How is biliary stricture diagnosed?

How is biliary stricture diagnosed?

Biliary stricture can be diagnosed through different forms of imaging studies that allow doctors to see the bile duct. Blood tests of the liver and biliary enzymes help the doctor determine if the patient may have biliary stricture and if an imaging test is needed to diagnose it.

The doctor may order the following imaging tests:

• Ultrasound of the liver is the imaging test that is usually ordered first, as it is easy and safe to perform. It cannot visualize the stricture if it is small, but in most cases it shows changes in the biliary tree that suggest biliary stricture.
• CT scan and MRI scan are capable of showing small strictures and possibly finding out what is causing the stricture.
• In a few cases, a procedure called ERCP (endoscopic retrograde cholangiopancreatography) is needed. In this procedure, the doctor uses a special endoscope (a long, flexible tube with a light and camera at the end) to examine the bile duct. The doctor identifies the place where the bile duct comes into the intestine and then feeds a tiny catheter (a plastic tube) into the duct and squirts a contrast agent into the bile system (and sometimes the pancreas) while X-rays are taken. The contrast agent allows the doctors to see the ducts of the bile system, gallbladder, and pancreas on the X-rays. This procedure not only helps diagnose small biliary strictures, but can also treat the biliary stricture.