possible biliary tract obstruction

[Felicia]

My question is a little complicated - My Mother has pancreatic cancer with mets to lungs and liver.  She has started a rather harsh chemotherapy protocol (gemzar, 5-fu, cisplatin combination).  Her Alk Phos is 218 and has been rising since she began this protocol.  Her GGTP has decreased since she began the protocol and her ALT and AST have decreased so that they are now both within the normal range.  Here is the question:  Is it possible that the chemotherapy is working and that is why her GGTP and ALT/AST are getting better? AND is it possible that her Alk Phos is increasing due to the chemotherapy considering that the former three liver function tests are "better"?  My Mother does not display symptoms of an obstruction and is able to keep her food down.  We are going for an ultrasound, but we are all (the family) very concerned about a possible obstruction and what would happen to her if she did, indeed, have an obstruction.

Thank you so much for any answers you can give me.

[HFHSm.D.-Gastro-rf]

Dear Felicia,
AST, ALT. and GGT are all markers of liveer disease.  The alk phos can be elevated by conditions that cause either liver or bone pathology.  In other words, an elevated alk phos does not necessarily indicate bile duct obstruction.  The answer to your question regarding obstruction will be provided by the ultrasound study which can identifty distended bile ducts.

[amanda]

I'm not sure how much help I can be, but when my son's common bile duct was obstructed, ALL of his Liver Function Tests went up.  And they continued to increase until they did the PTC  (percutaneous Tranhepatic cholangiogram) and since then he still has a biliary tube to keep his bile duct open but is **** much better.

[Cindy Carvutto]

Amanda,
My mom has been jaundice for 3 weeks and we know that it is her bile ducts(she has pancreatic cancer) she was scheduled for a cholangiagram on tuesday but was cancelled because her blood counts were too low, she is supposed to have it done next week.
Can you please provide any input as to how long the procedure took and were there any concerns about the difficulty of the procedure.  Is the bilary tube internal or external?  Was your son naueaous prior to the relief?  I hope he is doing better and keeps getting better. Any input would be appreciated.
Thank You
Cindy Carvutto
cindy.***@****

[Wasiem Bokhari]

My mother is 73. She was diagnosed as having obstructive Jundice.
CT scan shows Liver with moderate billiary dilatation.A large hypodense non-enhansingmass of 7.2*5.3cm laying in the region of porta hepatic anterior to IVC and suprmedial to gallblader.Gall Blader shows gernalized calcification its walls suggesting of porcelain gall bladder.She has under gone surgery resulting in palliative resection of gall bladder.Biopsy of liver tissue and porta hepatis says - hard fibrosed malignant calcified gall bladder adhent to liver bed.Large lynpnodes along CBD&porta hepatic.Small lymp node in omentum.Excision of malignant mass of gall bladder,removal of adjacent liver was done.
Microscopic Diagnosis says - Moderately differentiated adenocarcinoma of gall bladder with lymph node metastatsis and direct extention into the adjacent liver bed.
Can you please tell me if there is any treatement that can help her and what are her chances of recovery.If she cannot be treated,how much time has she got. Please help.
Many thanks.