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What Causes Sludge In The Bile Duct?
What causes sludge in the bile duct (gallbladder removed 2003) & what is the best way to treat it? I I have had pancreatitis two times as a result of attempt to place plastic stent in bile duct. I have mast cell release syndrome and wasn t on the correct dose of steroid pre op. The next time the plastic stent was placed without issue, sludge was removed & lasted 8 months before 100% blockage. Had stent replaced without incident but within a week the pain, nausea etc returned. They went it the stent was 100% occluded again. So, it was decided to not replace the stent and go into a wait and see mode. Unfortunately, I am experiencing increased pain, contraction type feeling in the area of the bile duct and am unable to eat many foods. I was already following the FOD MAP diet and I should also note that I have a pancreatic divisum which was found at the time of the first pancreatitis. Where do I go from here? permanent stent? And what if mast cell release syndrome causes this same issue - flares the mast cell and stent has to be removed
Tue, 17 Nov 2020
Hi,
Mast cell release syndrome can be controlled by steroids as you have mentioned and you should get the blood sugars, insulin and Vitamin D levels regularly and replaced as and when needed. Sludge in bile ducts indicates concentration of bile or slow passage and the cause is known like attacks of pancreatitis, pancreatic divsum. Another common cause is narrowing at the sphincter of oddi and proper sphincterolplasty should be sufficient in most of the cases.
Stent is placed to keep the sphincter wide open so that the bile flows easily without obstruction to allowing the sludge to be formed or stay in bile ducts and avoid stone formation. Take small amounts of foods frequently say divided in 4 times in 24 hours. Identify the foods and beverages that instigate or enhance the pains and other symptoms. Continue medicines for pancreatitis to avoid edema formation. Steroids also help in avoiding stricture formation. Further management is as advised by your gastroenterologist.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. T. Chandrakant, General Surgeon
Mast cell release syndrome can be controlled by steroids as you have mentioned and you should get the blood sugars, insulin and Vitamin D levels regularly and replaced as and when needed. Sludge in bile ducts indicates concentration of bile or slow passage and the cause is known like attacks of pancreatitis, pancreatic divsum. Another common cause is narrowing at the sphincter of oddi and proper sphincterolplasty should be sufficient in most of the cases.
Stent is placed to keep the sphincter wide open so that the bile flows easily without obstruction to allowing the sludge to be formed or stay in bile ducts and avoid stone formation. Take small amounts of foods frequently say divided in 4 times in 24 hours. Identify the foods and beverages that instigate or enhance the pains and other symptoms. Continue medicines for pancreatitis to avoid edema formation. Steroids also help in avoiding stricture formation. Further management is as advised by your gastroenterologist.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. T. Chandrakant, General Surgeon
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