On June 16th, 2008 my husband had over half of his liver removed because of Cholangiocarcinoma, He had a very small tumor in the bile duct in the left lobe of the liver about 2cm away from the common bile duct. The doctor did not use an fibrin glue on the cut side of the liver, and he developed a bile leak. After surgery the the output from the bile leak was over 400 ml a day. Now after numerous tube exchanges, and three different stents in the liver we are 7 months post surgery and he still has a bile leak. The output is now down to about 150 ml a day, however we are starting to get discouraged that this liver will never heal itself. Any others out there who have experienced a bile leak this long?
His doctors say that the liver has now grown back to normal size but give us no indications as to when or if the liver will ever heal completely. By the way, my husband is diabetic which I'm sure accounts for his slow healing.
it seems like they are handling the leak correctly. the best thing sometimes is to reoperate so I am assuming they do not wanjt to use this as an option. If an extrernal stent is in place, could it be internalized via an ERCP?
Thank you for your reply. At this time, another operation has not been suggested and it is my husband's wish that this not even be an option. He doesn't feel that he would survive another operation and says that he'll keep the JP Drain instead of surgery.
He does have an 'internal stent' in the liver which was placed via an ERCP. This stent will have to be removed in about 3 weeks.
To date, he has had 5 ERCP's including one where they failed to get to the blockage in the liver so he had to go back in three days and they accessed the liver from outside the stomach and went into the liver that way, then via the ERCP they were able to see the wire and balloon the blockage, get a scraping, put a stent in and that is how they found the cancer (from the scrapings of the bile duct).
We are dealing with the VA Zablocki Medical Center in Milwaukee Wisconsin. He has many different teams of doctors dealing with him but at this point in time we have lost our confidence in his doctors...almost like too many Chiefs and not enough Indians....His surgeon was awesome, but now we're dealing with the interventional Radiologist and gastrointestional doctors.
Would a 'second' opinoin be worth our while at this point? Would any other doctor take on his 'case' being that they did not place the JP Drain or do the initial surgery?
i think a second opinion never hurts. there are now pecial wallstents that can be placed to obviate the need for repeated ERCP etc. I would highly recommend dr mark catalano who is a nationally known biliary and therapeutic endoscopist in wisconsin.
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