Is common bile duct stenosis serious?

Common bile duct stenosis refers to blockage and narrowing caused by bile duct damage or inflammation. Such symptoms have a great impact on the secretion of bile by the common bile duct, and can lead to bile duct tumors and gallstones. It is a relatively serious disease, so patients are advised to receive timely treatment. Now let us learn about the treatment and causes of bile duct stenosis.

Bile duct stenosis is a scarring of the bile duct lumen caused by bile duct injury and recurrent cholangitis or congenitally. Biliary duct stenosis can be caused by iatrogenic injury, abdominal trauma, gallbladder stones, bile duct stones, bile duct inflammation, etc., leading to hyperplasia of fibrous tissue in the bile duct wall, thickening of the wall, and gradual narrowing of the bile duct lumen. Clinical manifestations include abdominal pain, chills, high fever, intermittent jaundice, etc. Antibiotic treatment is feasible in the early stage, but surgical treatment is the fundamental treatment for this disease.

Causes

1. Lesions of the bile duct itself

(1) Congenital abnormalities

(2) Inflammatory disease is common after ulceration of the bile duct wall caused by bile duct stones, mainly in the hilar area and intrahepatic bile duct.

(3) Most injuries are iatrogenic.

(4) The vast majority of tumors are bile duct cancers. (5) In addition to the bile duct anastomosis technique, the main reason after liver transplantation is insufficient blood supply to the bile duct, which is related to the prolonged cold ischemia time during transplantation.

2. Lesions outside the bile duct

(1) Pancreatic lesions The distal bile duct is closely attached to the back of the pancreatic head. Therefore, in addition to pancreatic cancer, chronic pancreatitis, especially autoimmune pancreatitis, can sometimes affect the distal bile duct, causing poor bile drainage.

(2) Enlarged hepatoduodenal lymph nodes Gastric cancer, pancreatic head cancer, etc. can metastasize to the lymph nodes within the hepatoduodenal ligament, thereby compressing the extrahepatic bile duct.

(3) Gallbladder cancer invades the hepatic hilar region and the hepatoduodenal ligament. Clinical manifestations include traumatic bile duct stenosis and a history of biliary surgery. Patients may occasionally develop cholangitis several months or 1 to 2 years after cholecystectomy, with abdominal pain, chills, high fever, and intermittent jaundice. The intervals between episodes gradually shorten and the symptoms become increasingly severe. A small number of patients present with painless jaundice or have developed biliary cirrhosis with portal hypertension.

diagnosis

Diagnosis can be aided by medical history and clinical symptoms such as abdominal pain, chills, high fever, intermittent jaundice, etc., combined with imaging examinations.

treat

1. General treatment effectively controls biliary tract infection, provides a high-sugar and high-protein diet, improves nutritional status; supplements energy mixtures and vitamins K, B, and C to maintain the liver and systemic immune system, etc.

2. Surgical treatment Surgical treatment is the first choice for this disease. The principle of treatment is to remove the stenotic scar lesions and repair and reconstruct the bile duct. The specific surgical method depends on the duration of biliary obstruction, the type and degree of stenosis, the pathological state and the general condition of the patient. Mucosa-to-mucosa Roux-en-Y anastomosis of the hepatic duct and jejunum has become the "gold standard" for the treatment of traumatic bile duct strictures and can achieve good therapeutic effects for most stricture diseases.