Biliary Disease

billiary diseaseBiliary disease refers to several diseases that affect the biliary system. The biliary system consists of bile ducts, the gallbladder and other structures involved in the production and transportation of bile.

Bile is a fluid produced by the liver that aids digestion. Bile drains from the liver through bile ducts to the duodenum and eventually back to the bile ducts and liver. If any duct in this complex system becomes diseased or blocked, a number of serious diseases may result.

Risk factors

Heredity, increasing age, obesity, a high-fat diet, certain gastrointestinal conditions and certain prescription medications may increase the risk of developing biliary disease.

Symptoms of possible biliary disease

Although symptoms may differ among bile duct disorders, symptoms common to many of the disorders include:

  • Jaundice (yellowing of the skin and whites of the eyes)
  • Abdominal pain, especially in the upper right side of the abdomen under the rib cage
  • Nausea or vomiting
  • Loss of appetite, which may result in weight loss
  • Fatigue
  • Fever or chills
  • Itching
  • Light brown urine
  • Greasy or clay-colored stools

Detection and diagnosis

The tests performed vary according to the suspected bile duct disorder. However, tests commonly performed to diagnose many bile duct disorders may include:

  • Blood tests
  • Liver function tests
  • Ultrasound
  • Endoscopic ultrasound
  • Computed tomography (CT) scan
  • Magnetic Resonance Imaging (MRI)
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Liver biopsy

Treatment

Treatment depends largely on the diagnosis. Some common treatments include:

  • Medications/antibiotics: Patients are treated with medications to increase the flow of bile from the liver and relieve itching, and antibiotics are used to treat infection.
  • Hepatoportoenterostomy: This is a type of surgery that drains bile from the liver when bile ducts are blocked.
  • Endoscopic retrograde choliangiopancreatography (ERCP): This procedure may help identify and remove gallstones from the bile duct.
  • Cholecystectomy: The GW Digestive Disorder Center offers single incision laparoscopic cholecystectomies (removal of the gallbladder). During this procedure, surgeons operates through a single port that has three distinct openings, located in an incision in the patient's belly button. The flexible port allows the surgeons to operate three laparoscopic instruments simultaneously. This surgery may result in a scar that is invisible or barely visible, compared with traditional laparoscopic surgeries that may leave three to four small but visible scars. Additionally, some patients who have single-incision laparoscopic surgery have shorter hospital stays and use significantly less pain medication.

Prevention

Biliary disorders due to gallstones may be prevented by having the gallbladder surgically removed. The formation of gallstones may also be prevented by eating a well-balanced diet, maintaining a healthy weight and exercising regularly.

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