A small hole anywhere along the bile ducts can cause bile to leak into the abdominal cavity. A bile duct leak can arise either as a complication of a surgery, such as gallbladder removal or liver transplant, or from trauma to the biliary system. At the Bile Duct and Pancreatic Diseases Program, part of the University of Michigan’s Division of Gastroenterology, our multidisciplinary team provides the newest minimally invasive treatments for bile duct leaks. These treatments are not widely available, and are performed by experienced gastroenterologists with high volumes in these procedures.
Bile is a digestive fluid produced by the liver and stored in the gallbladder, and is used by the body to break down fats so they can be absorbed. The biliary system—which includes the gallbladder and bile ducts—produces and transports bile into the duodenum (the first part of the small intestine) to aid in digestion. A bile duct leak can cause pain, inflammation and infection in the abdominal cavity where the bile has leaked.
Bile Duct Leak Symptoms
- Severe abdominal pain
Diagnosing a Bile Duct Leak
To diagnose a bile duct leak, we begin with a comprehensive exam and collecting a thorough history. Blood work is typically ordered to look at issues including elevated liver enzymes.
A biliary study called a hepatobiliary (HIDA) scan may be ordered. A HIDA scan shows the flow of bile from the liver to the small intestine. To perform this test, a radioactive tracer is injected into a vein in the arm and then a special camera takes pictures of the tracer as it moves through the bile ducts.
A leak can also be diagnosed by using a needle to remove a small amount of abdominal fluid. If the fluid contains bile, then a bile duct leak is confirmed.
Treating Leaks in the Biliary System
Our standard treatment for a bile duct leak is an endoscopic retrograde cholangiopancreatography (ERCP) with placement of a temporary bile duct stent (which looks like a plastic straw).
An endoscopic retrograde cholangiopancreatography is a minimally invasive procedure that combines x-ray and upper endoscopy—an exam of the upper gastrointestinal tract, consisting of the esophagus, stomach, and duodenum (the first part of the small intestine)—using an endoscope, which is a lighted, flexible tube, about the thickness of a finger. The doctor passes the tube through the mouth and into the stomach, then injects a contrast dye into the ducts to view the bile ducts, which can be seen on x-ray. Special tools can be guided through the endoscope to insert a stent to stop the leak.
Patients can typically go home same day, once their sedation wears off.
Other Information About Digestive and Liver Health
To see related medical services we offer, visit our Digestive and Liver Health overview page.
Make an Appointment
To schedule an appointment to discuss your need for bile duct stone treatment, call us at 888-229-7408.