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MBBS
MMed
MRCS (IRE)
FRCSED
FAMS
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.
Bile duct disorders encompass a variety of conditions that can affect the normal functioning of the bile duct system.
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 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.
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.
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.
Diagnosing bile duct disorders involves a combination of clinical evaluation, laboratory testing, and imaging techniques.
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.
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:
Imaging studies are critical for visualising the structure of the bile ducts and identifying blockages, narrowing, or other abnormalities. Common imaging modalities include:
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.
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The treatment of bile duct disorders varies significantly depending on the type and severity of the condition.
For conditions like mild cholestasis or specific forms of hepatitis affecting the bile ducts, medical treatment may include:
Endoscopic techniques are commonly used to diagnose and treat bile duct disorders, especially for removing blockages or relieving strictures:
Surgery may be necessary for more severe or complex bile duct disorders.
Treatment decisions for bile duct disorders are highly individualised, considering the specific diagnosis, the extent of the disease, and the patient’s overall health.
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.
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).
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820 Thomson Road, #06-05 ,Singapore 574623
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(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
3 Mount Elizabeth, #08-06, Singapore 228510
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Saturday: 9.00am-1.00pm
Sunday & PH: Closed
38 Irrawaddy Road, #08-43, Singapore 329563
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(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
319 Joo Chiat Place, #05-01, Singapore 427989
Monday-Friday: 9.00am-5.00pm
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Saturday, Sunday & PH: Closed
6 Napier Road, #05-10, Singapore 258499
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
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
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.
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.
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.
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.