Hepatobiliary Disease

Hepatobiliary disease is a catch-all term for any condition or disorder that affects the liver, gallbladder and bile ducts. These diseases can include minor infections, cysts, gallstones, liver cirrhosis, abnormal growths and cancer.

Hepatobiliary disease can be caused by a range of things, including viral, bacterial or parasitic infections, neoplasia (abnormal cell growth), toxic chemicals, alcohol consumption, poor nutrition, metabolic disorders and cardiac failure.

At Welbeck, our consultant gastroenterologists are experts in hepatobiliary disease care, ensuring you receive the world-class treatment you need to make the best possible recovery.

Liver disease 

Your liver performs hundreds of functions required to sustain life. It's also a gland because it makes proteins and hormones that other parts of the body need.

Some of the key roles of the liver are:

• blood detoxification and purification

• bile production (used in digestion)

• metabolism of proteins, carbohydrates and fats for energy

• regulating blood sugar levels

• blood clotting

• regulating the amount of blood in the body

• storage of vitamins, minerals, fat, and sugar

• bile production for digestion of fats and removal of waste from the body. 

• immune response

• hormone production

• bilirubin removal

Hepatobiliary disease can affect the health and function of the liver, which can have a widespread impact throughout the entire body. 

Most people with liver problems don’t have any symptoms at all. Blockages of the bile ducts can cause abdominal pain. In the severest forms of both conditions, complications can include jaundice (where too much bilirubin has built up in the blood and the skin and whites of the eyes turn yellow), or other symptoms of liver failure, including: 

• ascites (a build-up of fluid in the belly area), 

• itchy skin,

• loss of appetite and weight loss, 

• feeling or being sick

• abdominal pain

• swollen legs or ankles and weakness and fatigue

Common liver diseases 

Some of the most common liver diseases are:

• alcoholic fatty liver disease (ArLD)

• fatty liver disease (metabolic associated steatotic liver disease (MASLD)

• inflammation of the liver (hepatitis A, B, C, E, medication-induced liver injury or autoimmune hepatitis)

• scarring of the liver (cirrhosis)

• haemochromatosis (a genetic condition causing high iron levels)

• benign (non-cancerous) and malignant (cancerous) tumours

Diagnosing liver diseases

How liver disease is diagnosed depends on the symptoms you are experiencing. At a consultation, your Welbeck specialist will take a medical history and ask you questions to build a picture of your overall health. 

They may then perform one or a combination of the following diagnostic tests:

• blood tests to measure liver function, look for signs of abnormal blood clotting and check for high levels of alpha-fetoprotein (AFP), a protein which can indicate liver cancer, other cancers, liver disease, active liver inflammation and hepatitis

• imaging scans such as ultrasound, MRI scan, CT scan and FibroScan to evaluate the size and structure of your liver and identify any abnormalities, such as scarring or growths

• biopsy to remove a small piece of the tissue from the liver and evaluate the cells under a microscope to make or confirm a diagnosis

Gallbladder disease

Your gallbladder is a small organ that sits just under your liver. Its key function is to store and release the fat-digesting bile produced by the liver.

It’s connected to other parts of your digestive system through a series of bile ducts called the biliary system, which carries bile from your liver to your small intestine, where it helps to break down and digest food.

If your gallbladder is infected or blocked, bile can become backed up in the biliary system affecting the function of the gallbladder, bile ducts, liver and pancreas. 

The symptoms of gallbladder problems can vary but can include upper right or upper mid abdominal pain, pain after eating fatty foods, fever or chills, nausea and vomiting, jaundice light-brown pee or light-coloured poo.

Conditions affecting the gallbladder

Several conditions can cause problems in your gallbladder, including:

• gallstones (cholelithiasis), commonly caused by high cholesterol

• gallbladder inflammation (cholecystitis) 

• gallstone pancreatitis (inflammation of the pancreas caused by a gallstone blocking the common bile duct and pancreatic duct)

• gallbladder polyps (non-cancerous growths)

• gallbladder cancer

Diagnosing gallbladder diseases

• abdominal ultrasound is the most frequently used diagnostic imaging scan used to detect gallstones and cholecystitis

• imaging scans including endoscopic ultrasound, CT scan and X-ray may be used to detect duct stones and gallbladder cancer

• MRCP (magnetic resonance cholangiopancreatography) may be used to provide detailed imaging of the bile ducts and biliary system where other imaging tests have been inconclusive

Bile duct disease

Your bile ducts connect the organs in your biliary system. They are responsible for carrying the bile created by your liver and stored in your gallbladder to your small intestine.

If your bile ducts are affected by disease, bile can become blocked (obstructed) and back up into the other organs in your biliary system. This can cause inflammation and damage to those organs, which can result in cholecystitis (gallbladder inflammation), gallstone pancreatitis, liver cirrhosis, infections and cancer. Blocked bile ducts can also impact digestion, which can lead to malabsorption and malnutrition. 

Common bile duct diseases 

Common conditions affecting the bile ducts include:

• bile duct stones (choledocholithiasis)

• bile duct inflammation (cholangitis)

• primary sclerosing cholangitis (PSC) (a chronic liver disease)

• bile duct cancer (cholangiocarcinoma)

Diagnosing bile duct diseases 

• EUS (endoscopic ultrasound) 

• MRCP (magnetic resonance cholangiopancreatography) can be used to assess the bile ducts and identify blockages

• blood tests may be done to measure liver function, which can indicate bile obstruction