What does it mean?

Here is my current interpretation of what is going on. The surgery was done "at the max." Literally, there was no more tissue it could have taken. As Dr. Visser said, he had to have a minimum amount of bile duct to work with and connect to or the surgery would have failed for lack of a connection from the remaining liver to the intestine. In this graphic, I have added an estimated "cut line" and how it slices through two tiny bile ducts in the retained liver. Those are, my interpretation, the 2mm ducts he had to connect the intestine to.

This link shows the real complexity with the bile ducts, arteries and veins. To me it clearly makes the point that they were able to do the surgery at all is absolutely amazing.

The pathologists spent the week confirming and re-confirming their findings and conclusions. And, the final answer is there was not sufficient margin (distance) along the bile ducts from the cancerous location(s) to Mary's remaining liver. Without sufficient margin (distance), the presumption is that cancer has a high possibility of being present in those very small ducts of her remaining liver.

So what is the difference? We've always know radiation and chemo was on the agenda although later in the summer. The difference is that the radiation and chemo treatments now are Mary's primary line of defense to stop this thing so they must be done as soon as possible. Previously, the radiation and chemo steps were to assure completeness. Its a different role and represents different risk.

Anyway, I am on my way to the hospital. Reenie has been there since this morning and the two sisters are having a bit of an all day picnic with "Quirk" food rather than hospital fare. And, Reenie reported that Mary is eating the goodies that Reenie prepared. Hooray! Reenie did get permission from the nutritionist yesterday to bring in food if it would help Mary eat. It is helping, Reenie reports.