eMedicine Specialties > Gastroenterology > Biliary

Bile Duct Strictures: Multimedia

Author: William R Brugge, MD, Professor of Medicine, Harvard Medical School; Director, Gastrointestinal Endoscopy Unit, Massachusetts General Hospital
Coauthor(s): Ashraf Saleemuddin, MD, Staff Physician, Department of Internal Medicine, Boston University Medical Center; Hemant Pande, MD, Consulting Staff, Department of Gastroenterology, Leesville Surgical Clinic and Digestive Disease Center; Parviz Nikoomanesh, MD, Clinical Director of Gastroenterology, Director of Endoscopy, Associate Professor, Department of Internal Medicine, Bayview Medical Center, Johns Hopkins University School of Medicine; Lawrence J Cheskin, MD, Associate Professor, International Health/Human Nutrition, JH Bloomberg School of Public Health; Joint Appointment, Department of Medicine, Division of Gastroenterology, Johns Hopkins University School of Medicine
Contributor Information and Disclosures

Updated: Mar 27, 2009

Multimedia

Endoscopic retrograde cholangiopancreatographic i...Media file 1: Endoscopic retrograde cholangiopancreatographic image of a cholangiocarcinoma at the bifurcation of the right and left hepatic ducts (Klatskin tumor).
Endoscopic retrograde cholangiopancreatographic i...

Endoscopic retrograde cholangiopancreatographic image of a cholangiocarcinoma at the bifurcation of the right and left hepatic ducts (Klatskin tumor).

Endoscopic retrograde cholangiopancreatographic c...Media file 2: Endoscopic retrograde cholangiopancreatographic cholangiogram demonstrating a long bile duct stricture that represents external compression by gallbladder cancer.
Endoscopic retrograde cholangiopancreatographic c...

Endoscopic retrograde cholangiopancreatographic cholangiogram demonstrating a long bile duct stricture that represents external compression by gallbladder cancer.

Transhepatic cholangiogram with an external drain...Media file 3: Transhepatic cholangiogram with an external drainage catheter in place.
Transhepatic cholangiogram with an external drain...

Transhepatic cholangiogram with an external drainage catheter in place.

Endoscopic retrograde cholangiopancreatographic i...Media file 4: Endoscopic retrograde cholangiopancreatographic image of a cholangiogram in a patient with cholangiocarcinoma whose condition has been treated with a metal stent.
Endoscopic retrograde cholangiopancreatographic i...

Endoscopic retrograde cholangiopancreatographic image of a cholangiogram in a patient with cholangiocarcinoma whose condition has been treated with a metal stent.

Endoscopic retrograde cholangiopancreatographic c...Media file 5: Endoscopic retrograde cholangiopancreatographic cholangiogram of a solitary benign stricture of the distal bile duct. Resection demonstrated sclerosing cholangitis.
Endoscopic retrograde cholangiopancreatographic c...

Endoscopic retrograde cholangiopancreatographic cholangiogram of a solitary benign stricture of the distal bile duct. Resection demonstrated sclerosing cholangitis.

Endoscopic retrograde cholangiopancreatographic c...Media file 6: Endoscopic retrograde cholangiopancreatographic cholangiogram demonstrating an isolated mid-hepatic duct stricture as a result of pancreatic cancer.
Endoscopic retrograde cholangiopancreatographic c...

Endoscopic retrograde cholangiopancreatographic cholangiogram demonstrating an isolated mid-hepatic duct stricture as a result of pancreatic cancer.

Endoscopic retrograde cholangiopancreatographic c...Media file 7: Endoscopic retrograde cholangiopancreatographic cholangiogram demonstrating diffuse stricturing of the intrahepatic ducts that is consistent with primary sclerosing cholangitis.
Endoscopic retrograde cholangiopancreatographic c...

Endoscopic retrograde cholangiopancreatographic cholangiogram demonstrating diffuse stricturing of the intrahepatic ducts that is consistent with primary sclerosing cholangitis.

Periductal onion skin fibrosis seen in primary sc...Media file 8: Periductal onion skin fibrosis seen in primary sclerosing cholangitis.
Periductal onion skin fibrosis seen in primary sc...

Periductal onion skin fibrosis seen in primary sclerosing cholangitis.

Periductal lymphocytic and plasma cell infiltrate...Media file 9: Periductal lymphocytic and plasma cell infiltrate that is consistent with autoimmune cholangiopathy.
Periductal lymphocytic and plasma cell infiltrate...

Periductal lymphocytic and plasma cell infiltrate that is consistent with autoimmune cholangiopathy.

Focal intrahepatic benign bile duct stricture aft...Media file 10: Focal intrahepatic benign bile duct stricture after cholecystectomy.
Focal intrahepatic benign bile duct stricture aft...

Focal intrahepatic benign bile duct stricture after cholecystectomy.

Multiple small bile duct stones seen on magnetic ...Media file 11: Multiple small bile duct stones seen on magnetic resonance cholangiopancreatography (MRCP).
Multiple small bile duct stones seen on magnetic ...

Multiple small bile duct stones seen on magnetic resonance cholangiopancreatography (MRCP).

Irregular common bile duct stricture as a result ...Media file 12: Irregular common bile duct stricture as a result of cholangiocarcinoma.
Irregular common bile duct stricture as a result ...

Irregular common bile duct stricture as a result of cholangiocarcinoma.

This image is an example of an intraoperative cho...Media file 13: This image is an example of an intraoperative cholangiogram performed during a laparoscopic cholecystectomy.
This image is an example of an intraoperative cho...

This image is an example of an intraoperative cholangiogram performed during a laparoscopic cholecystectomy.

Focal bile duct stricture as a result of pancreat...Media file 14: Focal bile duct stricture as a result of pancreatic cancer in the head of the pancreas.
Focal bile duct stricture as a result of pancreat...

Focal bile duct stricture as a result of pancreatic cancer in the head of the pancreas.

Percutaneous transhepatic cholangiogram with ball...Media file 15: Percutaneous transhepatic cholangiogram with balloon dilation of a postoperative bile duct stricture.
Percutaneous transhepatic cholangiogram with ball...

Percutaneous transhepatic cholangiogram with balloon dilation of a postoperative bile duct stricture.

Benign distal common bile duct stricture seen dur...Media file 16: Benign distal common bile duct stricture seen during a cholecystostomy injection in an elderly male. The stricture resolved with a 4-week course of oral corticosteroid therapy.
Benign distal common bile duct stricture seen dur...

Benign distal common bile duct stricture seen during a cholecystostomy injection in an elderly male. The stricture resolved with a 4-week course of oral corticosteroid therapy.

More on Bile Duct Strictures

Overview: Bile Duct Strictures
Differential Diagnoses & Workup: Bile Duct Strictures
Treatment & Medication: Bile Duct Strictures
Follow-up: Bile Duct Strictures
Multimedia: Bile Duct Strictures
References
Further Reading

References

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Further Reading

Best Evidence

Clinical Trials

National Guidelines Clearinghouse

Keywords

bile duct strictures, biliary stricture, biliary stenosis, bile duct stenosis, bile duct constriction,  operative trauma, surgical trauma, ascending cholangitis, liver abscess, secondary biliary cirrhosis, pancreatic cancer, benign strictures, malignant strictures, bile duct injury, pancreatitis, bile duct stones, choledocholithiasis, primary sclerosing cholangitis, PSC, postoperative bile duct stricture, cholecystectomy, Charcot triad, cholangiocarcinoma

Contributor Information and Disclosures

Author

William R Brugge, MD, Professor of Medicine, Harvard Medical School; Director, Gastrointestinal Endoscopy Unit, Massachusetts General Hospital
William R Brugge, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Federation for Clinical Research, American Gastroenterological Association, American Pancreatic Association, American Society of Gastrointestinal Endoscopy, and Crohns and Colitis Foundation of America
Disclosure: Nothing to disclose.

Coauthor(s)

Ashraf Saleemuddin, MD, Staff Physician, Department of Internal Medicine, Boston University Medical Center
Disclosure: Nothing to disclose.

Hemant Pande, MD, Consulting Staff, Department of Gastroenterology, Leesville Surgical Clinic and Digestive Disease Center
Hemant Pande, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Parviz Nikoomanesh, MD, Clinical Director of Gastroenterology, Director of Endoscopy, Associate Professor, Department of Internal Medicine, Bayview Medical Center, Johns Hopkins University School of Medicine
Parviz Nikoomanesh, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Lawrence J Cheskin, MD, Associate Professor, International Health/Human Nutrition, JH Bloomberg School of Public Health; Joint Appointment, Department of Medicine, Division of Gastroenterology, Johns Hopkins University School of Medicine
Lawrence J Cheskin, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, and American Gastroenterological Association
Disclosure: Medifast Salary Employment; Mushroom Council Grant/research funds research grant; Pharmaceutical Companies Honoraria Speaking and teaching

Medical Editor

David Greenwald, MD, Fellowship Program Director, Associate Professor, Department of Medicine, Division of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine
David Greenwald, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

James L Achord, MD, Professor Emeritus, Department of Medicine, Division of Digestive Diseases, University of Mississippi School of Medicine
James L Achord, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Medical Association, American Society for Gastrointestinal Endoscopy, Mississippi State Medical Association, New York Academy of Sciences, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD, Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania
Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

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