Biliary stricture

Alternative Names: Bile duct stricture

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 of Biliary stricture

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.

Biliary stricture Symptoms

• Abdominal pain
• Chills
• Fever
• Itching
• Jaundice
• Nausea and vomiting
• Pale or clay-colored stools

Tests and Exams

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:

• Amylase level
• Lipase level
• Fecal fat
• Urine bilirubin
• Prothrombin time (PT)

Treatment of Biliary stricture

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

Prognosis (Outlook)

Treatment is usually successful.

Potential 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.

When to Contact a Health Professional

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

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.

Bile pathway

Review Date: 5/23/2010
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.

_{Do not use this information for medical emergencies - Call 911. This information should not be used for the diagnosis or treatment of any medical condition. A licensed medical practitioner should always be consulted for diagnosis and treatment of any and all medical conditions. Links to other websites do not constitute endorsements and are provided for information only. Any duplication or distribution of this information is strictly prohibited.
Copyright 2012 A.D.A.M., Inc.}