Cholangitis, Gallstones & Strictures in the Bile Ducts

The multidisciplinary team of physicians at Froedtert & the Medical College of Wisconsin have significant training and experience in treating diseases of the bile ducts, including:

  • Cholangitis — an infection of the bile ducts that may lead to serious illness. Treatment includes antibiotics, supportive care and drainage of the bile ducts — surgically, endoscopically or percutaneously through the liver.

  • Stones in the bile duct (choledocholithiasis) — a gallstone may form in the bile duct, causing an obstruction in the duct. Complete obstruction of bile duct can cause cholangitis or can lead to an obstruction of the pancreatic duct, which may cause pancreatitis.

  • Bile Duct Tumors — many people with bile duct tumors have jaundice due to the tumor obstructing the bile ducts. Tumors in the bile duct can cause obstruction with biliary stasis (an accumulation of bile), liver dysfunction, malnutrition, bleeding, kidney dysfunction, and cholangitis. Treatment depends on the tumor site, and the type and extent of the tumor. Surgery offers the only potential cure for this type of tumor.

  • Strictures of the bile duct — a stricture is a narrowing of the bile duct, which prevents bile from draining into the intestine. The bile backs up into the liver, causing obstructive jaundice. Strictures of the bile duct can be benign or malignant.
    • Benign bile duct strictures — non-cancerous bile duct strictures occur when a bile duct is injured, such as damage to a duct during surgery for gallstones, trauma to the abdomen or disease such as chronic pancreatitis. This may cause serious complications such as cholangitis (an infection in the bile duct), liver abscess or biliary cirrhosis.

    • Malignant bile duct strictures — bile duct strictures are caused by tumors of the bile duct (cholangiocarcinomas), gallbladder or pancreas

Bile DuctsTreatments/Interventions

People with bile duct injury or disease often require complex, multidisciplinary procedures. The liver/pancreas/gallbladder/bile duct team at Froedtert & the Medical College has the skill and experience to treat a wide variety of procedures.

  • Biliary biopsy and brushings — a technique to gather cells and scrapings from a bile duct to provide a biopsy sample. This involves using a catheter with a brush strip on the end. The catheter is inserted into a duct and pulled back and forth to gather cells. The brush allows collection of enough tissue to provide a biopsy sample without great risk of damaging the duct. 
  • Choledochoscopy — a minimally invasive procedure to explore the bile duct for suspected stones. A tool called a choledochoscope is used to look for stones. This tool also provides a channel through which instruments can be passed to remove the stones.

  • Resection (surgical removal) of the extrahepatic (outside the liver) bile duct with reconstruction to a loop of small bowel for the bile to drain (a procedure that rearranges the drainage system of the liver). This may be a Roux-en-Y hepaticojejunostomy procedure or a choledochojejunostomy procedure, depending on where the bile duct joins the bowel.

  • Percutaneous transhepatic cholangiography (PTC) — a radiologist performs this procedure using conscious sedation. This procedure can also be done by a surgeon in the operating room. A thin needle is inserted through the skin (percutaneously) and through the liver (transhepatic) into a bile duct. Dye is then injected into the liver to enable the bile duct system to be seen on X-rays (cholangiography).

  • Placement of a T-tube — placement of a tube into the bile duct. Various diagnostic and therapeutic procedures are possible through these tubes (i.e., stone retrieval, cholangiograms, stent placement, etc.). 
  • Stenting — a stent is a thin, flexible tube inserted into a duct to keep it open. A stent may be placed in the liver to drain bile into the small intestine or a collection bag outside the body. A stent may also be placed in a bile duct to guide surgery, to keep a duct open if a tumor cannot be removed, or to open strictures (narrowing) of the bile duct.

Appointments

For gastroenterology or hepatology treatment:

  • 414-805-3666
Request AppointmentView Treatment Team

Locations

Locations offering gastroenterology and hepatology services: