Bile Duct Injury/Stricture

Bile Duct Injury/Stricture

Overview

The bile duct is a group of tubes that are connected from the liver to the small intestines. They carry the digestive fluid “bile” from the liver to the gall bladder from where it carried to the small intestines. Bile Duct Stricture or Biliary stricture is when this duct is narrowed and obstructs the passage of the bile to the small intestines, making it difficult for food to digest and also causing the accumulation of the excess bile.

Signs and symptoms

Symptoms of Bile duct injury/stricture can sometimes appear over years and include fatigue, weight loss, greasy grey coloured stools, fever, night sweats, reduced appetite, pain in the abdomen especially towards the right side of the rib cage; and excess bilirubin causing dark urine and itching anywhere on the skin.

Causes and risk factors

The main causes that could trigger Biliary stricture are intestinal injuries especially small bowel injuries, presence of gall stones in the bile duct, damage to bile duct especially during gall bladder surgery, bile duct infection and cancerous bile duct and pancreatic cancer.

Complications

If left untreated bile duct strictures can cause an increase of gall stones in the area close to the stricture causing abscess in the liver leading to infections and various diseases of the liver and sepsis.

Diagnosis

Blood tests and imaging are used to decide if there is bile duct injury. Imaging tests that help to diagnose Biliary strictures are Ultra-sound of the Liver, CTI & MRI scans.

Surgery

ERCP (Endoscopic retrograde cholangiopancreatography) in which the doctor uses a special endoscope and contrast fluid that is injected through a catheter to identify bile duct strictures which are opened using a bile stent. Percutaneous Transhepatic Cholangiography (PTHC) is the other process in which a catheter is inserted through the abdominal wall to keep the stricture open and help drain the excess bile. In some cases, the stricture is surgically removed and then the healthy duct is reconnected.

Prevention

Bile duct strictures can be prevented by maintaining a healthy diet, losing weight gradually and maintaining a healthy weight and the reduced intake of sugars and fatty foods.

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