Bile duct strictureBile duct stricture; Biliary stricture
A bile duct stricture is an abnormal narrowing of the common bile duct. This is a tube that moves bile from the liver to the small intestine. Bile is a substance that helps with digestion.
A bile duct stricture is often caused by injury to the bile ducts during surgery. For example, it may occur after surgery to remove the gallbladder.
Other causes of this condition include:
- Cancer of the bile duct, liver or pancreas
- Damage and scarring due to a gallstone in the bile duct
- Damage or scarring after gallbladder removal
- Primary sclerosing cholangitis
- Abdominal pain on the upper right side of belly
- General feeling of discomfort
- Loss of appetite
- 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.
This condition may also alter the results of the following tests:
The goal of treatment is to correct the narrowing. This will allow bile to flow from the liver into the intestine.
This may involve:
- Endoscopic or percutaneous dilation or insertion of stents through the stricture
If surgery is done, the stricture is removed. The common bile duct will be rejoined with the small intestine.
In some cases, a tiny metal or plastic mesh tube (stent) is placed across the bile duct stricture to keep it open.
Treatment is successful most of the time. Long-term success depends on the cause of the stricture.
Inflammation and narrowing of the biliary duct may return in some people. There is a risk for infection above the narrowed area. Strictures that remain for a long period can lead to liver damage (cirrhosis).
When to Contact a Medical Professional
Call your health care provider if symptoms recur after pancreatitis, cholecystectomy, or other biliary surgery.
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Ball CG, Lillemoe KD. The management of benign biliary strictures. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017: 445-451.
Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 155.
Jackson PG, Evans SRT. Biliary system. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier Saunders; 2017:chap 54.
Review Date: 4/2/2018
Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.