Hi All,

Am back to give a quickie update.  So we decided to get a second opinion from one of the biggest cancer institution here in Asia and met with an Oncologist.  We have done several tests and here is the results -

CEA 2.38
CA-19.9 < 2.00

Bil - 1.83
Alb - 4.0
WBC - 8.67

MRCP (31.03.14): Non-visualization of proximal CHD. Distal CHB 6.5 mm
Pneuobilia bilaterally

CECT Chest, Abdomen, Pelvis (TMH) on 07.05.14:
Biliary stent in situ (CBD & CHD) with pneumobilia. No evidence of malignancy

Imp: Benign biliary stricture
However, since very old h/o cholecystectomy in 1992, risk of malignancy is present

Plan: Close observation
Review with PET-CT after 2 months

Now i am confuse whether to believe this knowing that there are lots of false negative tests.

I just want to include the cytological examination results, i am not sure if this is going to help us find the right diagnosis -

Specimen Type : Smear
Microscopy : Smear shows benign biliary epithelial cells in cohesive sheets and dispersed singly admixed with fair number of neutrophils.  Backgroud shows microorganisms (bacilli).

Impressions : Acute cholangitis.  Negative for Malignant cells.

Thank you all for your input.  We will go to a different oncologist to make sure that she is rightly diagnosed.  She is doing very well after the metal stents only that she is having this mild pain in the rib cage area near the stomach while coughing or sneezing.  As per your suggestion, i will take her to the gastro to check on her stents again if it is rightly placed.

Thank you Lainy for your warm welcome and your suggestion. This site has given me so much relieve knowing that we are all in this together fighting for this dreadful illness. I will try to give regular updates on the progress of my mothers treatment. 

I want to know if this bilary brushing is accurate or not? I have research the internet and the number of false negative is around 45%.  I will talk to our doctor to see if they can take biopsy to secure the findings.

Hi All,  I am thankful to have found this site. My mother (50 years old) has been diagnosed with Hilar Cholagiocarcinoma last month and the doctor informed me that she has only 6 to 12 months to live (which i don't want to believe).  Metal stents have been implanted in her bile duct to ease the jaundice. And now she is gaining her weight back, in 3 weeks she gained back 2 kgs. Her only complain after the stents is that she is having a mild stomach ache and she is taking pain killer which kills the pain for almost 2 days. Is this normal while having stents in place? And also, the bilary brushing that her doctor performed during endoscopy shows negative.  Now that her billirubin level comes down to 2, (it was 9 before the stents) we are advice by the doctor to take chemotherapy.  How accurate is this brushing, can we take biopsy for this type of cancer?