Bile Duct Stricture
What is bile duct?
One of the main functions of the liver is to produce bile which is then channelled through tiny tubes inside the liver to bigger tubes which coalesce as the two tubes as they exit the liver. Finally forming a single tube (bile tube or bile duct). Bile tube traverses the pancreas and enters the small bowel just beyond the stomach. Attached to the bile tube is the gall bladder which stores and concentrates bile.
One of main functions of bile is to help digest the fat in the diet.
What are symptoms of bile duct stricture?
Narrowing of bile duct causes obstruction to the flow of bile. Liver has limited capacity to store bile, and after some time patients notice jaundice, yellowness of whites of eyes and of skin. At times jaundice may be complicated by infection (cholangitis), fever, shakes and chills. Infection in bile is a dangerous condition and requires urgent treatment in the hospital.
Why should a stricture form in the bile duct?
Narrowing of bile duct may be due to benign or non-cancerous causes, such as previous surgery, body’s immune cells attacking bile tube cells (autoimmune, primary sclerosing cholangitis) or pressure from outside (cancer or inflammation of the pancreas).
How is a bile duct stricture diagnosed?
History of painless jaundice and itching are indicative. Blood tests such as liver function tests are crucial. Scans (ultrasound, CT and MRI) are required. A special form of endoscopy may need to be performed called ERCP.
How is bile duct stricture treated?
The treatment of bile duct strictures depends on the cause and a thorough assessment by a specialist is required. Where possible, cancerous strictures should be removed with surgery. Some benign strictures may respond to placement of tubes inside the bile tube to keep the bile flowing, these are called stents. It is important to prevent and treat infection in bile. For some benign strictures, surgery may entail a bypass operation. Small bowel is joined to the bile tube to divert the bile flow away from the stricture and in to the bowel.