Biliary hypertension: what is it?

The term «biliary hypertension» refers to increased pressure of the bile in the biliary structures of the liver, gall bladder and common duct. The main reason for this situation is the obstacle to the outflow of bile. Such a breach can develop at any age, more often it occurs in women.

Biliary hypertension – what it is, the reasons for the development

Liver cells produce bile, which itself contains bilirubin, cholesterol, some foods metabolism and bile acids. Bile, participating in digestion, excreted from the liver into the lumen of the duodenum through a system of hollow structures, which involves the intrahepatic ducts, gallbladder, cystic and common duct. These structures are called «hepatobiliary system».

The increased pressure of the bile on the walls of the hollow structures of the hepatobiliary system called the «biliary hypertension». It in most cases develops as a result of violations of the outflow in various pathological processes. These include:

  • Tumors (malignant or benign tumors) in one of the bile ducts, which prevent the outflow. Also to biliary hypertension may cause compression of one of the ducts by a tumor developing in nearby organs (often cause is cancer of the pancreatic head).
  • Calculous cholecystitis and gallstone disease – metabolic pathology characterized by the formation of insoluble concretions (stones) with their localisation in different parts of the hepatobiliary system and the development of jaundice (icteric staining of the skin due to increased concentration of bilirubin in the blood).
  • Parasitism of some species of helminths (opisthorchis) in the ducts.

Also this condition may occur as a consequence of congenital malformations of the biliary tract with the change in their shape and diameter of the lumen. The signs of this pathological process may occur already in childhood.

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Symptoms

The increase in pressure in the hepatobiliary system is a syndrome, not a disease. This is due to the fact that this condition develops as a result of other pathological processes. There are several major clinical indications for the development of biliary hypertension:

  • Unstable stool, which may have light staining or be colorless (due to inadequate flow of bile into the intestine).
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  • Bloating and rumbling, which intensified after a fatty meal (in the normal course of digestion of fats requires the presence of bile in the intestines).
  • Icteric staining of the sclera of the eyes and skin.
  • Periodic intense itching of the skin caused by irritation of the sensitive nerve endings of bile acids, which are absorbed from the hollow structures of the hepatobiliary system into the bloodstream when the biliary hypertension.

With a slight obstacle to the flow of bile increased pressure in the structures of the hepatobiliary system may not be apparent for a long time.

Diagnosis

The basis for the diagnosis of biliary hypertension is the visualization of the liver, the hollow structures of the hepatobiliary system using ultrasound (ultrasound). Typically, this is determined by an increase in size of the liver and gallbladder, dilated bile ducts. With the help of this method, instrumental studies have also revealed the mechanical obstacle. Additionally, it held radiography of hollow structures of the hepatobiliary system with the introduction of the contrast connection (the method allows to visualize the shape of the ducts) and duodenal intubation (functional method, which determines the release rate of different portions of bile, with subsequent laboratory research).

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Treatment

In most cases a radical treatment of biliary hypertension aimed at the removal of barriers to the outflow of bile. This is accomplished by surgical intervention. Modern methods of surgical intervention involve the use of laparoscopy sparing minimal invasive surgery in which through small incisions are entered thin tube with micromanipulators, camera and lighting. Under visual control on the monitor, the doctor performs the removal of obstacles. Before surgical intervention is obligatory to perform conservative therapy aimed at improving the General condition of the body.

The pressure increase in the hollow structures of the hepatobiliary system is always the result of some other pathological process, therefore effective treatment of this condition is possible only after treatment of the underlying disease.

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