Cancer can block the bile ducts, which carry bile from the liver to the small intestine to help digest fats. However, there are several types of noncancerous bile duct disorders that can also cause problems. Examples of noncancerous bile duct disorders include:
- Cholangitis (infection of the bile duct)
- Bile duct leaks, which can occur after certain surgeries and cause infection
- Biliary stricture (an abnormal narrowing of the bile duct)
- Biliary stones (choledocholithiasis, the presence of a gallstone in the common bile duct)
- Biliary changes after liver transplant (such as bile leaks or narrowing)
The diagnosis and treatment of bile duct disorders is best handled by a team of experts. The specialists at the Center for Advanced Digestive Care (CADC) of NewYork-Presbyterian/Weill Cornell Medical Center have extensive experience treating bile duct disorders, including the use of both surgical and advanced endoscopic approaches to relieve obstructed ducts and improve patients' quality of life.
Symptoms of Bile Duct Disorders
Disruption of bile duct function can cause a variety of symptoms, the most common of which include:
- Nausea and vomiting
- Itchy skin
Diagnosis of Bile Duct Disorders
The following diagnostic tests may be performed to diagnose blockages and other disorders of the bile ducts:
- Imaging tests, such as CT scanning and magnetic resonance imaging (MRI)
- Endoscopic ultrasound (EUS): EUS involves the use of a special endoscope with high-energy sound waves ("echoendoscope") to visualize the digestive tract and nearby organs.
- Probe-based confocal endomicroscopy: The CADC is one of few centers offering this highly specialized approach, which involves the use of a small microscope to evaluate narrowing in the bile ducts.
- Narrow band imaging: With this endoscopic technique, doctors use a special system to capture high-resolution images of the bile ducts without the use of dyes. NBI relies on the fact that light of different wavelengths penetrates tissue at different depths. The longer the wavelength, the deeper the tissue penetration. Blue light penetrates superficially, while red light penetrates more deeply. By using light of different wavelengths, doctors can see fine features of the lining (mucosa) of the bile ducts.
Treatment of Bile Duct Disorders
Our specialists are very experienced in diagnosing and treating disorders of the bile ducts. An interdisciplinary team of gastrointestinal specialists in advanced endoscopy, radiology, and surgery works together to provide each patient with coordinated, advanced, and individualized care.
The treatment of bile duct strictures, obstructions, and leaks can be treated with various surgical techniques and also endoscopically. One common procedure for these types of disease is endoscopic retrograde cholangiopancreatography (ERCP) to insert a stent within the blocked or narrowed area. ERCP is an advanced procedure which combines x-rays and the use of an endoscope. Our interventional endoscopists use ERCP or EUS-guided ERCP to insert special stents to re-open a blocked or clogged bile duct, restore function, and relieve patients' symptoms. Learn more about ERCP.
Biliary stones may be treated with ERCP and sphincterotomy (an endoscopic cut from the inside into the muscle in the common bile duct). Our interventional endoscopists also employ "laser lithotripsy" or mechanical lithotripsy (use of shock waves) to destroy biliary stones using a minimally invasive approach which spares the patient from a large open surgical procedure. Learn more about biliary stone treatment.