How is biliary stricture treated?

Endoscopic treatment consists of passing the stricture and placement of at least one large bore plastic stent, followed by further sessions of stenting with multiple plastic stents. Temporary placement of multiple plastic stents is the recommended approach in patients with benign biliary strictures.

Table of Contents

What is 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.

Can biliary stricture be cured?

There are no medical treatments for biliary stricture. Most of the times, it can be treated with a procedure, and possibly a surgery.

What causes a bile duct stricture?

The causes of benign bile duct strictures are usually surgical inexperience, failure to recognize abnormal biliary anatomy and congenital anomalies, acute inflammation, misplacement of clips, excessive use of cautery, and excessive dissection around the major bile ducts, resulting in ischemic injury.

Can a biliary stricture be benign?

Abstract. Biliary strictures can be broadly classified as benign or malignant. Benign biliary strictures are most commonly iatrogenic in nature and are a consequence of hepatobiliary surgery. Cholangiocarcinoma and adenocarcinoma of the pancreas are the most common causes of malignant biliary obstruction.

What is the normal size for the common bile duct?

4.1 mm

The mean diameter of the normal common duct was 4.1 mm. A common duct greater than 7 mm in diameter can be seen in (a) nonjaundiced pa- tients with gallstones and/or pancreatitis, or (b) jaundiced patients with common duct ob- struction by stone or tumor.

Can pancreatitis cause bile duct stricture?

After pseudocyst formation, bile duct stricture is the second most common complication in CP. It is most commonly found in chronic pancreatitis with inflammatory head mass or when there is dense calcification in the pancreatic head.

What percentage of biliary strictures are malignant?

It can be the result of either benign or malignant pathologies, but unfortunately, the majority of biliary strictures are malignant (76–85%) at the time of diagnosis [1].

Is 7mm bile duct normal?

A common duct greater than 7 mm in diameter can be seen in (a) nonjaundiced pa- tients with gallstones and/or pancreatitis, or (b) jaundiced patients with common duct ob- struction by stone or tumor. A common duct greater than 11 mm in diameter is strongly sug- gestive of obstruction by stone or tumor.

What is mild biliary dilatation?

Biliary dilatation (also called dilation) is a procedure to stretch bile ducts that are too narrow. Bile, a substance that helps in the digestion of fats, is made in the liver and stored in the gallbladder.

What are the symptoms of bile duct problems?

Symptoms of possible biliary disease

Jaundice (yellowing of the skin and whites of the eyes)
Abdominal pain, especially in the upper right side of the abdomen under the rib cage.
Nausea or vomiting.
Loss of appetite, which may result in weight loss.
Fatigue.
Fever or chills.
Itching.
Light brown urine.

What will happen if the bile duct is blocked?

If something is blocking the bile duct, bile can back up into the liver. This can cause jaundice, a condition in which the skin and white of the eyes become yellow. The bile duct might become infected and require emergency surgery if the stone or blockage is not removed.

How long can a bile duct be blocked?

After a period varying from four to six months, however, patients suffering from occlusion of the common bile duct usually deteriorate rapidly and die.

How can you tell the difference between benign and malignant strictures?

A benign stricture can be differentiated from a malignant one if it shows regular, symmetric and short segment narrowing. Irregular, asymmetric and long segment narrowing was more commonly found in malignant stricture.

What is common bile duct size?

The mean diameter of common bile duct was observed to be 4.1 mm (SD 0.95 mm) for males and 4.0 mm (SD 1.07 mm) for females.

What size should bile duct be?

What is normal bile duct size?

Gross and Ultrasound Anatomy
The CBD is approximately 8 cm long and usually < 6-7 mm wide in internal diameter, in adults. It joins the pancreatic duct at the ampulla of Vater, which drains into the second part of the duodenum through the major duodenal papilla.

Will a CT scan show blocked bile ducts?

CT scans can show the organs near the bile duct (especially the liver), as well as lymph nodes and distant organs where cancer might have spread to. A type of CT known as CT angiography can be used to look at the blood vessels around the bile ducts.

How long can you live with a blocked bile duct?

How do you unblock a biliary duct?

Surgical procedures like gallbladder removal or cholecystectomy may be required to treat biliary obstruction caused by recurring gallstones. For bile duct obstruction caused by cancer, your doctor will widen and drain your bile ducts using endoscopy or by inserting a needle through your skin.

Is bile duct surgery safe?

Possible risks and side effects of bile duct surgery
All surgery carries some risk, including the possibility of bleeding, blood clots, infections, complications from anesthesia, pneumonia, and even death in rare cases.

Does malignant mean cancerous?

Malignant tumors are cancerous (ie, they invade other sites). They spread to distant sites via the bloodstream or the lymphatic system. This spread is called metastasis. Metastasis can occur anywhere in the body and most commonly is found in the liver, lungs, brain, and bone.

Is 5mm bile duct normal?

In a study by Dewbury [16] the range of measurements in all patients was from 2 mm to 5 mm. He therefore recommended the upper limit to be 6 mm. Among 750 adult subjects, Bruneton et al., [17] found only 5.9% of to have a bile duct with a diameter greater than or equal to 5 mm.

Is 8mm bile duct normal?

The upper limit of normal for common bile duct diameter is 6 to 8 mm when measured with transabdominal ultrasonography, and 8 to 10 mm with CT. To adjust for age, adding 1 mm to the measurement per decade of life after age 60 or 0.4 mm for each decade of life has been proposed, although the evidence varies.

What blood test shows bile duct blockage?

Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), and gamma-glutamyl transpeptidase (GST) are liver enzymes. The amount in your blood can be measured to check for liver inflammation, irritation, or bile duct blockage.

How is biliary stricture treated?