Bile Duct

doctor img
Dr Thng Yongxian

MBBS

MMed

MRCS (IRE)

FRCSED

FAMS

image

What Is the Bile Duct?

The bile duct is an important component of the human body’s digestive system. It serves as a channel through which bile, a yellow-green fluid produced by the liver, is transported to the small intestine. Bile plays an essential role in digesting and absorbing fats and fat-soluble vitamins from the food we consume.

The structure of the bile duct system is intricately designed to facilitate the efficient transport and storage of bile.

Structure and Function of the Bile Duct

  • Hepatic Ducts
    Originating in the liver, the hepatic ducts collect bile from the liver cells. The liver’s bile ducts converge to form the left and right hepatic ducts, which merge to create the common hepatic duct. This duct transports bile from the liver towards the gallbladder and small intestine.
  • Gallbladder and Cystic Duct
    The gallbladder is a small organ located beneath the liver. It functions as a reservoir for bile. The cystic duct connects the gallbladder to the common hepatic duct. When bile is not needed for digestion, it is stored in the gallbladder through the cystic duct.
  • Common Bile Duct
    The common bile duct is formed by the union of the common hepatic duct and the cystic duct. It is a pathway through which bile flows from the liver and gallbladder to the small intestine. The common bile duct empties into the small intestine at the duodenum.

Bile Duct Disorders

Bile duct disorders encompass a variety of conditions that can affect the normal functioning of the bile duct system.

Cholestasis

Cholestasis occurs when the bile flow from the liver is reduced or blocked. This can happen within or outside the liver. Causes may include liver diseases, bile duct obstructions, or genetic conditions.

Gallstones

Gallstones are solid particles that form in the gallbladder from bile cholesterol and bilirubin. When gallstones block the bile ducts, they can cause acute pain, inflammation, and infections such as cholecystitis. Gallstones can also migrate to the common bile duct, leading to more severe blockages.

Primary Sclerosing Cholangitis (PSC)

PSC is a chronic liver disease characterised by inflammation and scarring of the bile ducts, leading to their narrowing and obstruction. The cause of PSC is unknown, though it is often associated with autoimmune disorders. PSC gradually damages the liver and can lead to liver failure.

Bile Duct Cancer (Cholangiocarcinoma)

Cholangiocarcinoma is an aggressive form of cancer that originates in the cells of the bile ducts. It is often diagnosed at an advanced stage due to its subtle early symptoms, which can include jaundice, weight loss, and abdominal pain.

Diagnosis

Diagnosing bile duct disorders involves a combination of clinical evaluation, laboratory testing, and imaging techniques.

Clinical Evaluation

The diagnostic process begins with a thorough clinical evaluation, including a detailed medical history and physical examination. Healthcare professionals will assess symptoms, previous health conditions, and risk factors associated with bile duct disorders.

Laboratory Tests

Liver function tests (LFTs) can detect elevated levels of liver enzymes, bilirubin, and other substances indicative of liver or bile duct dysfunction. Additional tests may include:

  • Bilirubin tests: These tests are used to measure the levels of bilirubin in the blood, a substance produced by the liver and excreted in bile.
  • Alkaline phosphatase (ALP): Elevated levels of this may suggest bile duct obstruction or liver injury.
Imaging Studies

Imaging studies are critical for visualising the structure of the bile ducts and identifying blockages, narrowing, or other abnormalities. Common imaging modalities include:

  • Ultrasound: A non-invasive test that uses sound waves to create images of the bile ducts, liver, and gallbladder.
  • Magnetic Resonance Imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP): These techniques provide detailed images of the bile ducts, liver, and pancreas.
  • Computed Tomography (CT) Scan: This offers cross-sectional images of the abdomen, which help detect tumours, inflammation, or other abnormalities in the bile ducts.
Biopsy

In cases where cancer is suspected, a biopsy may be performed to obtain a small sample of tissue from the bile duct for microscopic examination.

Get an Accurate Diagnosis & Specialised Treatment For Your Condition Today

Consult our dual fellowship-trained surgeon for a personalised treatment plan today.

Treatment Options

The treatment of bile duct disorders varies significantly depending on the type and severity of the condition.

Medical Management

For conditions like mild cholestasis or specific forms of hepatitis affecting the bile ducts, medical treatment may include:

  • Medications: Ursodeoxycholic acid to improve bile flow, antibiotics for infections, or corticosteroids for inflammatory conditions.
  • Vitamin Supplements: To address deficiencies in fat-soluble vitamins due to malabsorption.
Endoscopic Procedures

Endoscopic techniques are commonly used to diagnose and treat bile duct disorders, especially for removing blockages or relieving strictures:

  • Endoscopic Retrograde Cholangiopancreatography (ERCP): Allows for the removal of gallstones, the insertion of stents to bypass obstructions, or the dilation of narrowed ducts.
    Percutaneous Transhepatic
  • Cholangiography (PTC): A technique used to image bile ducts or to facilitate drainage or stent placements in cases where ERCP is not feasible.
Surgical Treatment

Surgery may be necessary for more severe or complex bile duct disorders.

  • Cholecystectomy: The surgical removal of the gallbladder, often performed when gallstones cause recurrent problems.
  • Biliary Bypass: Bypassing blocked areas of the bile duct to restore bile flow into the intestine.
  • Liver Resection: Removing a portion of the liver affected by cancer or severe disease.
  • Liver Transplantation: Considered for patients with end-stage liver disease or inoperable bile duct cancer.

Treatment decisions for bile duct disorders are highly individualised, considering the specific diagnosis, the extent of the disease, and the patient’s overall health.

image

Dr Thng Yongxian

MBBS (SG)

MMed (Surg)

MRCS (Ire)

FRCSEd (Gen)

FAMS (Surg)

Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.

  • Bachelor of Medicine & Bachelor of Surgery,
    National University of Singapore
  • Membership of the Royal College of Surgeons, Ireland
  • Master of Medicine, General Surgery, Singapore
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Fellow of the Academy of Medicine, Singapore

He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.

Dr Thng set up and pioneered the Minimally invasive surgery program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.

Dr Thng has served on various committees at hospital, cluster and ministry level. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).

Patient Reviews

I cannot possibly express how grateful I am for the compassionate care received by Dr Thng during my hospitalization. I was 20 hours away from flying back to the USA after a long work trip, and homesick already when diagnosed with acute appendicitis and a UTI. To say that I was nervous to undergo surgery so far away from home, friends and family is an understatement. He was expedient, attentive and thorough. He even took the time to text and call my husband back home multiple times to update him on my status. His infectious laugh, sense of humor and kindness helped to sooth my own frazzled nerves. I am so appreciative to have had Dr Thng as my surgeon.

Ms Tina Hunter

I was diagnosed for ampullory cancer in 2021. I am very thankful to Dr. Thng Yongxian who kept me calm when revealing the report to me. I really felt like God sent his angel to speak to me.He helped me overcome the operation. Dr. Thng said 3 things that I needed to do before the operation....Stay positive, exercise n eat well, have faith in God. He even gave me his handphone number incase I need to consult him when home. Indeed the 8 hrs operation was a success n I am able to write this testimonial, living a normal life. Finally, its still God who works all things good for those who love Him... Romans 8:28.

Mdm Tang K H

I recently underwent gallbladder stone removal surgery performed by Dr. Thng, and I am impressed with the quality of care I received during this process. Dr. Thng demonstrated exceptional professionalism and expertise throughout my entire experience. From the initial consultation to the post-operative care, Dr. Thng explained the procedure in great details, answered all my questions, and alleviated my concerns and ensuring that I fully understood each step of the process. His compassionate and caring demeanor put me at ease, making me feel confident in his abilities. The outcome of the procedure was beyond my expectations. Dr. Thng successfully removed all my 3 gallstones, and I experienced a smooth recovery process. I am grateful for his expertise and the care I received under his supervision. Overall, my experience with Dr. Thng was exceptional. I highly recommend him for his professionalism, compassion, and outstanding surgical skills. Thank you, Dr. Thng for your excellent care.

Mr Low LT

Corporate & Personal Insurance Plans

Navigating the financial aspects of healthcare can be overwhelming. Allow us to assist you with your insurance claims, enabling you to concentrate on recovery & getting well. Our friendly clinic staff is here to answer any questions you have about insurance or payment options.

Visit Us

Please leave us a message and we will be in touch with you shortly.

    Full Name*

    Email Address*

    Phone Number*

    Your Message*

    For Faster Response, Call us!

    +65‎ 9838‎ 5827

    Our Clinic Locations

    Nexus Surgical @ Mt. Alvernia

    820 Thomson Road, #06-05 ,Singapore 574623

    Monday-Friday: 9.00am-5.00pm
    (Lunch: 1.00-2.00pm)
    Saturday: 9.00am-1.00pm
    Sunday & PH: Closed

    Frequently Asked Questions (FAQ)

    What factors increase the risk of developing bile duct disorders?

    Risk factors for bile duct disorders include age, a history of gallstones, chronic liver disease, certain genetic conditions, and autoimmune diseases. Additionally, lifestyle factors such as obesity and a diet high in fats and cholesterol can contribute to gallstone formation.

    How do bile duct disorders impact digestion and overall health?

    Bile duct disorders can significantly affect digestion, particularly the absorption of fats and fat-soluble vitamins, leading to nutritional deficiencies. Compromised bile flow can also result in jaundice, itching, and increased susceptibility to infections.

    What are the long-term outcomes for individuals with bile duct disorders?

    The prognosis for bile duct disorders varies widely depending on the specific condition, its severity, and how early it is diagnosed and treated. Conditions like gallstones can be effectively treated with a good long-term outlook.
    However, chronic conditions such as primary sclerosing cholangitis or bile duct cancer often have a more guarded prognosis, requiring ongoing management and, in some cases, liver transplantation.

    Is it possible to live without a bile duct?

    Yes, living without the original bile duct structure is possible, but not without a means for bile to reach the small intestine. In cases where the bile duct is removed due to disease or injury, surgical procedures such as a biliary bypass or reconstruction create a new pathway for bile flow from the liver to the small intestine.

    +65‎ 9838‎ 5827