Bile Duct Diseases: An Introduction

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Bile ducts are tubes that primarily carry bile from the liver and gallbladder to the small intestine to help digest fats.

Several diseases in the bile ducts can prevent proper bile duct functioning. Read along to find out more.

Bile duct disease

There are several bile duct diseases that can occur. Gallstones are one common issue for bile ducts. These form when deposits of digestive fluid harden in the gallbladder. They can cause inflammation, increasing pressure in the gallbladder and potentially blocking a bile duct. Another common bile duct condition is cholangitis, which is inflammation in the bile duct system. This is often caused by a bacterial infection.

Bile ducts can also have strictures (narrowing). In other cases, they can leak. Cancer can also occur in the bile ducts. Bile duct cancer is rare and aggressive. Additionally, some infants are born with a condition called biliary atresia, in which bile ducts are scarred and blocked. This causes a buildup of bile in the liver and can damage it.

Symptoms of Bile Duct Diseases

Bile duct diseases tend to have some of a group of symptoms. These include abdominal pain, nausea, vomiting, itchy skin, fever, chills, weight loss, loss of appetite, and jaundice. Pain may occur in the upper abdomen and radiate to the back in some cases. Depending on the disease, these symptoms can be at differing levels of severity and present in varied ways. The progression the disease also influences the severity and types of symptoms.

Diagnosis

Doctors diagnose bile duct diseases in a few different ways. Bilirubin blood testing can identify high levels of bilirubin in your bloodstream and can diagnose jaundice. Doctors can perform an Endoscopic Retrograde Cholangiopancreatogram (ERCP) to diagnose diseases. In an ERCP, they can inject contrast dye to help image your bile ducts during an x-ray. They can also perform an Endoscopic Ultrasound (EUS) to examine your bile ducts and make a diagnosis.

Treatment

Treatments vary depending on the type of bile duct disease. ERCP, in addition to helping with diagnosis, can help treat disease. Doctors can pass tools through the endoscope during an ERCP and open blocked ducts, remove or break up gallstones, insert stents, and even remove tumors. Doctors can also help drain bile during an EUS by inserting a stent to help drain into the small intestine or stomach. One other emerging treatment involves using Radiofrequency Ablation for palliative care to treat the symptoms of bile duct cancer. This can be a way to manage pain for long-term cases of cancer.

Surgery may also be necessary in some cases. For example, with patients who have bile duct cancer, surgery can help to remove tumors. If tumors are very large, doctors may need to remove the liver and perform a liver transplant.

Our experienced team at GHP has years of experience treating conditions including bile duct diseases. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Radiofrequency Ablation: What You Should Expect

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Radiofrequency ablation (RFA) is a procedure that utilizes radio waves to destroy diseased tissue. Here’s what you need to know if you are preparing for the procedure. 

When it’s used

Radiofrequency ablation can be used during an upper endoscopy to treat Barrett’s esophagus. People with Barrett’s esophagus have an increased risk of esophageal cancer, and RFA can eliminate this risk by destroying pre-cancerous tissue in the esophagus. Patients with both high and low grade dysplasia should almost always pursue radiofrequency ablation. It has an 80-90% success rate in removing Barrett’s esophagus long-term. There is a chance that Barrett’s can develop again after a successful procedure. However, repeat treatments are effective and often able to eliminate abnormal tissues entirely. 

Preparing for Radiofrequency Ablation

To prepare for RFA, your physician will discuss preoperative steps with you. First, you will need to talk to them about medications you are taking that could be a risk factor. For example, blood-thinning medications can increase the risk of excessive bleeding during the procedure. Additionally, if you use insulin, you may need to adjust dosage or timing leading up to the RFA. Your doctor will also ask you about any allergies to medications. You will be instructed to stop eating at midnight the day before the procedure. 

During the procedure

Before the procedure, you will be on an IV and will give your medical information in a pre-op area. An anaesthesiologist will then discuss sedation for the procedure. Then, you will go to the procedure room. Doctors will connect you to monitors that measure your heart rate, blood pressure, and blood oxygen levels.

Your doctor will perform radiofrequency ablation during an upper endoscopy. You will be on your left side. A bite block will be in your mouth to prevent damage to your teeth or the endoscope. You will be under sedation for the duration of the procedure. 

Your doctor will advance the endoscope into your esophagus and examine the Barrett’s esophagus. If they see any visible abnormalities, they may perform an endoscopic mucosal resection. This involves either injecting or banding any identified lesions and then using a snare device to capture, cut, and remove them. If this is not necessary, your doctor will perform RFA. They will inflate a balloon-catheter to make contact with the targeted area and apply heat energy for a second or so. 

After the Radiofrequency Ablation

Afterwards, you will wait in a post-op area where you can recover from the sedation while being monitored for any complications. Once you have recovered, your doctor will discuss their findings with you. Some results may take days or weeks to return. They will also give you information on any follow-up appointments. 

For the first 24 hours after the procedure, you should not drive or make important decisions due to sedative effects. Your doctor will also recommend a clear liquid diet for a few days following the treatment. 

Patients commonly feel some chest discomfort and have difficulty swallowing for a few days after the procedure. Your doctor will be prescribe medications to help with any pain or nausea. You will also need to take a proton pump inhibitor twice a day for 30 days. 

Complications

There are a few complications that can occur from the procedure. In around 6% of cases a stricture or narrowing of scar tissue develops in the esophagus. Doctors can treat this with dilation during an upper endoscopy. Another more rare complication is a tear in the esophagus, which occurs less than .02% of the time. 

Our experienced team at GHP has years of experience performing radiofrequency ablation. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.