Gallgångstenoser

Gallgångstenoser, also known as biliary strictures, are abnormal narrowings of the bile ducts. These ducts are responsible for transporting bile from the liver and gallbladder to the small intestine, where it aids in digestion. Stenoses can occur in any part of the biliary tree, from the intrahepatic ducts within the liver to the common bile duct leading to the duodenum.

The causes of gallgångstenoser are varied. They can be benign, often resulting from chronic inflammation such as that caused by gallstones or cholecystitis, or following surgical procedures on the bile ducts or surrounding organs like the pancreas or duodenum. Post-surgical strictures are a common complication. Other benign causes include primary sclerosing cholangitis, a chronic inflammatory disease of the bile ducts, and pancreatitis, which can cause inflammation and scarring that affects the bile ducts.

Malignant causes are also significant. Cancers originating in the bile ducts (cholangiocarcinoma) or cancers that spread to the bile ducts from nearby organs, such as pancreatic cancer or liver cancer, can compress or invade the ducts, leading to stenosis.

Symptoms of gallgångstenoser depend on the location and severity of the narrowing. If the blockage is significant, bile can back up, leading to jaundice (yellowing of the skin and eyes), pruritus (itching), dark urine, and pale stools. Abdominal pain, particularly in the upper right quadrant, can also occur. Persistent blockage can lead to infection of the bile ducts (cholangitis) and liver damage.

Diagnosis typically involves medical imaging such as ultrasound, CT scans, MRI with MRCP (magnetic resonance cholangiopancreatography), or endoscopic retrograde cholangiopancreatography (ERCP). Treatment aims to relieve the obstruction and address the underlying cause. This may involve endoscopic procedures to dilate the stricture, stent placement to keep the duct open, or surgical interventions. For malignant strictures, treatment is often focused on palliation or managing the underlying cancer.