Biliary obstruction is when your bile duct becomes blocked. Bile ducts or pancreatic ducts are vessels that carry bile from your liver and gallbladder through your pancreas to your intestines. A blockage in your bile duct can cause severe complications if left untreated.
What Are Bile Ducts?
Your liver produces a greenish-yellow fluid called bile, which helps break down fats in your food. Bile is made of cholesterol, bile salts, and water. It gets its color from bilirubin, which is formed when your blood cells break down.
Bile and pancreatic ducts are a network of tubes connecting your liver, gallbladder, pancreas, and intestine. They transport bile and digestive juices from the liver and pancreas to your small intestine to break down your food.
Bile flows through the bile ducts from the liver to the gallbladder. The gallbladder stores bile until it is needed. From the gallbladder, the bile passes through the pancreas via the pancreatic duct.
Here, the bile duct collects pancreatic juice, which contains digestive enzymes to break down sugars. Then, it carries these fluids to the small intestine for digesting fats and sugars.
Bile Duct Obstruction
Bile duct or biliary obstruction is blockage of one or more bile ducts in your body. If your bile duct is blocked, it can’t transport bile or pancreatic juice to your intestines for digestion. This causes bile to build up in your liver and increases bilirubin levels in your blood.
Causes of Biliary Obstruction
Here are some of the common causes of biliary obstruction.
Cholelithiasis — or gallstones. Bile can solidify in your gallbladder if you have high blood cholesterol levels. This leads to stone-like deposits called gallstones. Large gallstones can get stuck in your bile duct and result in biliary obstruction.
Injury during surgery. Bile duct injuries like a cut, burn, scar, or pinch during gallbladder surgery can cause a blocked bile duct.
Choledochal cysts. These can occur when parts of your bile duct become enlarged. In a few cases, they can lead to bile duct obstruction.
Chronic pancreatitis. Biliary obstruction can result from other conditions like pancreatitis — which is chronic inflammation in your pancreas.
Other causes. Your bile duct can become blocked if you get an injury in your abdomen. It may also occur due to infections, especially if you are taking drugs to suppress your immune system.
Symptoms of Biliary Obstruction
A biliary obstruction prevents bile from flowing out of your liver. This causes bile to build up in your liver cells as well as make bilirubin to leak into your blood.
Bile duct obstruction also stops bile from reaching your intestines. Without digestive juices, your food can’t be digested and absorbed properly. This may cause a vitamin deficiency.
A blockage in your bile duct can cause bilirubin to collect in your body because bile can’t escape. This can make your eyes and skin turn yellow, leading to jaundice. Without bilirubin in the bile, you may have pale, clay-colored stools and dark yellow urine.
You may also experience:
- Pruritus — or itchy skin
- Pain in your upper right abdomen
- Nausea and vomiting
- Tiredness and fatigue
- Weight loss
- Loss of appetite
Diagnosis of Biliary Obstruction
If you have a biliary obstruction, your doctor will examine your gallbladder and check your symptoms. Certain symptoms of biliary obstruction like jaundice can be confused with liver disease. Your doctor may check your history and ask about your alcohol or drug use.
Your doctor will order blood tests to check if the levels of the following are high:
- Alkaline phosphatase
- Pancreatic enzymes like amylase and lipase
- Liver enzymes like gamma-glutamyltransferase, ALT, and AST
If your blood test results suggest biliary obstruction, your doctor may confirm the diagnosis using:
Treatment of Biliary Obstruction
Bile duct obstruction can be treated by removing the blockage or curing the underlying cause.
Gallstones can be removed using endoscopic retrograde cholangiopancreatography. 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. Your doctor may recommend chemotherapy, radiotherapy, or surgery to treat your cancer.
If your bile duct is blocked due to choledochal cysts, your doctor will perform surgery to treat your enlarged bile ducts.
Biliary obstruction due to pancreatitis can be treated with endoscopic retrograde cholangiopancreatography. Your doctor may also prescribe medications to relieve pain.
Complications of Biliary Obstruction
If a bile duct obstruction is left untreated, it can result in:
Prevention of Biliary Obstruction
Gallstones are the most common cause of biliary obstruction. If you notice any symptoms of a blocked bile duct, consult your healthcare provider for medical advice.