Everything You Need to Know About Bile Duct Strictures


What is a Bile Duct Stricture?

In the past, we have discussed what your gallbladder is and what it does.  And, unbeknownst to many people, the gallbladder is actually a key player when it comes to digesting the fats you consume on a daily basis.  In fact, the gallbladder stores bile produced by the liver, releases it during the digestive process through the biliary system via the bile duct, and helps break down food found in the stomach and small intestine.

While typically a smooth process, the flow of bile through the biliary system can become quite complicated if the bile duct becomes narrowed.  Called a bile duct stricture, this narrowing of the bile duct dramatically reduces the amount of bile delivered to the small intestine for digestive purposes.  And, as you might guess, this reduced amount of bile can create many health issues if not treated properly by an experienced bile duct specialist.

Today we are going to look at bile duct stricture causes, possible symptoms you may experience if you have a bile duct stricture, and the potential treatment options your bile duct stricture specialist may recommend.


3 Causes of Bile Duct Strictures

There are several reasons your bile duct may become narrowed thus restricting the flow of bile into your small intestine.  Here are some of the most common causes for developing a bile duct stricture.


1. Bile Duct Injury

A common bile duct injury is most likely to occur during the surgical procedure called a laparoscopic cholecystectomy, or gallbladder removal.  Although very rare, this type of injury can lead to very serious health complications, such as a bile duct stricture.

During a gallbladder removal, there are times when the surgeon mistakenly cuts, burns, or pinches the bile duct causing a small hole or tear.  This can be because of your anatomical structure, excess fat, or bleeding; all of which can hinder the surgeon’s view during surgery.

This tear will cause bile to leak out in to your abdomen and cause things like pain, inflammation, and infections.  Additionally, the amount of bile delivered to the small intestine is reduced and the fats you consume do not digest properly.

If you experience a bile duct injury and do not treat it right away, the tear will begin to heal on its own, which can lead to excessive scar tissue formation.  This scar tissue is the root cause of bile duct narrowing.  Again, bile is then unable to flow properly to its intended location.


2. Bile Duct Cancer

Though a rare type of cancer that affects a small percentage of Americans each year, bile duct cancer can severely restrict your bile duct and prevent proper amounts of bile being delivered to the small intestine during digestion.

There are three types of bile duct cancer you can be diagnosed with – intrahepatic, perihilar, or distal bile duct cancer – all of which will affect your bile duct in a negative way.  The main reason you might develop a bile duct stricture with cancer is because of the formation of a tumor within or near the bile duct.  These tumors can either block the duct itself or place pressure on the duct restricting its overall size and ability to deliver bile smoothly.


3. Pancreatitis and Pancreatic Cancer

Another common reason the bile duct becomes scarred, inflamed, or damaged is because of the development of either acute or chronic pancreatitis.  The infection and inflammation that results from pancreatitis can affect the nearby bile duct and damage it.

Additionally, since the gallbladder, pancreas, and bile duct are in such close proximity, pancreatic cancer has been known to create a bile duct stricture due to tumor growth.  Unfortunately, pancreatic cancer is a very serious condition that requires the skilled hands of a pancreatic surgeon and a complicated surgery called the Whipple procedure to resolve.


Bile Duct Stricture Symptoms


Those with a bile duct stricture will typically experience some symptoms.  This is especially true as the duct becomes more restricted over time.  Common symptoms of a bile duct stricture include:

  • Pain in the upper-right abdomen
  • Fever
  • Itching
  • Chills
  • Nausea
  • Jaundice (or yellow skin)
  • Pale or clay colored stools
  • Fatigue
  • Weight loss
  • Night sweats


If you experience any of these symptoms, it is crucial you see your bile duct specialist.  If not you may develop inflammation that extends to your gallbladder, liver, or pancreas.  Moreover, you may develop a serious infection, low blood pressure, or even sepsis of the blood.


Treating a Bile Duct Stricture

The overall treatment goal for a bile duct stricture is a widening of the duct so normal bile flow can resume. Here are the most common treatment options available for treating a bile duct stricture:

  • The first thing your bile duct specialist will do is prescribe you medication and antibiotics to reduce the inflammation and fight any present infections.  Many people respond to this treatment well.  However, additional treatment is typically required.
  • Endoscopic Dilation. This treatment is done by placing a hollow tube within the restricted bile duct to widen it and keep it open.  This will allow the normal flow of bile through the duct.
  • Surgical Therapy. If endoscopic dilation is unsuccessful or is not a viable treatment option, surgery is then recommended.  Surgery will either repair or completely remove the stricture form the bile duct.  From there, the healthy portion of the duct is then reattached to the small intestine so bile can begin flowing normally again.


In the end, no one wants to experience a bile duct stricture.  Whether from a surgical mishap, a cancer scare, or some other source of inflammation or infection, the keys to treating and preventing further bile duct strictures are good health, quick diagnoses, and quality treatment by a specialist experienced in treating bile duct strictures.

If you are in the Baltimore region and fear you may have a bile duct stricture, or a related condition that may cause a stricture in the future, contact Dr. Fraiman and his team of experts and get help right away.  With years of experience treating bile duct strictures, bile duct injuries, and related diseases that may cause bile duct narrowing, Dr. Fraiman will know exactly how to treat your individual case.  Taking pride in his individualized approach to patient treatment, you can rest assured you will get the highest quality care with Dr. Fraiman and walk out at the end of your treatment with a completely new outlook on life.


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