Bile Duct Stricture

Bile duct stricture refers to the narrowing of the bile ducts, which can obstruct bile flow from the liver to the intestine. This condition can lead to symptoms such as jaundice, abdominal pain, and cholangitis (bile duct infection). Strictures can be benign or malignant, and treatment depends on the underlying cause, severity, and location of the stricture.

Causes of Bile Duct Stricture

Benign Strictures:

• Post-surgical injury (e.g., following cholecystectomy).
• Chronic pancreatitis.
• Primary sclerosing cholangitis (PSC).
• Biliary stones or inflammation.

Malignant Strictures:

• Cholangiocarcinoma (bile duct cancer).
• Pancreatic cancer compressing the bile duct.
• Gallbladder cancer or metastases from other cancers.

Symptoms of Bile Duct Stricture

• Jaundice (yellowing of the skin and eyes).
• Pruritus (itching).
• Dark urine and pale stools.
• Abdominal pain, particularly in the upper right quadrant.
• Fever and chills in cases of cholangitis.

Treatment Options

Endoscopic Therapy:

• Balloon Dilation: Widening the narrowed duct using a balloon catheter.
• Stent Placement: Insertion of plastic or metal stents to maintain duct patency.

Percutaneous Intervention:

• Percutaneous Transhepatic Cholangiography (PTC): Used when endoscopic access is challenging.

Surgical Repair:

• Reserved for complex or recurrent strictures.
• Techniques include hepaticojejunostomy or other biliary reconstructions.

Treatment of Underlying Conditions:

• For malignant strictures, chemotherapy, radiation, or palliative stenting may be required.
• For PSC, liver transplantation may be an option in advanced cases.