What Is a Biliary Obstruction?

Written by Madeline Laguaite
Medically Reviewed by Nayana Ambardekar, MD on July 10, 2025

‌Biliary obstruction is when something stops your bile from flowing normally. For example, your bile duct may become blocked or get too narrow.  

 

A blockage in your bile duct can cause serious complications if left untreated.

‌Your liver produces a greenish-yellow fluid called bile, which helps break down fats in your food. Bile is made of cholesterol, bile salts, and water. It gets its color from bilirubin, which is formed when your blood cells break down.‌

Bile and pancreatic ducts are a network of tubes connecting your liver, gallbladder, pancreas, and intestine. They transport bile and digestive fluid from the liver and pancreas to your small intestine to break down your food.

Bile flows through the bile ducts from the liver to the gallbladder. The gallbladder stores bile until it’s needed. From the gallbladder, the bile passes through the pancreas via the common bile duct, which joins the pancreatic duct to carry digestive enzymes and fluids from the pancreas. This is where bile and pancreatic liquids, which have digestive enzymes to break down sugars, enter a small opening in the first part of the small intestine (duodenum).

Your small intestine is where the digestion of fats and sugars begins.

‌Bile duct or biliary obstruction is blockage of one or more bile ducts in your body. If your bile duct is blocked, it can’t transport bile or pancreatic liquid to your intestines for digestion. This causes bile to build up in your liver and increases bilirubin levels in your blood.

Here are some of the common causes of biliary obstruction.‌

Cholelithiasis (or gallstones). Bile can solidify in your gallbladder if you have high blood cholesterol levels. This leads to stone-like deposits called gallstones. Large gallstones can get stuck in your bile duct and result in biliary obstruction.‌

Cancer. Bile duct cancer, gallbladder cancer, or pancreatic cancer can spread quickly. These cancers can cause bile duct obstruction.‌

Injury during surgery. Bile duct injuries like a cut, burn, scar, or pinch during gallbladder surgery can cause a blocked bile duct.

Choledochal cysts. These can happen when parts of your bile duct get bigger. In a few cases, they can lead to bile duct obstruction.‌

Chronic pancreatitis. Biliary obstruction can result from other conditions like pancreatitis, chronic inflammation in your pancreas.

Other causes. Your bile duct can become blocked if you get an injury in your abdomen. It may also happen because of infections, especially if you take drugs that suppress your immune system.

‌A bile duct obstruction stops bile from reaching your intestines. Without digestive fluids, your food can’t be digested and absorbed properly. This may cause a vitamin deficiency.‌

A blockage in your bile duct can cause bilirubin to collect in your body because bile can’t escape. This can lead to jaundice,which can make your eyes and skin turn yellow. Without bilirubin in the bile, you may have pale, clay-colored poop and dark yellow pee.‌

You may also have:‌

  • Pruritus (itchy skin)
  • Pain in your upper right abdomen
  • Fever
  • Nausea and vomiting
  • Tiredness and fatigue
  • Weight loss
  • Loss of appetite

‌If you have a biliary obstruction, your doctor will examine your gallbladder and check your symptoms. Certain symptoms of biliary obstruction like jaundice can be confused with liver disease. Your doctor may check your history and ask about your alcohol or drug use.

Your doctor will order blood tests to check if the levels of the following are high:‌

If your blood test results suggest biliary obstruction, your doctor may confirm the diagnosis using:

‌Bile duct obstruction can be treated by removing the blockage or curing the underlying cause.‌‌

Gallstones can be removed using endoscopic retrograde cholangiopancreatography. Surgical procedures like gallbladder removal or cholecystectomy may be required to treat biliary obstruction caused by recurring gallstones.

For bile duct obstruction caused by cancer, your doctor will widen and drain your bile ducts using endoscopy or by inserting a needle through your skin. Your doctor may recommend chemotherapy, radiotherapy, or surgery to treat your cancer.

If your bile duct is blocked due to choledochal cysts, your doctor will perform surgery to treat your enlarged bile ducts.

Biliary obstruction due to pancreatitis can be treated with endoscopic retrograde cholangiopancreatography. Your doctor may also prescribe medications to relieve pain.

‌If a bile duct obstruction is left untreated, it can result in:‌

‌Gallstones are the most common cause of biliary obstruction. If you notice any symptoms of a blocked bile duct, consult your healthcare provider for medical advice.

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