Biliary stricture: 

 
A biliary stricture is an abnormal narrowing of the common bile duct.A biliary stricture is often caused by surgical injury to the bile ducts. For example, it may occur after surgery to remove the gallbladder (Cholecystectomy).Other causes of this condition include: damage and scarring due to a gallstone in the bile duct, Pancreatitis, Primary sclerosing cholangitis. Finally it may be due to Cancer of the bile duct.

Narrowing of the biliary duct causes infection above the narrowed area. Long-standing strictures can lead to fibrosis of liver called secondary liver cirrhosis

The common Symptoms are abdominal pain on the upper right side,chills,fever, Itching, Jaundice,nausea ,vomiting , pale or clay-colored stools and high coloured urine.

The following tests can help diagnose this condition: Abdominal ultrasound , Endoscopic retrograde cholangiopancreatography (ERCP), Magnetic resonance cholangiopancreatography (MRCP)

The following blood tests can indicate biliary obstruction: Bilirubin level and Alkaline phosphatase (ALP) are higher than normal. Increased prothrombin time (PT) is suggestive of coagulopathy.

Treatment

The goal of treatment is to correct the narrowing so that bile flow normally from the liver into the intestine. In some cases, a stent is placed across the bile duct stricture to keep it open.

The definitive treatment is to remove the stricture part of bile duct followed by joining of bile duct with intestine ( Roux -Y- hepatico jejunostomy) .

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