Bile duct stricture

If you’ve been diagnosed with a bile duct stricture, you may wonder what it is and how it happened. We're here to help. Your Advocate digestive health specialist will answer all your questions and provide expert diagnosis and the latest treatments.

What is a bile duct stricture?

The digestive fluid bile is made in the liver and stored in the gallbladder. Bile ducts are thin tubes that drain the bile from the gallbladder to the small intestines where it’s used to help digest food. A bile duct stricture is a condition where a bile duct becomes narrowed or blocked. Other names for this condition are biliary stricture, bile duct stenosis and common bile duct stricture.

What causes bile duct strictures?

Bile duct strictures happen because of an injury to the duct during a gallbladder removal surgery (cholecystectomy). There are other bile duct strictures causes, and many are related to other conditions of the liver, gallbladder, pancreas and small intestines. Some of the causes include:

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

Occasionally, no cause can be found for a stricture in a bile duct.

Symptoms of bile duct stricture

You may have a broad set of symptoms when you have bile duct stenosis. Symptoms may be mild at first and get worse as the condition continues. Common symptoms of bile duct stricture include:

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

Testing for bile duct stricture or blockage

Your doctor will order blood tests to check for infections and measure levels of substances that indicate problems with your liver or bile ducts.

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

An endoscope can also be used to take a biopsy (small sample) or remove damaged tissues. In addition to the camera, small surgical tools can be inserted so they can be used for needed procedures.

Some tests that may be ordered include:

• Endoscopic retrograde cholangiopancreatography (ERCP): Uses an endoscope to view the bile ducts and take tissue samples.
  
• Ultrasound: Uses sound waves to create images of the bile ducts.
  
• Hepatic iminodiacetic acid (HIDA) scan: A small amount of radioactive fluid is put into your body. Scans provide images of the fluid flowing through the bile ducts to show whether the ducts are narrowed or blocked.
  
• Magnetic resonance cholangiopancreatography (MRCP): A special kind of detailed MRI that shows problems with the bile ducts.

Treatment for bile duct stricture

You may receive treatment from doctors in different specialties. Depending on the cause of your bile duct stricture, your multidisciplinary care team may include a gastroenterologist, infectious disease specialist, interventional radiologist or oncologist.

If testing has shown signs of infection, you may be treated with oral or IV antibiotics. Such treatment often resolves a bile duct stricture.

If antibiotics don’t work, your doctor may perform a minimally invasive procedure to drain the bile, remove any gallstones or place a stent inside the bile duct. A stent is a thin, flexible tube that’s placed inside your bile duct and then expanded so it stretches the walls of the bile duct.

Sometimes open surgery is performed to remove the section of the bile duct that's narrowed or blocked. The remaining parts of the bile duct are stitched together to allow bile to continue to flow from the gallbladder to the small intestines. A stent may also be placed in the bile duct during surgery.

Our surgeons use minimally invasive methods whenever possible to reduce recovery time, lessen complications and minimize scarring.