Biliary stricture, also referred to as bile duct stricture, is a narrowing of the bile ducts. The bile ducts carry bile from the liver to the small intestine. Bile is created in the liver, where it helps with the digestion of fat-rich foods. When bile has completed its job, it’s sent to the small intestine via the bile ducts to be removed from the body. When the bile ducts start to narrow, bile can begin to back up and cause symptoms. It becomes harder to digest fatty foods with a narrow bile duct.
Bile duct stricture can be classified as non-cancerous (benign) or cancerous (malignant) based on the cause. There are a wide variety of medical conditions that can cause biliary stricture.
Symptoms of biliary stricture are similar to those of other diseases associated with the bile ducts, like bile duct leaks. They include:
The causes of biliary stricture can be categorised by non-cancerous (benign) and cancerous (malignant). Biliary stricture is assumed to be due to cancer until imaging can confirm otherwise.
The noncancerous causes include:
The cancerous causes include:
Risk factors for biliary stricture include:
To make a definitive diagnosis, a doctor will order blood tests to look at levels of liver proteins and imaging tests like a magnetic resonance imaging scan (MRI) to get a detailed look at the narrow bile duct.
Complications of biliary stricture include:
Treatment of biliary stricture includes an ERCP. During an ERCP, a doctor inserts an endoscope – a flexible, small, tube- down the mouth and into the abdomen. They can use the endoscope to inject radioactive dye into the bile ducts if they want a more detailed image of the narrow bile duct. For treatment purposes, the endoscope is used to place a stent – a tiny rubber tube- in the bile duct that is blocked and open it up again.
A doctor can also elect to do a percutaneous transhepatic cholangiography (PTHC). A PTHC involves the placement of a drain in the right side of the abdomen into the liver where the bile duct connects to it. The drain removes excess bile from the body and opens the stricture up.