When there’s a hole in any part of the bile duct, it can leak bile. This can occur during some procedures or due to injury.
A bile duct is a tube-like structure that connects through your liver, gallbladder, and pancreas before it ends in the small intestine. It’s designed to carry bile out of your gastrointestinal (GI) system. Bile itself is made in your liver and released from your gallbladder to aid digestion.
A bile duct leak can occur as a result of certain GI surgeries or injuries, and may lead to serious complications. Here’s what you need to know about a leaking bile duct and how it’s diagnosed and treated.
How serious is a leaking bile duct?
A leaking bile duct is considered a serious medical condition. When your biliary system leaks bile, your digestive system may no longer perform important functions, such as fat absorption.
While considered relatively rare, a leaking bile duct can be life threatening if left untreated.
A leaking bile duct is most often caused by surgery of the surrounding area. In some cases, it may be attributed to trauma of the involved organs or other less common causes.
Surgery
Surgeries that involve the liver, gallbladder, or pancreas may carry the risk of accidental cuts or punctures to the bile duct. This can ultimately cause it to leak and not work as it should. Gallbladder removal is the most common surgery associated with a leaking bile duct.
If you have a gallbladder removal, liver transplant, or other type of surgery in the area scheduled, it’s important to discuss such risks with a doctor so you can report possible symptoms of a leaking bile duct right away.
Abdominal injuries
In some cases, trauma to the surrounding area may also damage the biliary system. This is especially true of injuries in your abdominal area, such as those that may occur during a vehicle collision or other serious trauma.
Other possible causes
Less commonly, a leaking bile duct may be attributed to other issues affecting the GI system. For example, one 2021 case study found that a ventral hernia in the abdominal region could be another possible cause of leaking bile duct that should be considered outside of surgeries and injuries.
Possible symptoms of a bile duct leak include:
- abdominal pain
- swollen abdomen
- jaundice (yellowing of the skin)
- fever
- flu symptoms
If left untreated, a bile duct leak can be fatal. The accompanying symptoms, such as abdominal pain and swelling, fever, and jaundice, may also interfere with your overall quality of life.
It’s also possible to develop a rare type of infection of the bile ducts called acute cholangitis. This is a life threatening infection that may also lead to organ failure.
A potential leaking bile duct is diagnosed with a combination of:
- a physical exam
- symptom history
- imaging tests of the abdominal area, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI)
- abdominal fluid samples to look for the presence of bilirubin
- blood tests to look for elevated liver enzymes, such as alkaline phosphatase and bilirubin
- endoscopic retrograde cholangiopancreatography (ERCP)
- percutaneous transhepatic cholangiography (PTC, in which dye is injected through your skin into your bile duct, followed by an X-ray of the ducts)
The goal of leaking bile duct treatment is to close the openings while also draining excess bile that has accumulated in the abdominal area. A doctor will likely consider minimally invasive procedures first before opting for surgical treatment.
Endoscopic retrograde cholangiopancreatography (ERCP)
ERCP is a minimally invasive procedure that uses an endoscope passed through your esophagus down toward the biliary system. A doctor may address leaks with the use of tools or stenting.
Biliary stenting
Biliary stenting is a process combined with ERCP where plastic or metal tubes called stents are placed in the biliary tree to help close openings and stop bile leakage, while also draining bile.
Embolization
Also used with ERCP, embolization involves the use of synthetic glue to help seal leaks in the biliary tree. This is also considered a minimally invasive procedure.
Surgery
In some cases, a leaking bile duct may happen during surgery and a surgeon may be able to correct it right away. However, in other cases, a separate, corrective surgery may be needed. Surgery may also be considered if ERCP techniques don’t work.
Medical emergencyA leaking bile duct is considered a medical emergency, as it can be deadly if not treated. If you have certain risk factors, such as a recent gallbladder surgery, and are experiencing possible symptoms of a biliary system issue, see a doctor right away.
If you’ve recently received a diagnosis of a leaking bile duct, follow a doctor’s next steps concerning treatment. They may also refer you to a gastroenterologist, a type of specialist who treats conditions of the GI tract.
A leaking bile duct is caused by obstruction of the biliary tree, which runs between the liver and small intestine. While most commonly attributed to surgeries, such as a gallbladder removal, these obstructions may also be caused by other injuries.
Since a leaking bile duct can be fatal, it’s important to see a doctor if you experience symptoms. Corrective treatments can help close the biliary tree opening and stop the leak.
