ERCP after liver resection
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We are definitely looking at a second opinion if the subject of the ERCP comes up again. So far the last set of blood cultures are clear and his white count is normal. Temp crept up the other night but I suspect that is related to overdoing it and not drinking enough fluids.
I am seeing that infections do seem to be a bigger issue after the resection which I wouldn’t know unless I had read about it here. It was not something that we were warned about after surgery. Well other than the initial concerns of infection after any surgery. We are continuing to keep an eye on it and it sounds like the oncologist is going to keep a good eye on it.Kris
Kris…infections of the biliary tract is not uncommon with this disease pre-and post surgery and it can occur anytime. It is my opinion that the risk of infection due to the ERCP may have ruled out the surgery however; at this time, with completed resection, monitoring your husband for “possible” occurring infection is an ongoing task, but should not hold you back from planning on adjuvant chemotherapy treatments. Hence, I would be vigilant and report any rise in temperature (101 F) to the physician. This is standard protocol for anyone.
Much is a “wait and see” kind of situation and for all we your your husband may not be troubled by another infection.Biliary stents will fail at one point and need to be replaced or cleaned out. That (generally) is prompted due the occurrence of an infection.
Hugs,
MarionDEAR Kris, no experience here on this particular subject but I always say when 2 DOCs have diff. opinions seek a 3rd unbiased opinion and then make up your mind. Blood infections are common with CC, my husband had them like 2 X a year even after his Whipple. Hope your husband is doing better and also listen to your gut feeling it is usually right. Sometimes I feel like I graduated from Gut 101! Best of luck and Be Strong!
Hopefully someone has some insight into this or their own personal experience.
My husband had a liver resection, Roux-en-y procedure for Hilar CC in June 2013. Prior to the surgery there was discussion about an ERCP and stent placement. The surgeon vetoed the idea due to increased risk of bile infection. We are now 2 months post surgery and he was recently hospitalized for a Klebsiella blood infection. At that time the GI specialist (not the surgeon) wanted to do an ERCP as he was concerned that the anastamosis between the small bowel and the bile ducts was narrowing and that this is what caused the blood infection. They did an MRCP which was not conclusive for any narrowing. It showed no bowel gas in the bile system which the GI doc thought there should be. The original surgeon said he saw no reason at this time to do the ERCP (he said the bowel gas was not a 100% proof of narrowing) so the plan now is that they are monitoring his blood closely for return of infection.
My concerns were that if we didn’t want to do the ERCP back before surgery due to the risk of infection, why would we want to increase that risk of infection now that surgery is done and we are getting ready to start chemo? It seemed to me that we would do everything to decrease this risk.
Also the stents are no permanent so they would have to go back in and change them out or remove them at some point. So wouldn’t the problem return again?I asked these questions of both docs and didn’t get real clear answers. We aren’t having to make any decisions right now but I would like to hear anyone else’s experiences or thoughts.
Thanks, Kris
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