Symptoms and treatment for obstruction of the bile ducts. Blockage of the bile ducts: causes, symptoms and treatment features

Inna Lavrenko

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Obstruction of the bile ducts is usually associated with their blockage by some mechanical obstruction, which does not allow bile from the liver and gallbladder to enter the duodenum.

The cause of such blockage may be cholelithiasis, inflammation of the bile ducts, their narrowing (stricture), as well as the formation of tumors and scars in the lumen of the common bile duct (common bile duct). As a rule, it is the listed pathologies that cause bile duct obstruction. Treatment of such diseases is carried out mainly by surgical methods - from endoscopic intervention to extended abdominal or laparoscopic surgery. Blockage of the bile duct, description, symptoms and treatment is the topic of today’s article,

This very dangerous complication occurs after a number of different diseases of the digestive system, the most common of which is cholelithiasis, which is diagnosed in almost every fifth person. Women are much more susceptible to this disease than men.

With the development of this pathology, gallstones are formed in the cavity of the bladder, which, during their migration, can partially or completely block the lumens of the bile ducts, leading to their obstruction. Disruption of normal bile outflow is accompanied by the appearance of signs of obstructive jaundice, which is characterized by yellowing of the skin and eye sclera, as well as severe pain. If the patient is not provided with qualified assistance in a timely manner, obstruction of the bile ducts can even lead to death.

It is worth noting that blockage of the bile ducts can be caused not only by a mechanical obstruction inside the bile duct (for example, a stone), but also by compression of the duct from the outside.

The severity of the clinical picture of the disease depends on how much the lumen of the duct is blocked.

As a rule, the process of obstruction of the bile duct begins with its inflammation, as a result of which the mucous membrane of the bile ducts thickens and the lumen, accordingly, narrows. When a gallstone enters such an inflamed canal, it becomes stuck, resulting in the common bile duct being partially or completely blocked. Bile, having no outlet, accumulates in the ducts and stretches their walls. Since hepatic bile first enters the gallbladder, if the cystic or common duct is obstructed, the walls of this organ also stretch, thereby exacerbating the course of cholecystitis. If this occurs against the background of cholelithiasis, then stones from the bladder cavity can begin to migrate into the cystic duct, causing its obstruction. The most dangerous complications of this pathological process are dropsy or empyema of the gallbladder.

If bile is retained in the intrahepatic bile ducts, this can cause destruction of liver cells (hepatocytes), as a result of which bilirubin and bile acids can enter the blood, causing general intoxication of the entire body. In addition, since bile is responsible for the breakdown and subsequent absorption of heavy lipids, its lack in the intestines leads to impaired absorption of vitamins contained in fats (A, E, K and D). This leads to the development of hypoprothrombinemia, disruption of normal blood clotting and other manifestations of hypovitaminosis. If the stagnation of hepatic bile in its excretory tract continues long enough, this leads to serious damage to the liver parenchyma, against which liver failure develops.

Risk factors that increase the likelihood of bile duct obstruction, experts include:

improper diet and regimen;
obesity;
rapid loss of body weight;
injuries in the area of the right side of the abdominal cavity;
the patient has recently undergone surgery on the organs of the biliary and digestive system;
infectious lesions of the biliary organs;
weakened immunity.

Clinical picture of bile duct blockage

As a rule, pathology begins to manifest itself gradually.

Acute manifestations at an early stage are quite rare. As we said above, usually the onset of this process is associated with the development of inflammation or infection of the bile ducts. The patient begins to complain of increased body temperature, weight loss and paroxysmal pain on the right side under the ribs. Yellowness of the skin and eye sclera may appear, accompanied by itchy skin. A deficiency of bile acids in the intestines causes discoloration of stool, and an increase in the level of direct bilirubin causes darkening of urine. If the blockage of the bile ducts is partial, alternating between discolored and normally colored stool is observed.

The destruction of hepatocytes leads to disruption of all liver functions and the development of acute liver failure. The very first thing that is disrupted is the detoxification function of this organ, which is expressed by the following symptoms:

general weakness;
increased fatigue;
gradual disruption of the functions of other internal organs and systems of the body (brain, kidneys, heart, lungs).

The onset of this stage of pathology development is characterized by a very unfavorable prognosis.

The clinical picture of this pathology at an early stage of its development resembles the symptoms of cholecystitis or hepatic colic.

These external signs may lead to hospitalization of the patient.

Initial diagnosis is carried out using an abdominal ultrasound procedure. If gallstones are detected, magnetic resonance cholangiography or computed tomography may be prescribed to search for them in the bile ducts.

In order to clarify the causes that cause obstructive jaundice, as well as to determine the location of the stone and the degree of blockage of the lumen of the duct, the technique of percutaneous transhepatic cholangiography and the method of dynamic scintigraphy of the biliary system are used. These instrumental diagnostic methods make it possible to identify disturbances in the dynamics of bile and bile outflow.

The most informative method for diagnosing biliary tract obstruction is considered to be the method of retrograde cholangiopancreatography, which involves simultaneous endoscopic and x-ray examination of the bile ducts. If stones are detected in the lumen of the bile duct, during such a procedure it is possible to extradite the stone from the common bile duct, and if a tumor is detected compressing the duct, it is possible to take a biopsy from it.

If we talk about laboratory diagnostic methods, they can reveal the following:

biochemical liver tests reveal elevated levels of direct bilirubin, transaminases, alkaline phosphatase, blood lipase and amylase;
a general blood test determines leukocytosis, in which the leukoformula shifts to the left;
this analysis also makes it possible to detect a decrease in the level of platelets and red blood cells characteristic of this pathology;
The coprogram in this disease is characterized by a significant content of fat in the feces and the absence of bile acids.

Firstly, patients with this diagnosis need consultation with a gastroenterologist and surgeon. After all the necessary examinations have been carried out, the location and degree of blockage have been determined, a surgical therapy technique is selected. Such pathologies cannot be treated with conservative methods.

If the patient is in serious condition, he is transferred to the intensive care unit, where urgent infusion, antibacterial and detoxification treatment is carried out. Before the patient's condition becomes stable, surgical intervention is very dangerous, and therefore preliminary methods of facilitating bile outflow are used, namely:

If the use of these techniques does not alleviate the patient’s condition, a more complex operation is performed for percutaneous transhepatic drainage of the biliary tract.

After normalization of the patient’s general condition, in the absence of contraindications, the use of endoscopic methods of surgical treatment is recommended. During this intervention, bougienage (expansion of the lumen) of the bile ducts is performed (in cases of cicatricial stenosis and structures caused by tumors). It is possible to introduce special plastic or mesh tubular prostheses into the lumen of the canal to increase patency (endoscopic common bile duct stenting procedure). If the calculus has blocked the scar-narrowed papilla of the duodenum, then the procedure of endoscopic balloon dilatation of the sphincter of Oddi is used.

If endoscopic methods do not allow removing obstacles to normal bile outflow, advanced types of surgical intervention are used.

Choledochotomy involves opening the common bile duct, and therefore it is necessary to take measures to prevent subsequent leakage of bile into the abdominal cavity through postoperative sutures. For this purpose, external drainage of the biliary tract is carried out according to Keru using a T-shaped tube.

After cholecystectomy (surgery to remove the gallbladder), external drainage is performed according to Halstead using a polyvinyl chloride catheter, which is inserted into the area of the cystic duct stump.

If obstruction of the biliary tract is not treated in a timely manner using surgical techniques, this can lead to the development of sepsis, liver cirrhosis, bilirubin encephalopathy and the occurrence of liver failure (if the obstruction of the duct is complete - in acute form, if partial - in chronic form).

If medical care is provided to a patient with this diagnosis on time, then the overall prognosis is favorable. Cancer of the common bile duct seriously complicates the treatment of such pathologies.

If we talk about preventive measures for such diseases, they consist in the timely treatment of existing diseases of the biliary system and digestive organs, as well as in maintaining the correct regime and diet and in a healthy lifestyle.

Blockage of the bile ducts is a mechanical obstruction that occurs in the path of the flow of bile entering the duodenum to organize a stable process of digestion and breakdown of fatty acids. In most cases, it develops against the background of inflammatory diseases of the gallbladder or as a result of the formation of stones of various structures, sizes and nature of origin. The symptoms of this disease are almost always acute, and the patient admitted to the hospital complains of severe pain in the right hypochondrium. Treatment of bile obstruction is surgical in nature and is aimed at restoring the lumen of the bile duct and removing foreign objects that block the normal functioning of this organ of the digestive tract.

It will not be difficult for an experienced gastroenterologist to suspect, just by external signs, that the patient’s channels through which bile should circulate are clogged.

Symptoms of the disease first develop gradually, and then acquire vivid and specific manifestations, which is expressed in the following pathological sensations on the part of the patient:

In addition to this, the patient complains of loss of appetite, nausea, general physical weakness, periodic vomiting, and upset stool.

If the duct is only partially blocked, then the symptoms of the disease disappear from time to time, but after 1-2 days they return again.

This suggests that the body is independently trying to unblock the path for a stable outflow of bile, but despite all attempts, the negative influence of the factor still remains, which does not allow digestive secretions to circulate freely and enter the organs of the gastrointestinal tract.

Causes of bile duct obstruction

Obstruction of the bile ducts can occur due to static compression of their walls from the outside, on the sides, or from inside the duct itself. The presence of these circumstances has a direct impact on the clinical picture of the disease. In addition, there are a number of pathologies of this part of the human digestive system that disrupt the functioning of both the gallbladder itself and its ducts. Based on this, the following reasons for canal obstruction are identified:

In medical practice, there are clinical cases where patients with symptoms of bile duct obstruction were admitted to the inpatient department of a hospital after suffering an abdominal injury. This is a strong blow to the right side of the abdomen, or a fall from a great height, which provoked swelling of the mucous membranes and epithelial tissues located in the circumference.

Which doctor should I go to and what tests should I undergo?

It all depends on where exactly the person who is experiencing signs of bile duct blockage lives. It is recommended to make an appointment with a gastroenterologist or hepatologist. If for one reason or another there are no specialists of the specified profile in the clinic as a staff unit, then in this case it is necessary to visit a general practitioner. This is a family doctor who has a large amount of knowledge and is able to conduct an initial examination of the patient, palpate the abdominal cavity and establish that the localization of the pathology is concentrated on the right side in the hypochondrium.

After this, the patient is prescribed an additional list of tests and diagnostic measures, which consists of the following actions:

blood from a finger for her clinical study;
morning urine on an empty stomach;
Ultrasound diagnostics of the abdominal cavity with a particularly careful study of the structure of the liver tissue, the gallbladder, its ducts and communication routes with neighboring organs of the gastrointestinal tract;
venous blood for its biochemical analysis;
feces to examine feces for the presence or absence of bilirubin, bile particles and other enzymes, the synthesis of which is closely related to the functional activity of the gallbladder.

In particularly complicated cases, MRI diagnostics may be required if all of the above methods have not brought the desired result and the attending physician still doubts the diagnosis.

For oncological pathologies, a biopsy is used with histological analysis of selected tissue samples in order to establish the malignant or benign etiology of the tumor body.

Treatment of clogged bile ducts

Therapy for the disease largely depends on the clinical picture of its manifestation and the symptoms that are present in a particular patient. The following treatment methods are most often used.

Surgical stone removal

It can be carried out using endoscopic equipment with the goal of minimal trauma to the patient’s body, or through extensive surgery with a strip incision and opening of the common bile duct (choledochotomy). At this time, the patient is in the operating room under general anesthesia.

Bougienage

The therapeutic method is intended to expand the lumen of the bile ducts if they have narrowed after suffering a severe inflammatory process associated with the formation of multiple scars on the inside of the canal walls. Special medical equipment and endoscopic instruments are used.

Common bile duct stenting

This is a minimally invasive operation, the principle of which is that a special expansion stent is inserted into the cavity of the common bile duct. Its functional purpose is to relieve painful symptoms, restore bile patency and prevent relapse of the disease in the future.

Transrenal drainage

It is used only in particularly complex clinical cases, when blockage of the biliary tract has caused complications and liver disorder has occurred, and the patient himself is at risk of liver failure. In order to avoid this kind of negative consequences, forced bile drainage is installed.

Anti-inflammatory and antibacterial drugs are actively used in combination with surgical treatment. Especially if the narrowing of the lumen of the bile duct occurs due to the entry of pathogenic microflora into it.

Prevention

In order to never encounter blockage of the common bile duct, or to minimize the risk of the disease, you should follow simple rules of prevention daily, consisting of the following actions:

eating only biologically healthy foods;
complete cessation of alcoholic beverages, smoking and drug use;
maintaining an active lifestyle, playing sports;
balanced and moderate consumption of foods containing fiber, fats of plant and animal origin, meat and dishes prepared on their basis;
fried, smoked, pickled, highly fatty foods should be excluded from the menu completely;
periodically take (1 course every 6 months) natural-based medications that stimulate the outflow of bile and prevent it from stagnating in the bladder and ducts with further transformation into stones.

It is very important to promptly treat infectious and viral liver diseases, not to transform them into a chronic condition, which can at any time go into the acute stage and negatively affect the functioning of the gallbladder. People who pay attention to these preventive measures never have problems with this part of the digestive system and always have an excellent appetite, but do not gain weight.

Biliary obstruction is a blockage of the bile ducts that carry bile from the liver to the gallbladder and small intestine.

Causes

It is a fluid formed in the liver. It contains cholesterol, bile salts and metabolic products such as bilirubin. Bile salts help the body break down fats. From the liver, bile flows through the bile ducts into the gallbladder, where it accumulates. After eating, bile enters the small intestine.

When the bile ducts are blocked, bile accumulates in the liver, and due to an increase in the level of bilirubin in the blood, jaundice (yellow coloration of the skin) develops.

Risk factors for the disease include:

Medical history of gallstones, chronic pancreatitis or pancreatic cancer
Abdominal injuries
Recent surgery on the biliary tract
History of biliary system cancer (eg, bile duct cancer)

In people with weakened immune systems, obstruction can also be caused by infection.

Symptoms

Pain in the upper right corner of the abdomen
Darkening of urine
(jaundiced discoloration of the skin)
Nausea and vomiting
Stool discoloration

Diagnostics

The doctor or nurse will examine you and your stomach.

The following blood test results may indicate possible obstruction:

Increased bilirubin levels
Increased alkaline phosphatase levels
Increased liver enzyme levels

The following tests may be ordered to identify possible bile duct obstruction:

Ultrasound of the abdominal organs
abdominal organs
Endoscopic retrograde cholangiopancreatography (ERCP)
Percutaneous transhepatic cholangiography (PTCH)
Magnetic resonance cholangiopancreatography (MRCP)

Bile duct obstruction may also affect the following tests:

Amylase content in blood
Radionuclide scan of the gallbladder
Blood lipase content
Prothrombin time (PT)
Bilirubin content in urine

Treatment

The goal of treatment is to relieve the obstruction. Stones can be removed through an endoscope during ERCP.

In some cases, surgery may be necessary to relieve the obstruction. If the blockage is caused by gallstones, they are usually removed. If you suspect an infection, your doctor may prescribe antibiotics.

If the obstruction is caused by cancer, the duct may be dilated. This procedure is called endoscopic or percutaneous (done through the skin near the liver) dilatation. A special tube may be placed in the duct to provide drainage.

Forecast

If the obstruction is not corrected, it can lead to life-threatening infections and a dangerous buildup of bilirubin.

Long-term obstruction can lead to chronic liver disease. Most obstructions can be relieved by endoscopy or surgery. Blockages caused by cancer tend to have a worse prognosis.

Possible complications

If left untreated, complications such as infections, sepsis and liver diseases such as biliary cirrhosis can occur.

When to see a doctor

Call your doctor if you notice changes in the color of your urine or stool, or if you have jaundice.

Prevention

Being aware of your risk factors will help you get timely diagnosis and treatment if you have a blocked bile duct. There are no methods to prevent biliary obstruction.

– a mechanical obstacle to the movement of bile from the liver and gallbladder into the duodenum. Develops against the background of cholelithiasis, tumor and inflammatory diseases of the biliary tract, strictures and scars of the common bile duct. Symptoms of the pathology are pain in the right hypochondrium, jaundice, acholic stool and dark urine, and a significant increase in the level of bilirubin in the blood. The diagnosis is made based on studies of biochemical blood samples, RP, ultrasound, MRI and CT of the abdominal organs. Treatment is usually surgical - endoscopic, laparoscopic or extended surgery is possible.

General information

Blockage of the bile ducts is a dangerous complication of various diseases of the digestive system, which leads to the development of obstructive jaundice. The most common cause of blocked bile ducts is gallstone disease, affecting up to 20% of people. According to the observations of specialists in the field of gastroenterology and abdominal surgery, women suffer from cholelithiasis three times more often than men.

Difficulty in the outflow of bile from the liver and gallbladder is accompanied by the gradual development of the clinical picture of subhepatic (obstructive) jaundice. Acute blockage of the biliary tract can develop immediately after an attack of biliary colic, but this is almost always preceded by symptoms of inflammation of the biliary tract. Failure to provide timely assistance to a patient with bile duct blockage can lead to the development of liver failure and even death of the patient.

Causes

Obstruction of the bile ducts can be caused either by blockage from the inside or compression from the outside. A mechanical obstruction to the outflow of bile can be complete or partial; the severity of the clinical manifestations depends on the degree of obstruction. There are a number of diseases that can interfere with the passage of bile from the liver to the duodenum. Blockage of the ducts is possible if the patient has: stones and bile duct cysts; cholangitis or cholecystitis; scars and ductal strictures.

The pathogenesis of blockage of the bile ducts is multicomponent; the inflammatory process in the bile ducts usually begins. Inflammation leads to thickening of the mucosa and narrowing of the lumen of the ducts. If at this moment a calculus enters the ducts, it cannot leave the common bile duct on its own and causes complete or partial closure of its lumen. Bile begins to accumulate in the bile ducts, causing them to expand. From the liver, bile can first enter the gallbladder, significantly stretching it and causing an exacerbation of the symptoms of cholecystitis.

If there are stones in the gallbladder, they can enter the cystic duct and block its lumen. In the absence of bile outflow through the cystic duct, empyema or hydrocele of the gallbladder may develop. An unfavorable prognostic sign for blockage of the bile ducts is the secretion of whitish mucus (white bile) from the common bile duct mucosa - this indicates the onset of irreversible changes in the bile ducts. Bile retention in the intrahepatic ducts leads to the destruction of hepatocytes and the release of bile acids and bilirubin into the bloodstream.

Active direct bilirubin, not bound to blood proteins, enters the blood, causing significant damage to the cells and tissues of the body. Bile acids contained in bile facilitate the absorption and metabolism of fats in the body. If bile does not enter the intestines, the absorption of fat-soluble vitamins A, D, E, K is impaired. Because of this, the patient develops hypoprothrombinemia, blood clotting disorders, and other symptoms of hypovitaminosis. Further stagnation of bile in the intrahepatic tract leads to significant damage to the liver parenchyma and the development of liver failure.

Symptoms

Symptoms of bile duct blockage usually appear gradually; acute onset is quite rare. Typically, the development of clinical biliary obstruction is preceded by a biliary tract infection. The patient complains of fever, weight loss, and cramping pain in the right hypochondrium. The skin becomes jaundiced, and the patient is bothered by itching of the skin. The lack of bile acids in the intestines leads to discoloration of stool, and increased excretion of direct bilirubin by the kidneys leads to the appearance of dark-colored urine. With partial blockage, alternation of discolored portions of feces with colored ones is possible.

Complications

Against the background of destruction of hepatocytes, all liver functions are disrupted, and acute liver failure develops. First of all, the detoxification activity of the liver suffers, which is manifested by weakness, increased fatigue, and gradual disruption of the functioning of other organs and systems (lungs, heart, kidneys, brain). If the patient does not receive help before this stage of the disease, the prognosis is extremely unfavorable. In the absence of timely surgical treatment of the pathology, the patient may develop sepsis, bilirubin encephalopathy, and cirrhosis of the liver.

Diagnostics

The initial manifestations of blockage of the bile ducts resemble symptoms of cholecystitis or biliary colic, with which the patient can be hospitalized in the gastroenterology department. Preliminary diagnosis is carried out using such a simple and safe method as ultrasonography of the pancreas and biliary tract. If biliary tract stones, dilatation of the common bile duct and intrahepatic bile ducts are detected, MR pancreatocholangiography and CT scan of the biliary tract may be required to clarify the diagnosis.

To clarify the cause of obstructive jaundice, the location of the stone, the degree of blockage of the bile ducts, percutaneous transhepatic cholangiography and dynamic scintigraphy of the hepatobiliary system are performed. They make it possible to detect disturbances in the dynamics of bile, its outflow from the liver and gallbladder. The most informative diagnostic method is retrograde cholangiopancreatography. This technique includes simultaneous endoscopic and x-ray examination of the biliary tract. If stones are detected in the lumen of the duct during this procedure, stones can be extracted from the common bile duct. If there is a tumor compressing the bile duct, a biopsy is taken.

Biochemical liver tests show increased levels of direct bilirubin, alkaline phosphatase, transaminases, amylase and blood lipase. Prothrombin time is prolonged. A general blood test may reveal leukocytosis with a shift of the leukocyte formula to the left, a decrease in the level of red blood cells and platelets. The coprogram contains a significant amount of fat and no bile acids.

Treatment of blocked bile ducts

All patients require consultation with an abdominal surgeon. After all examinations have been carried out, the location and degree of obstruction have been determined, the tactics of surgical treatment are determined. If the patient's condition is severe, it may be necessary to transfer him to the intensive care unit for antibacterial, infusion and detoxification therapy.

Until the patient's condition is stabilized, extensive surgery can be dangerous, so non-invasive methods are used to facilitate the outflow of bile. These include extraction of bile duct stones and nasobiliary drainage during RPCG (through a probe inserted above the site of narrowing of the bile ducts), percutaneous puncture of the gallbladder, cholecystostomy and choledochostomy. If the patient's condition does not improve, a more complex intervention may be required: percutaneous transhepatic drainage of the bile ducts.

After the patient’s condition returns to normal, the use of endoscopic treatment methods is recommended. During endoscopy, dilation (endoscopic bougienage) of the biliary tract is carried out in case of cicatricial stenosis and tumor strictures, and a special plastic or mesh tube is inserted into the biliary tract to preserve their lumen (endoscopic stenting of the common bile duct). If a scar-narrowed duodenal papilla is obstructed by a calculus, endoscopic balloon dilatation of the sphincter of Oddi may be required.

If stones and other obstructions to the outflow of bile cannot be removed endoscopically, an extended operation is required. During such a surgical intervention, the common bile duct is opened (choledochotomy), so in the future it is necessary to prevent the leakage of bile through the sutures of the bile duct into the abdominal cavity. To do this, external drainage of the bile ducts is performed according to Kehr (with a T-shaped tube), and after cholecystectomy - external drainage of the bile ducts according to Halsted (with a polyvinyl chloride catheter inserted into the stump of the cystic duct).

Prognosis and prevention

The prognosis for timely provision of medical care is favorable. Cancerous obstruction of the common bile duct significantly worsens the course of the disease and the results of treatment. Prevention consists of the treatment of chronic inflammatory diseases of the hepatobiliary system, cholelithiasis. It is recommended to maintain a healthy lifestyle, proper nutrition with the exception of fatty, fried and extractive foods.

It is very important to know what to do when the bile ducts are clogged, the symptoms and treatment of which disease should be considered, and what consequences of this condition are possible. What is a blocked duct? This is the name for obstruction in the form of a mechanical obstacle that bile encounters during its movement, leaving the liver or gallbladder towards the duodenum.

Symptoms of the disease

According to medical statistics, about 20% of the people studied experience this phenomenon. And most of them are women.

May occur as a consequence of the following diseases:

cholelithiasis;
various tumors or inflammations associated with the liver or gall bladder;
strictures and scars in the common duct.

The main symptoms indicating that there is a problem with the ducts include:

the occurrence of pain in the hypochondrium on the right;
manifestation of symptoms of jaundice;
acholic feces are observed along with dark urine;
The level of bilirubin in the blood increases.

The diagnosis should be made only by a doctor based on biochemical blood tests. In addition, RCCP, ultrasound, MRI and CT of the abdominal organs are required. If a problem is identified, surgical treatment should be performed.

Depending on the severity of the disease, it is possible to carry out endoscopic or laparoscopic treatment. In more advanced or severe cases, the question of performing an extended operation to remove the blockage is raised.

As a result of difficulties in the movement of bile, a disease called subhepatic jaundice may occur. Quite often, conduction problems can occur after attacks of colic, as well as when symptoms associated with the development of inflammation appear. In this case, it will be necessary to provide medical assistance to a patient suffering from blocked bile ducts as soon as possible.

Cholangitis symptoms and treatment

The main causes of the disease

Caused by obstruction of the biliary tract, the problem is not only the formation of internal blockage, but also as a consequence of external compression. Doctors identify a complete or partial mechanical obstruction to the outflow of bile. Moreover, its degree will depend on what clinical manifestations are observed at the moment.

It is already known that there are a number of diseases that can lead to obstruction, which results in intrahepatic pain as a consequence of the absence or incomplete flow of bile from the liver into the duodenum.

Blockage of passages may occur when the patient is diagnosed with:

Symptoms of the development of a disease associated with blockage of the bile ducts are a multicomponent process. Most often, it shows that an inflammatory process has appeared and is beginning to develop in the bile ducts. Moreover, the inflammation itself contributes to a significant thickening of the mucosa, which inevitably leads to a decrease in the lumen in the ducts themselves.

Naturally, a stone that gets into the passage simply gets stuck in it and cannot be washed out with bile. As a result, the common passage is blocked completely or partially. Bile begins to accumulate, widening the passages. As a result, when bile leaves the liver, it enters the gallbladder, stretching it. Because of this, symptoms worsen and cholecystitis develops.

A diagram of such a situation is possible provided that the stones arise in the gallbladder. During their life, they can get into the duct, blocking it completely or partially. As a consequence of this process, empyema or dropsy will develop. If secretion of whitish mucus from the common bile duct mucosa is detected, this may indicate not only a blockage, but also the beginning of irreversible changes in the bile ducts themselves, which will inevitably affect the state of health.

As a result of obstruction of bile along its ducts, destruction of hepatocytes begins to develop. As a result, acids and the accompanying bilirubin can enter the blood, and its infection begins. Moreover, both the blood vessels themselves and organ tissues are affected.

Lack of bile in the body also negatively affects the functioning of the body. After all, it participates in the digestion process, breaking down fats and vitamins, accelerating their absorption. As a result, a person experiences hypoprothrombinemia, which is a disease associated with blood clotting, hypovitaminosis.

If bile stagnation occurs, a significant disruption of the liver parenchyma may occur, which means that the person faces liver failure.

How to check your gallbladder

Etiological factors

The main risk factors for the occurrence and subsequent development of blockage in the bile ducts include obesity. This process can also be triggered by rapid or sudden weight loss, as well as:

injuries received in the area of the right half of the abdominal cavity;
surgeries performed on the biliary tract, liver or gall bladder in the near past;
penetration of infections associated with the hepatobiliary system, pancreas, developing due to weakened immunity;
during the chronic stage of pancreatitis;
if there are stone formations in the gallbladder;
with advanced pancreatic cancer.

It is for this reason that doctors will need to know exactly all the symptoms of the disease and conduct a full study. This is necessary to identify the cause and prescribe precise treatment, including emergency surgery.

Therapy methods

If during the study a blockage of the bile ducts was identified, then additional consultation with a gastroenterologist or surgeon may be required. Only this makes it possible not only to determine the severity of the disease, but also to prescribe treatment. Moreover, if a severe form of the disease is detected, the patient should be transferred to the department to provide intensive care and undergo antibacterial, infusion and detoxification therapy. This is due to the fact that before surgical treatment, it is necessary to stabilize the patient’s condition in order to avoid the risk of complications or even death.

In order to facilitate the outflow of bile, it is necessary to use various non-invasive techniques. This may be extraction of bile duct stones or nasobiliary drainage using a special probe, cholecystostomy and choledochostomy.

If the patient is in satisfactory condition, or relief has occurred, then endoscopic treatment methods are used for treatment. In this case, during endoscopy, all clogged ducts will be dilated, which involves the introduction of a special plastic or mesh tube into the bile ducts. Thanks to it, it is possible to guarantee that sufficient clearance width is maintained. This procedure is called endoscopic common bile duct stenting. In some cases, endoscopic balloon dilatation of the so-called sphincter of Oddi is necessary.