Management of Biliary Obstructions

The biliary tree is a key component in your digestive system.  Delivering bile that is produced in your liver and stored in your gallbladder until it is needed, the bile ducts are the bile’s pathway to the small intestine where fats you consume are broken down into usable nutrients and waste.


Unfortunately, there are times when your bile ducts can become obstructed and as a result, you may experience major health issues. And remember, an obstruction can include either a narrowing of the bile duct that restricts bile flow, or an actual blockage preventing the passage of bile through the duct at all.

Called a biliary obstruction, this health concern is something that your Baltimore biliary duct physician should treat right away to prevent further complications.

Today we are going to look at the common causes of biliary obstructions, how your biliary surgeon diagnoses obstructions, and how to manage a biliary obstruction in the case you develop one.

After all, educating yourself about things like biliary obstructions can make a significant difference in your recovery time post treatment, not to mention your overall health.


What Causes a Biliary Obstruction?

Several things can cause your bile ducts to become obstructed.  As a result, it is imperative you enlist the help of your Baltimore biliary surgeon to help diagnose and treat the problem appropriately according to the obstruction’s original cause.



Many types of cancer can cause bile duct obstructions.  Take a look:

  • Bile Duct Cancer. If you have been diagnosed with bile duct cancer, there is a likely chance that tumor growth within the bile ducts will cause a blockage. In addition, if you have ever had bile duct inflammation or irritation, the chances of your bile ducts narrowing and becoming restricted increase.
  • Liver Cancer. Some liver cancers that metastasize into the biliary system can cause bile duct obstructions.  Moreover, if you have cancer in your bile ducts near the liver, tumor growth can travel down the bile ducts and obstruct the pathway leading to the small intestine.
  • Pancreatic Cancer. Since the pancreas is located near the small intestine, any tumor growth in the pancreas has a chance of infecting the nearby bile ducts that empty bile into the small intestine for digestion of food.
  • Bile Duct Injuries. If you have suffered a bile duct injury, often caused during a laparoscopic cholecystectomy, it is not unusual to have a narrowing of the bile duct immediately afterwards.


Bile Duct Injuries

If you have suffered a bile duct injury, often caused during a laparoscopic cholecystectomy, it is not atypical to have a narrowing of the bile duct immediately afterwards.  Luckily, most experienced biliary surgeons notice the injury right away and resolve it during the surgical procedure already taking place.

However, if the injury goes unnoticed, you must take care to watch the symptoms post-surgery and seek help from your doctor right away if you suspect a biliary obstruction.


Gallstones and Biliary Stones

One of the easiest ways to create a blockage in the bile ducts is to lodge a gallstone or biliary stone in the pathway.


Of course, you would never do this purposefully, though those with gallstones or biliary stones may find themselves in extreme pain should one of those stones break through from the gallbladder or liver and wedge itself in the bile ducts rather than passing through to the small intestine.


How to Diagnose a Biliary Obstruction

In order to treat a biliary obstruction, you must be seen and diagnosed by a doctor who treats them.  However, before making the appointment to see your specialist, chances are you will experience some of the following symptoms, thus prompting you to make a trip to the doctor:

  • Abdominal pain
  • Light-colored stools
  • Dark urine
  • Itching
  • Fever
  • Nausea
  • Vomiting
  • Weight loss
  • Jaundice


If you are seen by a doctor specializing in biliary obstructions, and have the above-mentioned symptoms, he will likely attempt to diagnose you using any of the following methods.


Blood Tests

There are several tests your physician can run help determine whether you have a blocked bile duct.  For example, the following blood test results may reveal that you have a possible bile duct obstruction:

  • Increased bilirubin levels
  • Increased alkaline phosphate levels
  • Increased liver enzymes


Visual Tests

Many times, your biliary physician will need to perform visual tests on you to determine whether there is a blockage in your bile duct:

  • Abdominal ultrasound. This is typically to check for gallstones.
  • Abdominal CT scan. Using x-rays, your biliary surgeon can detect obstructions from the cross-sectional images of your abdomen.
  • This test will provide visuals of your digestive system and the surrounding organs and tissues.
  • Using both x-rays and an endoscope to view your bile ducts internally, this test allows your doctor detects blockages.
  • This is a direst x-ray of your bile duct pathways.
  • Often used to check for developing pancreatic disease, this test can also look for biliary obstructions.
  • HIDA scan. Using radioactive material, this test will allow your physician to inspect your gallbladder and the surrounding bile ducts.


Treatment of Biliary Obstructions

If your biliary doctor suspects you have a biliary obstruction after performing the appropriate tests, the next step is to treat the cause for the blockage or narrowing of the duct so that you can regain your health as soon as possible.

Here are some of the options you may have for managing your biliary obstruction depending on the underlying cause:

  • Medication to dissolve existing gallstones or prevent more from forming
  • Low fat diet to reduce the amount of bile needed to thoroughly digest food
  • External radiation or chemotherapy
  • Antibiotics and pain management medication or therapy
  • Biliary surgery to remove tumors, gallstones, or other blockages
  • Stent insertion to inflate a collapsing bile duct and allow for bile to flow through naturally
  • Bile duct bypass to avoid the blockage and redirect the flow of bile into the small intestine
  • Full gallbladder removal if gallstones are the prevailing cause and other treatment options have failed to break them up or prevent them from blocking the bile ducts

In the end, there are several ways to manage a biliary obstruction depending on why it is obstructed in the first place.  The first thing to be aware of when it comes to obstructed bile ducts is whether you should see a biliary specialist . If you feel like you may be suffering from a blocked or narrowed bile duct, and are in the Baltimore, MD region, contact Dr. Fraiman today.

Having years of experience in the field of liver, pancreas, and gallbladder disease, and having performed numerous bile duct surgeries, Dr. Fraiman can detect a biliary obstruction right away and get you started on the right treatment path.  So, take your health into your own hands and have Dr. Fraiman and his team of experienced specialists help you regain your health in no time.