All's Well, Time to Wait (again)

Michelle's procedure yesterday went better than expected. Unlike the ERCP on the day after Christmas, the new stent slid right into place in her left hepatic duct. The doctors also placed a stent into the right hepatic duct. The two stents run next to each other through her common bile duct and both terminate at the opening into her small intestine (imagine a large Y made of 2 equal length tubes). Hopefully these two stents will provide adequate drainage so her bilirubin levels come down, allowing the chemo treatments to start. We'll know the outcome in about a week, as it will take that long for the excess bile to drain.

Our next appointment is Tuesday 1/13 with Dr. Weekes at the UCH Cancer Center in Denver.

We discussed additional therapies with the Gastroenterology team (Drs. Shah and Yen this time) and they have several more tricks up their sleeve in the event additional drainage is necessary.

Assuming yesterday's procedure is successful, and assuming the oncology team agrees, they will replace the temporary plastic stents with "permanent" metal stents in about 6 weeks. They used the plastic stents again because it is more difficult to work around metal stents if additional procedures to add drainage are required.

Dr. Shah also told us that there is a gastroenterology conference scheduled for mid-February, with specialists from across the country to hear him and Dr. Chen speak. The timing may work out such that Michelle could be the subject of a demonstration for placing metal stents (Shah and Chen would perform the procedure). Her face and identity would be obscured, but her innards could be famous! Michelle likes the idea of being able to contribute to the body of knowledge surrounding her condition and enthusiastically agreed to participate. Of course, Michelle's needs come first, and they will not attempt to delay necessary treatment for the sake of this demonstration.