1 (edited by kris00j Tue, 14 Feb 2012 10:31:58)

Topic: embolization before resection

Hi all:
My surgeon has suggested I have an embolization before the resection. The tumor is stable and finally operable. Since the tumor is stable, he suggests we "grow" the right side of the liver by blocking off the vein/artery (I always get them wrong) that branches off to the left side of the liver. That would cause the right side to do all the work BEFORE surgery. And cause it to grow. I don't know how long before resection will happen: I guess it depends on how long it takes my liver to respond. And the stability of the tumor.
The tumor is in the very very top of 1, 4a and 8. But it started in a bile duct and had a thin tail that meandered thru 2 at the start of all this. The little bit in the bile duct can't be seen anymore.
The resection will take out 1, 2, 3, 4a, 4b and parts of 5 and 8. Which leaves me with just 6, 7 and parts of 5 & 8 when the resection is done. So "growing" the right side makes sense to me.
I looked thru many of the titles in this section and didn't see any postings like this. Has anyone on this site had this procedure before resection? Was it successful? And did the liver react fairly quickly? I realize that anyone else's outcome won't necessarily be the same as mine, but I was just wondering.
I'm a little nervous about doing anything because I feel healthy and the tumor is stable. But I'm also nervous about the tumor starting to grow and thus make it inoperable again.

Kris

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: embolization before resection

Hi,
I do not have any EXPERIENCE on radioembolization But I think it is a good choice to do it a few week to 2 months  before resection in your case.
depending on how much is left after resection,you need at least 20% of the liver left to function correctly,
In your case ,all your left lobe and the caudate lobe and 2 out of four segments from the right liver are resected ;it is a big surgery.god luck and
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: embolization before resection

Kris,

I have no idea.  I haven't read about anyone going through this.  I feel the need to recognize your Dr in a positive way.  It seems they really do think outside of the box and it has worked out for you.  It seems so many others on here have had experiences where it appears their Drs have given up hope and they run out of options before they are even explored.  I guess that is why everyone encourages second and third opinions.

Keep us posted on what you decide to do! 

Susie

Re: embolization before resection

I met with the radiologist today and she said this is, while not common, done more often than I know. I said no one had answered this post saying they had it done. But I digress:
The embolization is set for March 5th. Under normal circumstances (those who know me, know I am NOT normal) she would go in thru the left vein and block it off. Well, the left vein has 3 branches, 2 of which look like they've already been clipped. The remaining branch is so skinny and snaky that she doesn't feel she would be able to puncture it and complete the embolization.
Now here's the scary part.
She plans on going thru the right branch of the vein and following it until she gets into the left branch and can close it off. If she damages the right side in any way I will lose blood flow to the good part of my liver.
I had 3 radiologists try to do an embolization this past summer. 2 failed. Dr. Brown is the one who succeeded. And my surgeon says she is the best. I told her he said that and I trust her, but I'd be lying if I said I wasn't scared. One mistake and there's no reason for a resection...
I just have to think positively and trust that God is watching over me. But it's hard to do.

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: embolization before resection

Hi Kris,
My doctor was going to do it before the surgery, but MRI showed it was already block on my right side of liver.  So I had natural embolization:)
They took more than 60% of my liver and last CT showed my left got bigger and working fine.
Good luck

Re: embolization before resection

Dearest Kris, I wish I could be by your side! But I will be praying for God to come through the Doctor's hands.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: embolization before resection

LeeAnn:
Thanks for the post. It's nice to hear about people that have had successful resections.
And Lainy: Thanks for the offer. My parents will be flying up for the resection but not for the embolization.
I know I shouldn't worry as much as I am, but it seems nothing about any of the procedures or surgeries they do are "normal". By normal, I mean they are always having to turn left to go right when it comes to my situation. I just would like for one thing to not have an additional complication!
It is so tempting to put this all off, as I am otherwise healthy. I have very little discomfort, in the scheme of things. Very little pain. And since they stopped chemo in Nov. I haven't had to go to the hospital at all! (Yep, it's the little things)
But I know I need the surgery. And if the tumor starts growing again I'll be in trouble with operability again. It doesn't make it easier emotionally, tho. I am putting my life into not one but 2 doctor's hands within weeks, and what I heard yesterday is scary. I would love to tell them to wait. Maybe the nanoparticles I've been reading about will help? Maybe the tumor will keep shrinking and disappear? And MAYBE I'm wishing for too much, but the brain won't stop asking.
I know I have to trust that my doctors know more than I do, and have weighed the options and the dangers. After all, this is what they do. But it doesn't seem to get thru to my brain.
Kris

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: embolization before resection

Kris, Congratulations on being normal with your feelings. We are all scared before something new and different. May I suggest they put tiny stop and go lights in permantly set on green for go and little one way signs. I am praying so hard for the biggest success. A million big hugs!

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: embolization before resection

Kris.....Finding the  "competent physician" in whom you trust is a huge step in the right direction.  You are fortunate to have done so.
Know that a tidal wave of support is heading your way. 
Hugs and love,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: embolization before resection

Amen on the support and well wishes, coming from here as well! I'm not sure of what  sections of my liver were removed, I just know the entire right lobe and half of the left were removed. Within 2-3 days of the surgery, my liver functions were 100% normal. It's a great positive that you have surgeons you trust, you have to put your faith in them at some point in this journey. Wishing you the best in your current 'embolization' procedure and subsequent resection!!

Derin

Husband to Eileen, Dad to Hunter (15) and Sydney (13)
Attitude is everything, you have to keep it positive! And take it one day at a time, it's all anyone can do with this disease...

Re: embolization before resection

Well, everything is set.
March 5 is my embolization. It is with the same radiologist that did my last embolization successfully. I don't remember if I posted, but I had 3 different radiologists try a different embolization last summer. 1 failed. 1 didn't even try after he or she got into the vein, and the 3rd went in and did the embolization successfully. THAT is the radiologist that will do this embolization. My surgeon says she's the best on staff, too.
She will go thru the right side of my liver into the vein and will block off the left branch of the vein so most of the blood goes into the right side of the liver. This will have the left side sort of "die off" and the right will take over the work. (what normally happens AFTER the resection). It's a little scary because if she nicks the vein I will have compromised blood flow, or no blood flow to the right side and that will be the end of my liver. But that WON'T happen! Dr. Brown is the best radiologist at SK and I believe she can do this. Of course, it doesn't keep me from worrying...
Then March 26 I have a CT scan to check on growth.
As long as all goes as planned, the resection is April 4th. I believe it is an auspicious day, as it is 1 year to the day of when I met Dr. Fong. So it's a sign that all will go well. I've told my parents to expect a 15 day hospital stay... I think it's safe to guess that much since I will be losing 75% of my liver. And I found out why he is taking so much out: it all has to do with blood flow and drainage. Those parts of the liver will die off when he removes what he HAS to remove, so he has to take them out, too.
I'm trying to stay positive but as all of you know, this is really scary. Worse to my nerves than being inoperable. Now I have the biggest hope and the biggest fear all at the same time.

Kris

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: embolization before resection

Kris,

Best of luck to you!!  I'm sure you must be scared but I'm sure that is normal. I think it is wonderful you are getting a resection and you will be in my prayers.

Take care

Susie

Re: embolization before resection

Kris, I have marked my calender for the "grand opening!" Of course you are scared and excited, sounds normal to me. You are going to be fine, with everyone tossing out great vibes to you and many prayers, you cannot miss. Think positive and I will be praying for God to come through the Radiologist's hands! Love you so very much and be strong!!!

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: embolization before resection

Hi Kris,

Thanks for keeping us up to date with what is going on for you. As for feeling really scarey, like Lainy says, that sounds normal to me and I know I would feel just like you do now! And of course, I will be keeping everything crossed for you and know that you have a whole army in your corner here!

Hugs,

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.

Re: embolization before resection

Kris....everything you have been working for is now happening.  I am thrilled for you.  You have a tidal wave of support heading your way.
Hugs and love,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: embolization before resection

Good Luck Kris.

Re: embolization before resection

Kris,

I think it is so awesome that you get to have surgery. That is what everyone hopes for and you are one of the lucky ones!! It is only natural to be nervous. I would think something was wrong with you if you weren't! I am so excited for you. You are so tough. I know you will sail through everything. Best wishes to you.

Love, -Pam

My beautiful daughter, Lauren Patrice, will live on in my heart forever.

My comments, suggestions, and opinions are based on my experience as a caretaker for my daughter, Lauren and from reading anything I can get my hands on about Cholangiocarcinoma. Please consult a physician for professional guidance.

Re: embolization before resection

Kris, I am so happy you get to have surgery. the liver is amazing, my surgeon took over 75 percent of my liver and it grows back !!  I was scared too but as long as you feel confident in your surgeon things will go well. 
Lisa

This Information Is Not Intended Nor Implied To Be A Substitute For Professional Medical Advice. You Should Always Seek The Advice Of Your Physician Or Other Qualified Health Care Provider

Re: embolization before resection

I guess it's time to close this thread. Hopefully I get to start another one here soon. Today was supposed to be the day of my surgery Unfortunately, due to the fluid in the lungs, and probably the growth in the tumor, it was put on hold. Fluid is way down, but now I'm back on chemo (see other thread under general discussion) to try to get the tumor and lymph nodes shrunk again. Hopefully in a couple of months I get to post my new resection date.

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: embolization before resection

Kris...we are counting on the new thread.
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: embolization before resection

Hi Kris,

Looking forward to your new thread too!

Hugs,

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.

Re: embolization before resection

Oh, well. Adding to this one.
Does anyone know how long I can leave the liver after the embolization? I'm a little worried about necrosis. I had the embolization March 5 and haven't had a CT scan since March 26 where they saw some possible necrosis.
Started 4 cycles of Xeloda and I don't think we are even going to look at surgery before June 12ish.

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: embolization before resection

Kris...don't quite understand. Why are you worried? You want it to be necrotic due to treatments.
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: embolization before resection

Marion:
I wasn't sure I wanted the liver to be necrotic for long tho. I'm trusting my doc but sometimes they don't tell me everything. And I don't always understand but don't think of questions until another day...

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: embolization before resection

Kris....the physicians probably don't have all the answers and are cautious with making predictions or false statements.
Much is about "wait and see."
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER