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    Biliary stricture

    Bile duct stricture

    A biliary stricture is an abnormal narrowing of the common bile duct, the tube that moves bile (a substance that helps with digestion) from the liver to the small intestine.

    Causes

    A biliary stricture is often caused by surgical injury to the bile ducts. For example, it may occur after surgery to remove the gallbladder.

    Other causes of this condition include:

    • Cancer of the bile duct
    • Damage and scarring due to a gallstone in the bile duct
    • Pancreatitis
    • Primary sclerosing cholangitis

    Risk factors include previous biliary surgery, pancreatitis, gallstones, or injury to the intestine.

    Symptoms

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

    Exams and Tests

    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)

    Treatment

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

    This may involve:

    • Surgery
    • Endoscopic or percutaneous dilation

    If surgery is done, the stricture may be removed and the common bile duct rejoined with the small intestine.

    In some cases, a stent (a tiny metal or plastic mesh tube) is placed across the bile duct stricture to keep it open. See: Stent

    Outlook (Prognosis)

    Treatment is usually successful.

    Possible Complications

    Inflammation and narrowingof the biliary duct may return in some people. There is arisk for infection above the narrowed area. Long-standing strictures can lead to cirrhosis.

    When to Contact a Medical Professional

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

    References

    Afdhal NH. Diseases of the gallbladder and bile ducts. In:Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: SaundersElsevier; 2011:chap 158.

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    • Bile pathway

      illustration

      • Bile pathway

        illustration

      A Closer Look

        Tests for Biliary stricture

          Review Date: 5/1/2012

          Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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