A biliary stricture is an abnormal narrowing of the common bile duct, the tube that moves bile from the liver to the small intestine. Bile is a substance that helps with digestion.
Causes of Biliary stricture
A biliary stricture is often caused by injury to the bile ducts during surgery. 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
- Primary sclerosing cholangitis
Risk factors include:
- Injury to the intestines
- Previous biliary surgery
Biliary stricture Symptoms
- Abdominal pain on the upper right side of belly
- 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 a problem with the biliary system.
This condition may also alter the results of the following tests:
Treatment of Biliary stricture
The goal of treatment is to correct the narrowing so bile can flow from the liver into the intestine.
This may involve:
- Endoscopic or percutaneous dilation
If surgery is done, the stricture is removed. The common bile duct will be rejoined with the small intestine.
In some cases, a tiny metal or plastic mesh tube (stent) is placed across the bile duct stricture to keep it open.
Treatment is successful most of the time.
Inflammation and narrowing of the biliary duct may return in some people. There is a risk for infection above the narrowed area. Strictures that remain for a long period can lead to liver damage (cirrhosis).
When to Contact a Health Professional
Call your health care provider if symptoms recur after pancreatitis, cholecystectomy, or other biliary surgery.
Afdhal NH. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 158.
|Review Date: 5/15/2014
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.