I am sorry to hear that your mother is feeling so poorly and having so much difficulty with her stents.
Today I was looking through the board to see if there were any unanswered questions, and I saw you had raised a very sensitive one related to end of life.
You had asked whether CCA could be terminal without spreading. It appears to me this is the case. Looking into this question, the medical literature indicates that often, the cause will be liver failure or infection (“sepsis”) arising in the bile ducts due to the cancer and the blockages it causes.
Here is an example of a source where this is indicated.
This is based on experience and facts, and I always have to be clear so it doesn’t apply to all individuals.
After about 5-6 ERCPs this year for my mom the stents no longer work. My understanding is tumor growth and possible sludge, debris, and stones. Percutaneous draining was also ineffective after a couple of days. This was so painful, uncomfortable, and awful with pain meds, antibiotics, anti nausea, you name it any medication imaginable. The body has taken a beating with these procedures that no longer work due to what was mentioned above. Now the doctors are blunt that my mom will die soon. This cancer has not spread and is only in the ducts, but not possible to drain. So that is an awful part of this is the side effects of sludge and debris build up and tumor growth in one spot also is the end all for someone. You would think draining bile is something not so complicated and would be easy to drain, but apparently not. Even if there is narrowing in many spots, somehow create a connection. Not advanced in our medical system. I have not heard of anyone with bile duct cancer dying without it spreading. Or am I wrong?