Bile duct stricture

Bile duct stricture; Biliary stricture

A bile duct 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, liver or pancreas
• Damage and scarring due to a gallstone in the bile duct
• Damage or scarring after gallbladder removal
• Pancreatitis
• Primary sclerosing cholangitis

Symptoms include:

• Abdominal pain on the upper right side of belly
• Chills
• Fever
• Itching
• Jaundice
• Nausea and vomiting
• Pale or clay-colored stools

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.

• 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
• Urine bilirubin
• Prothrombin time (PT)

The goal of treatment is to correct the narrowing so bile can flow from the liver into the intestine.

This may involve:

• Surgery
• 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. Long-term success depends on the cause of the stricture.

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).

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