Benign Biliary Stricture

Definition :-

• A benign biliary stricture is a non-cancerous narrowing of the bile ducts, which are the channels that carry bile from the liver and gallbladder to the small intestine.

Causes :-

• Surgical Injury :- The most common cause, often occurring after gallbladder surgery (cholecystectomy).
• Chronic Pancreatitis :- Inflammation of the pancreas can lead to scar tissue formation that compresses the bile ducts.
• Primary Sclerosing Cholangitis (PSC) :- A chronic disease that causes inflammation and scarring of the bile ducts.
• Bile Duct Stones :- These can cause scarring and narrowing over time.
• Infections :- Certain infections can lead to inflammation and subsequent stricture formation.

Symptoms :-

• Jaundice (yellowing of the skin and eyes)
• Itching (pruritus)
• Dark urine
• Pale stools
• Abdominal pain, particularly in the upper right quadrant
• Fever and chills (if an infection is present)

Diagnosis :-

• Blood Tests :- To check liver function and signs of infection.
• Imaging Tests :- Ultrasound, CT scan, MRI, and MRCP (Magnetic Resonance Cholangiopancreatography) to visualize the bile ducts.
• ERCP (Endoscopic Retrograde Cholangiopancreatography) :- Both a diagnostic and therapeutic procedure where an endoscope is used to examine the bile ducts and potentially treat the stricture.

Treatment :-

• Endoscopic Dilation :- Using ERCP, the stricture can be dilated (widened) with a balloon.
• Stent Placement :- A small tube (stent) can be placed in the bile duct to keep it open.
• Surgical Bypass :- In severe cases, surgery may be needed to bypass the stricture.
• Medications :- Antibiotics if there is an infection, and other medications to manage symptoms.

Complications :-

• Cholangitis :- Infection of the bile ducts.
• Liver Damage :- Long-term obstruction can lead to liver damage and cirrhosis.
• Biliary Cirrhosis :- A form of liver disease resulting from prolonged bile duct obstruction.

Prevention and Management :-

• Regular Monitoring :- For individuals with risk factors or previous bile duct injuries.
• Prompt Treatment :- Early intervention can prevent complications.
• Healthy Lifestyle :- Maintaining a healthy diet and avoiding alcohol can reduce the risk of conditions that may lead to biliary strictures.