Bile duct obstruction

A blockage or constriction of a bile duct (see biliary system). Bile duct obstruction results in accumulation of bile in the liver ( cholestasis) and jaundice due to a buildup of bilirubin in the blood. Prolonged obstruction of the bile duct can lead to secondary biliary cirrhosis. The most common cause of obstruction is gallstones. Other causes include a tumour affecting the pancreas (see pancreas, cancer of), where the bile duct passes through it, or cancer that has spread from elsewhere in the body. Cholangiocarcinoma (cancer of the bile ducts) is a very rare cause of blockage. Bile duct obstruction is a rare side effect of certain drugs. It may also be caused by cholangitis (inflammation of the bile ducts), trauma (such as injury during surgery), and rarely by flukes or worms. Bile duct obstruction causes “obstructive” jaundice, which is characterized by pale-coloured faeces, dark urine, and a yellow skin colour. There may also be itching. Other symptoms may include abdominal pain (with gallstones) or weight loss (with cancer). Treatment depends on the cause, but surgery may be necessary. Gallstones may be removed with an endoscope (see ERCP).