Bile Duct Injury

What is bile?

Bile is a fluid in the digestive system that is stored in the gall bladder, which helps to break down food and get rid of toxins from the body.

Bile ducts and the biliary system

The biliary system is made up of a series of tubes and organs, beginning with the liver and ending with the small intestine. There is also a number of bile ducts, such as the common bile duct and the hepatic duct.

Causes of bile duct injuries

Injuries to the bile duct are most common during laparoscopic gall bladder surgery, where it may be cut, pinched or burned. If the bile duct is injured then it will not function correctly, which could result in bile leaking into the abdomen or a blockage of the normal flow of bile. This can be very painful, and even deadly, if not treated.

Symptoms

Bile duct injuries could cause the following symptoms:

• Fever
• Nausea
• Abdominal pain
• Vomiting
• Swelling
• Jaundice
• Chills

Treatment and surgery

Once the injury to the bile duct has been noted, the main goal is to manage the infection and leakage caused by the injury. The surgeon may have to reconstruct the bile duct using a piece of intestine to bypass the blockage.

Most bile duct injuries are successfully repaired but in severe cases the patient may require months of recovery time.

Small bowel resection

This surgery removes part or all of your small bowel (small intestine) when it is blocked or diseased.

Most digestion (breaking down and absorbing nutrients) of the food you eat takes place in the small intestine. The surgery can be performed laparoscopically or with open surgery.

Small bowel resection is used to treat:

• A blockage in the intestine caused by scar tissue or congenital (from birth) deformities
• Bleeding, infection, or ulcers caused by inflammation of the small intestine. Conditions that may cause inflammation include regional ileitis, regional enteritis, and Crohn's disease

• Cancer
• Carcinoid tumor
• Meckel's diverticulum
• Noncancerous (benign) tumors
• Precancerous polyps

Most people who have a small bowel resection recover fully. Even with an ileostomy, most people are able to do the activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work. If a large part of your small intestine was removed, you may have problems with loose stools and getting enough nutrients from the food you eat.

Chron’s Disease

This is a long-term condition that causes inflammation of the lining of the digestive system.

Inflammation most commonly occurs in the last section of the small intestine (called the ileum) or the large intestine (the colon). However, the inflammation can affect any part of the digestive system, from the mouth to the back passage.

Symptoms of Chron's Disease include:

• diarrhoea
• abdominal pain
• fatigue (extreme tiredness)
• unintended weight loss
• blood and mucus in your faeces

The exact cause of Crohn's disease is unknown. However, research suggests a combination of factors may be responsible. These include:

• genetics
• the immune system
• previous infection
• smoking
• environmental factors

There's currently no cure for Crohn's disease, so the aim of treatment is to stop the inflammatory process, relieve symptoms (induce and maintain remission) and avoid surgery wherever possible.

The first treatment offered to reduce symptoms is usually steroid medication (corticosteroids). If this doesn't help, medication to suppress the immune system (immunosuppressants) and medication to reduce inflammation may be used.

In some cases, surgery may be needed to remove the inflamed section of intestine.

Crohn's disease is a relatively uncommon condition. There are currently at least 115,000 people living with the condition in the UK.

Stoma

A stoma is an opening on the front of your abdomen (tummy) which is made using surgery. It diverts your faeces or urine into a pouch (bag) on the outside of your body.

A stoma is a bud-like structure, which sits on the surface of your skin on your abdomen. It’s formed during surgery and can be either temporary (and reversed later) or permanent. A stoma collects faeces from your bowel or urine from your urinary tract, which have been diverted from their normal route through the body.

Once you have a stoma fitted, you should be able to carry on with life as normal. You need to keep it clean and change the collection bag regularly.

You may need to have an ileostomy or colostomy if you have bowel cancer or inflammatory bowel disease. Sometimes a temporary stoma is created to allow an internal join in your bowel to heal after surgery. You may need to have a urostomy if you have surgery for bladder cancer, severe urinary incontinence or damage to your pelvis.