Liver makes bile that is a digestive juice and helps in breaking fat. It is stored in gall bladder in between meals and on eating; bile is released by gall bladder into the tubes called bile ducts to carry it to small intestine. Following are the disorders that can affect bile duct and block it leading to problem with the flow of bile:

• Gallstones can block bile duct

• Bile duct cancer

• Bile duct infections

• Birth defects, such as biliary atresia

• Bile duct Inflammation

• Bile duct strictures

Symptoms of Bile Duct Disorders

Symptoms of bile disorder may be abrupt and severe or may take years to develop. It may include any of the following:

• Yellowing of the skin or eyes (jaundice)

• Greasy or clay-coloured stools

• Itching on more than one part of the body that gets worse in night or warm weather

• Light brown urine

• Fatigue

• Pain on the right side under the rib cage

• Weight loss

• Fever or night sweats

• Decreased appetite

Diagnosis of Bile Duct Disorders

Bile Duct disorders are diagnosed by performing following tests:

• Blood tests to measure your levels of alkaline phosphatase, bilirubin and/or gamma-glutamyltransferase (GGT)

• Right upper quadrant ultrasound

• Computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of the liver

• ERCP (Endoscopic Retrograde Cholangiopancreatography)

• HIDA Scan (Cholescintigraphy)

• Magnetic Resonance Cholangiopancreatography (MRCP)

• Cholangiography (X-rays of the bile ducts)

• Liver biopsy

Laparoscopic surgery for Bile Duct Disorders

In case of gallstones being the reason for bile duct disorder, gall bladder is removed laparoscopically.

Laparoscopic common bile duct exploration:

The procedure involves removal of stones from the bile duct by laparoscopic techniques.

The procedure is performed under general anaesthesia and is most commonly is done at the same time of a cholecystectomy (gallbladder removal). The surgeon makes about 3-4 small incisions in the abdomen. One of the incisions is used to insert a port (nozzle) that fills the carbon dioxide gas into the abdomen to inflate it. Now laparoscope is inserted through another incision. A laparoscope is a telescope lookalike with a light and camera on the end. It allows the surgeon to clearly view inside of the abdomen on the monitor outside. Other surgical instruments are inserted through rest of the incisions to explore the common bile duct and remove any stones. This is done by making a small cut on the duct, and then inserting a flexible scope and flexible instruments inside the duct. After exploring and cleaning the duct, the carbon dioxide gas is released out, and incisions are closed with sutures or staples, or covered with glue-like bandage.  

Advantages of Laparoscopic Bile Duct Exploration

• Blood tests to measure your levels of alkaline phosphatase, bilirubin and/or gamma-glutamyltransferase (GGT)

• Faster recovery

• Only few hours or overnight hospitalization

• Sooner return to work

• Very less pain during and after the procedure

• Smaller incisions without any cut on abdominal muscles

• Negligible risks and complications

• Less chances of wound infection

• High success rate with more than ninety-percent of symptom free patients after ten years of the procedure

Authored By DR.R.K.Sinha