Bile duct stricture

A bile duct stricture is often caused by injury to the bile ducts during surgery. For example, it may occur after surgery to remove the gallbladder.

Other causes of this condition include:

• Cancer of the bile duct, liver or pancreas
• Damage and scarring due to a gallstone in the bile duct
• Damage or scarring after gallbladder removal
• Pancreatitis
• Primary sclerosing cholangitis

Symptoms include:

• Abdominal pain on the upper right side of belly
• Chills
• Fever
• Itching
• General feeling of discomfort
• Loss of appetite
• Jaundice
• Nausea and vomiting
• Pale or clay-colored stools

Magnetic resonance cholangiopancreatography (MRCP) is preferred initial noninvasive test. Other tests that may be used to diagnose this condition include:

• Endoscopic retrograde cholangiopancreatography (ERCP)
• Percutaneous transhepatic cholangiogram (PTC)
• Endoscopic ultrasound (EUS)

The following blood tests can help reveal a problem with the biliary system.

• Alkaline phosphatase (ALP) is higher than normal.
• GGT enzyme level is higher than normal.
• Bilirubin level is higher than normal.

This condition may also alter the results of the following tests:

• Amylase level
• Lipase level
• Urine bilirubin
• Prothrombin time (PT)

The goal of treatment is to correct the narrowing. This will allow bile to flow from the liver into the intestine.

This may involve:

• Surgery
• Endoscopic or percutaneous dilation of the stricture or insertion of stents through the stricture

If surgery is done, the stricture is removed. The common bile duct will be rejoined with the small intestine.

In some cases, a tiny metal or plastic mesh tube (stent) is placed across the bile duct stricture to keep it open.

Treatment is successful most of the time. Long-term success depends on the cause of the stricture.

Inflammation and narrowing of the biliary duct may return in some people. There is a risk for infection above the narrowed area. Strictures that remain for a long period can lead to liver damage (cirrhosis).

Contact your health care provider if symptoms recur after pancreatitis, cholecystectomy, or other biliary surgery.

Bile duct stricture; Biliary stricture

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Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 141.

Glasgow RE. Treatment of gallstone disease. In: Chung RT, Rubin DT, Wilcox CM, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 12th ed. Philadelphia, PA: Elsevier; 2026:chap 68.

Melstrom L, Labadie K, Fong Y. The liver. In: Tyler DS, Hayes-Dixon A, Hines OJ, et al, eds. Sabiston Textbook of Surgery. 22nd ed. Philadelphia, PA: Elsevier; 2026:chap 89.

Zyromski NJ. Management of benign biliary strictures. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 15th ed. Philadelphia, PA: Elsevier; 2026:chap 83.

Updated by: Todd Eisner, MD, Private practice specializing in Gastroenterology in Boca Raton and Delray Beach, Florida at Gastroenterology Consultants of Boca Raton. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.