Biliary stricture involves an abnormal narrowing of the biliary duct that transports bile (a chemical used in digestion) from the liver to the small intestine.

Alternative Names

Bile duct stricture

Causes, incidence, and risk factors

Biliary strictures are often caused by surgical trauma to the bile ducts. The leakage of bile that results can lead to localized infection and scar tissue formation, which can impair the functioning of the bile ducts and sometimes nearby organs, such as the liver. Other causes of this condition are blunt injury to the intestine, pancreatitis , breakdown of the duct by a gallstone in the bile duct , primary sclerosing cholangitis , and cancer of the bile duct. Risk factors include previous biliary surgery , pancreatitis, cholelithiasis , or injury to the intestine.

Signs and tests

Tests that show stricture in the

bile duct:

ERCP

(

endoscopic retrograde cholangiopancreatography )

Percutaneous transhepatic cholangiogram (PTC)

Blood tests that indicate abnormal function of

biliary system :

Bilirubin

level is elevated

ALP

(

alkaline phosphatase ) is elevated This disease may also alter the results of the following tests:

Fecal fat

Urine bilirubin

Prothrombin time (

PT )

Amylase

Lipase

Treatment

Endoscopic

(using a tube called an endoscope through a small incision) or percutaneous (through the skin) dilation of the stricture can be used, depending on the location of the stricture.

The objective of surgical therapy is to re-establish the flow of bile from the liver into the intestine. Depending on the location, the stricture may be surgically removed and the biliary duct rejoined with the small intestine or the hepatic duct. For some patients, a stent is placed across the bile duct stricture to keep it open.

Expectations (prognosis)

Treatment is usually successful.

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 .

Calling your health care provider

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