stored in the gallbladder.

What causes bile duct strictures?

Injuries to the bile ducts during a previous liver or gallbladder surgery sometimes cause stricture in bile ducts. Several other bile duct stricture causes exist, and more than one may lead to a biliary stricture.

Some strictures are related to diseases or conditions of the gallbladder, liver, pancreas or small intestines. Conditions that can result in bile duct stenosis are:

• Blunt abdominal trauma
• Cancerous or benign (noncancerous) tumor pressing on the bile duct
• Crohn’s disease
• Diverticulitis
• Gallstone stuck in the bile duct
• Infection
• Pancreatitis
• Previous radiation therapy of the abdomen

The cause of a biliary stricture is sometimes unknown.

Symptoms of bile duct stricture or blockage

Bile duct stenosis may cause several different symptoms depending on its severity and the cause of symptoms. Some common symptoms of stricture of the bile duct are:

• Abdominal pain on upper right side of the belly
• Chills
• Fever
• General discomfort
• Itching
• Jaundice (yellowing of skin or eyes)
• Loss of appetite
• Nausea and vomiting
• Pale or clay-colored stools

Diagnosis of bile duct stricture or blockage

When you see a doctor about your potential symptoms of bile duct stricture, they’ll perform a physical exam and talk to you about your medical history and symptoms. Based on what they find, they’ll order tests to clarify your condition. They’ll likely begin with blood tests to check for infection and measure levels of bilirubin and other substances that may indicate problems with your bile ducts, gallbladder or liver.

Advanced testing for bile duct stricture

They may use magnetic resonance cholangiopancreatography (MRCP) – a special kind of detailed MRI that creates images that can show problems with the bile ducts and other tissues.

Some tests for common bile duct stricture diagnosis are done using endoscopy, a procedure where your doctor guides an endoscope (a narrow tube with a tiny camera at the end) through your mouth and down your throat to view structures in your digestive tract.

Endoscopes can also be used to insert small tools next to the camera. Your doctor uses those tools to take a biopsy (small sample) or to remove damaged tissues when needed.

Other tests that may be ordered include:

• Endoscopic retrograde cholangiopancreatography (ERCP): Uses an endoscope to view the bile ducts and take tissue samples.
• Hepatic iminodiacetic acid (HIDA) scan: A small amount of radioactive fluid is put into your body. Then scans provide images of the fluid flowing through the bile ducts to show whether the ducts are narrowed or blocked.
• Ultrasound: Uses sound waves to create images of the bile ducts.

Treatment for bile duct stricture

The first method of treatment may be antibiotics if your condition shows signs of infection.

If antibiotics don’t resolve your bile duct stricture, your doctor may recommend a procedure to drain the bile duct, remove any gallstones or insert a stent. A stent is a flexible thin tube that’s put inside the bile duct to stretch the walls and expand the constricted part.

When surgery is necessary, your surgeon will use minimally invasive techniques whenever possible to lessen complications, speed healing and minimize scarring.

Surgical removal of the narrowed or blocked section of the duct may also be suggested. After the removal, the rest of the bile duct is stitched in place to allow bile to flow through it again. A stent may be inserted to support the shortened duct. Any tumors may also be removed.