Table of contents Reviews Features Section 1. Anatomy, Pathophysiology, and Epidemiology of the Biliary System. Pathology of the Intrahepatic and extrahepatic Bile Ducts and Gallbladder. Epidemiology of Diseases of the Bile ducts and gallbladder. Percutaneous Biliary Imaging and Intervention. Surgery of the Biliary System. Natural History and Pathogenesis of Gallstones. The Intrahepatic and Extrahepatic Bile Ducts. Suyi Chang and Joseph Leung. Cystic Diseases of the Biliary System. Porte and Pierre-Alain Clavien. Biliary Complications of Liver Transplantation.
Markus Selzner and Pierre-Alain Clavien. Piotr Milkiewicz and Jenny Heathcote. It is also commonly referred to as biliary obstruction. A bile duct obstruction can lead to bile accumulating in the liver and a buildup of bilirubin in the blood. Gallstones are a common cause of bile duct obstruction.
They can form when there is a chemical imbalance in the gallbladder. If they are large enough, they may block a bile duct as they pass through the biliary system. Bile duct cancer refers to all cancers that develop within the biliary system. The resulting tumors may block a bile duct. Pancreatic cancers can cause a bile duct obstruction if the tumor enters the intestine.
Cancers that have started elsewhere in the body may also spread to the biliary system where they can cause an obstruction. A blockage can sometimes result from an injury that occurs during a medical procedure, such as gallbladder surgery or endoscopy.
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Choledochal cysts can sometimes cause bile duct obstructions. These cysts, which are sections of an enlarged bile duct, are congenital, meaning some people are born with them. They are also rare. Symptoms of a blocked bile duct may come on suddenly, or a person may start to notice them slowly over many years. Some of the symptoms are related to the obstruction, causing liver products to back up and leak into the bloodstream.
Others are caused by the bile duct not being able to deliver the digestive juices that the gut needs.
Diseases of the gallbladder and biliary tree. - PubMed - NCBI
This can stop the body from absorbing some fats and vitamins properly. When bilirubin is unable to enter the bile, it builds up in the body and can cause jaundice. This is when a person's skin and the whites of their eyes turn yellow. The lack of bilirubin in the bile can also cause dark urine and pale stools.
The first step in diagnosis is a physical examination, during which a doctor will try to feel the person's gallbladder.
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Liver damage can cause similar symptoms to biliary obstruction, so the doctor may also ask about alcohol or drug use as well as sexual practices. A doctor may also carry out blood tests.
The following results would suggest a biliary obstruction:. If blood tests suggest a biliary obstruction, the doctor may recommend one of the following imaging methods to confirm the diagnosis:. Doctors can usually remove gallstones using an endoscope during an ERCP. However, some people may still require surgery.
What causes bile duct obstruction?
Someone with severe or frequent symptoms may need to have their gallbladder removed. This will stop the problem of gallstones reoccurring. People can lead healthy lives without a gallbladder. If the cause is found to be cancer, the ducts may need to be stretched and drained. Doctors will do this either using an endoscope or by placing a needle through the skin.
They will then treat the cancer with a mix of chemotherapy and radiotherapy , depending on its type, size, and location. If someone has choledochal cysts, a doctor will usually recommend a surgical procedure to correct the enlarged areas of bile ducts.
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If left untreated, bile duct obstructions can lead to life-threatening infections. Extrahepatic bile duct obstruction is a well-recognized syndrome because of its association with pancreatitis and obvious jaundice.
Less common disorders of the biliary system include a cadre of diverse conditions, including necroinflammatory processes, cholelithiasis, malformations, neoplasia, and an emerging syndrome of gallblader dysmotility. National Center for Biotechnology Information , U. Didn't get the message?