The bile ducts are small tubes in the liver that transport bile , they are too small to be seen on normal scans.
When obstructed , the symptoms are not only horrible but life threatening too.
Symptoms Of Biliary System Obstruction
- Yellowing Of Eyes and skin (Jaundice) , commonest.
- General body Itching ; the itching is so intense that it affects the quality of life including sleep , on a sad note this itching does not respond to the best itching medications available in the world.
- Dark coloured urine
- Pale / clay colored stool
- Fever
- Easy bruising
- Weight loss
- Vague Abdominal (tummy ) pain , particularly the right upper side.
- Altered Mentation State / Psychosis ; Seen in terminal disease.
Treatment Of Biliary Obstruction
- Biliary Drainage.
- Biliary Stenting.
Percutaneous Transhepatic Biliary Drainage ( PTBD)
Percutaneous transhepatic biliary drainage ( PTBD) means that your insert a small tube from the skin (overlying the liver) , across the liver into the bile pipes , so that you can drain the stuck bile!
Below is a patient with a bile system drain
A successful bile drainage ( PTBD) brings great symptom relief allowing patient to stabilise and get more definitive treatment , if any or life long palliation.
Biliary Stenting
The use of a catheter to drain the biliary system is alway more than welcome in patient with horrible symptoms of bile system obstruction..
Common Issues With Bile System Catheters
- Leakage around the catheter making the catheter dressings wet.
- Bleeding around the catheter.
- Pain.
- Catheters can get blocked.
- Catheters can accidentally jump out of the bile system.
- Catheter can get infected.
- Discomfort , no one wants something hanging outside their body.
So for obvious reasons now , we at times don’t want to leave the patient with a catheter for a long time.
So we can replace the catheter with a stent , same route of skin, through liver , into biliary system.
This procedure is called percutaneous transhepatic biliary stenting.
What is a stent ?
A stent is tiny round mesh like pipe that is used to open up any blocked channel in the body.
It is reasonable to imagine a stent as a culvert.
The body stents are of different types depending on where it is going to be used , the world’s most expensive body stents are those meant for the brain.
Below is a photo of a stent used in the body
Below you can make out a stent inside the bile system.
Below is a stent inside the bile system of a patient.
Once a stent is placed inside the biliary system , we can then do away with a catheter.
There is more to the bile system we do that needs space , but i honestly feel that what is already shared is a good starting point.
