Health Encyclopedia

Bile duct stricture

Definition

A bile duct stricture is an abnormal narrowing, most often 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.

Alternative Names

Bile duct stricture; Biliary stricture

Causes

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
Pancreatitis
Primary sclerosing cholangitis

Symptoms

Symptoms include:

Abdominal pain on the upper right side of belly
Chills
Fever
Itching
General feeling of discomfort
Loss of appetite
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)
Endoscopic ultrasound (EUS)

The following blood tests can help reveal a problem with the biliary system.

Alkaline phosphatase (ALP) is higher than normal.
GGT enzyme level is higher than normal.
Bilirubin level is higher than normal.

This condition may also alter the results of the following tests:

Treatment

The goal of treatment is to correct the narrowing. This will allow bile to flow from the liver into the intestine.

This may involve:

Surgery
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.

Outlook (Prognosis)

Treatment is successful most of the time. Long-term success depends on the cause of the stricture.

Possible Complications

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

Contact your health care provider if symptoms recur after pancreatitis, cholecystectomy, or other biliary surgery.

References

Dudeja V, Ferrantella A, Fong Y. The liver. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 54.

Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.

Ibrahim-zada I, Ahrendt SA. Management of benign biliary strictures. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:462-466.

Williams MJ, Gordon-Walker TT. Hepatology. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 24.

Review Date:5/4/2022
Reviewed By:Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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. Call 911 for all medical emergencies. 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.

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.