She is out and in recovery

Doc Banerjee stopped by. The procedure is done, fairly straightforward. The biopsy reports from his conventional brushing will be done in 2-3 days, the path reports for the material taken by the super duper scope will take 5-7 days. (Note, the super duper scope did get up to the blockage--hooray!) He recommends and is scheduling surgery next week and the exact surgical procedure will depend on the results of the path reports.

He then described the appearance of the constriction--it is smooth, not rough or granular like a typical bile duct tumor. Taking that with Mary's symptomology of pain preceding jaundice by several days and it points to a higher probability that this whole thing is an infection, not a tumor (with a tumor, jaundice typically appears long before pain). Of course, he is not certain until the path reports come back and may not be certain until after the surgery is done.

He removed the two stents as he said he would and replaced them with a single and larger stent. The constriction is below the joining of the left and right bile ducts so he didn't see a need for two stents.

The gall bladder had not yet drained from the ERCP material of two weeks ago (meaning the cystic duct is blocked) and that gives another clue. He observed that the cystic duct may be impinging on the bile duct and they are pinching each other off. Why? Because there might be a gall stone (hidden in all the pictures) in the cystic duct at the pinch point. The stone's proximity may be the cause of an infection or an infection-like behavior in the bile duct while it simultaneously creates a blockage in the cystic duct. How's that for a twofer?

Our girl is in recovery and is expected down here in the endoscopy department in about an hour (hospital talk for we have no idea but you want us to tell you something.) As some point after that (another hospital hour?), I'll be taking her home.

And, in this particular waiting room, there is no phone service (ATT). However, Stanford runs a guest network and I am communicating by wifi.

That's all for now!

Pat
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Pat Lamey
http://www.lamey-hughes.com/ Los Gatos, California, USA