There are three main groups of causes of bile duct stenosis: traumatic, inflammatory, and neoplastic. Traumatic stricture of the bile ducts usually develops as a result of intraoperative lesions of the bile ducts, endoscopic manipulation, gastric resection, transplantation, and liver resection during cholecystectomy.
To this group belongs scar contraction biliodigestive anastomosis, superimposed on the obstruction of the biliary tract, abdominal injuries. Intraoperative damage to the bile ducts, as a rule, will take place under difficult conditions of surgery: the patient is in a serious condition, emergency surgery, bleeding into the abdominal cavity, the presence of severe swelling and pus in the area of surgical intervention, so the presence of obesity and .
In these cases are not included. Evaluation of the laser electrocoagulator and others Surgeon needling or damage to the anatomical structure of the bile ducts, or their intersection.
In case of complete ligation or junctional choledoch bile duct stenosis developed in the early postoperative period; With partial ligation or injury – within 2 to 6 months; Obliteration of biliodigestive anastomosis usually occurs within 1 year from the date of imposition.
Inflammatory stenosis of the bile ducts, sclerosing cholangitis, chronic pancreatitis, ulcer, low 12 duodenal ulcer, parasitic liver disease (echinococcosis, opistorhoze), stones Bedsores, fixed cystic duct, and so when the walls of the ducts cause sores. D. by the appearance
Tumor strictures of the bile ducts are found in cancer of the extrahepatic biliary tract, cancer of the gallbladder, metastatic lesions of the liver and gated hepatoduodenal ligament. In rare cases, bile duct strictures are caused by congenital anatomical anomalies of the biliary tract, radiation therapy.
The state of stenosis is the expansion and thickening of the walls of the bile ducts, arranged above the narrowing. Bile stagnates in its sealed ducts, viscous, easily becomes infected, creating the necessary conditions for the formation of gallstones. Long-term violation of the outflow of bile from the liver in unrecognized and unresolved obstruction contributes to the development of secondary biliary cirrhosis and portal hypertension.