Bile Duct Obstruction: A Guide

Medically Reviewed By Saurabh Sethi, M.D., MPH
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A bile duct obstruction refers to a blockage in the biliary system. It is commonly due to gallstones. People can take certain steps to reduce their risk of gallstones, thereby lowering their risk of a bile duct obstruction. These include maintaining a moderate weight and eating a diet low in fat and cholesterol.

This article will define what a bile duct obstruction is before looking at the types of bile ducts and the causes and treatment of an obstruction.

What is a bile duct obstruction?

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A bile duct obstruction is a blockage in one of the tubes that carry bile. Bile is a product of the liver. It contains cholesterol, bile salts to help digest fats, and waste products, such as bilirubin.

After the liver makes bile, this substance travels through a network of microscopic tubes called hepatic ducts. These small ducts meet to form one large duct called the common hepatic duct. Bile exits the liver through this duct. About half of the bile goes into the small intestine, and the rest goes to the gallbladder for storage.

The gallbladder releases stored bile into the small intestine when a person is eating. Bile from the gallbladder flows through a different pathway, called the cystic duct. The cystic duct meets the common hepatic duct from the liver to form the last bile duct, called the common bile duct. A blockage in any of these tubes is a bile duct obstruction.

The most common cause of a bile duct obstruction is a gallstone. Gallstones form inside the gallbladder and can move into the common bile duct, blocking it. Cysts, tumors, and inflammation are other possible causes of bile duct obstruction.

Bile duct obstructions are more common among people who have a history or increased risk of gallstones. Surgery or injury to the liver, gallbladder, or biliary network can also increase the risk.

When a blockage occurs in any of the bile ducts, bile accumulates within nearby structures. As bile builds up in the liver, it causes jaundice and other symptoms, such as nausea, vomiting, and upper abdominal pain.

Depending on the cause, these symptoms can appear abruptly or develop slowly with time. For example, gallstones may cause severe, acute symptoms, whereas tumors may cause a more gradual onset of symptoms.

Bile duct obstruction treatment usually involves surgery or an endoscopic procedure. The cause of the obstruction will determine what type of surgery or procedure is necessary.

Without treatment, a bile duct obstruction can cause life threatening complications. These include infection, sepsis, and liver damage. Contact a doctor right away if you notice symptoms of jaundice, such as yellow skin or eyes, dark urine, or pale stools.

What causes a bile duct obstruction?

There are various possible causes of a bile duct obstruction.

Gallstones

Gallstones are the most common cause of bile duct obstruction. Gallstones — which are small, hard pieces of material that resemble pebbles — form in the gallbladder. They typically consist of cholesterol or bilirubin.

These stones can block your bile duct, causing an obstruction. When this happens, it generally causes sudden pain in your upper right abdomen. Contact your doctor right away if you experience any of the following:

  • abdominal pain that lasts several hours
  • nausea and vomiting
  • fever or chills
  • jaundice
  • urine that is tea-colored or light-colored stools

Learn more about gallstones.

Cancer

Bile duct cancer does not generally cause symptoms. However, when symptoms are present, they are typically due to a bile duct obstruction.

The symptoms of bile duct cancer depend on whether the cancer is in the ducts inside or outside the liver. The symptoms may include:

If you experience any of these symptoms, contact a doctor.

Other causes of bile duct obstruction

Other causes of a bile duct obstruction include:

  • injury
  • surgery
  • inflammation

What are the types of bile ducts?

There are two types of bile ducts:

  • Extrahepatic bile ducts: These small tubes carry bile from the gallbladder and liver to the small intestine. They include the perihilar region and the distal region, also known as the haptic duct and the common bile duct.
  • Intrahepatic bile ducts: These small tubes carry bile within the liver. The smallest of these ducts come together to form the right and left hepatic ducts, which lead out of the liver.

What are the risk factors for a bile duct obstruction?

As gallstones are the main cause of a bile duct obstruction, having a history of gallstones or known risk factors for them increases the likelihood of obstruction.

Risk factors for gallstones include:

  • being 40 years old or older
  • having certain medical conditions, including Crohn’s disease, irritable bowel syndrome, or cirrhosis
  • having a family or personal history of gallstones or gallbladder attacks
  • being assigned female at birth
  • carrying excess body weight
  • rapid weight loss

Reducing your risk of a bile duct obstruction

Reducing your risk of gallstones may help you lower your risk of a bile duct obstruction. You may be able to reduce your risk by:

  • getting regular exercise
  • eating a low fat, low cholesterol, and high fiber diet
  • losing weight slowly and steadily
  • maintaining a moderate weight

If you have concerns about your risk of a bile duct obstruction, talk with a doctor.

What are the treatments for a bile duct obstruction?

Regardless of the cause, the goal of bile duct obstruction treatment is to alleviate the blockage. This usually means surgery or an endoscopic procedure.

If gallstones are the cause, many cases will require gallbladder removal, along with the removal of any stones blocking the ductal pathways. Often, this is possible with laparoscopic surgery. Removing the gallbladder is sometimes the most efficient way to prevent future problems.

If you are not experiencing any symptoms, your doctor may recommend active monitoring of the gallstones and any symptoms you may develop.

For other causes, a surgeon may be able to remove or bypass the blockage.

Learn more about gallbladder removal.

What are the potential complications of a bile duct obstruction?

The potential complications of a bile duct obstruction are serious and potentially even life threatening. They include dangerously high levels of bilirubin in the blood and infection, which can lead to sepsis.

Long-term bile duct blockages can result in chronic liver disease, such as biliary cirrhosis.

Summary

Bile duct obstructions are commonly due to gallstones. They can also be the result of certain cancers, inflammation, and injury.

A bile duct obstruction is a blockage in one of the tubes that carry bile. The symptoms of a blockage include abdominal pain, jaundice, and itching.

Treatment for a bile duct obstruction typically involves clearing the blockage, which is generally possible through an endoscopic procedure or surgery. A doctor may recommend removing your gallbladder if gallstones are the cause of the obstruction.

If you are experiencing symptoms of an obstruction, contact a doctor.

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Medical Reviewer: Saurabh Sethi, M.D., MPH
Last Review Date: 2022 Aug 25
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