Re: Question about Common Bile Duct Stricture
I have a few comments:
The Doctor that performed the EUS had noted the Common Bile Duct was somewhat thickened at 2-3mm, but not such to make one think of Cholangiocarcinoma.(?)
You put a question mark in there. I'm afraid I'm not sure what your question is. This note seems pretty clear to me. The bile duct was thicker than normal. But not as thick as what they usually see in cholangiocarcinoma.
The CBD had no tumor associated with the pancreas causing the compression.
A portion of the common bile duct sits inside pancreas. Think of it as a pipe going into a tunnel. In some patients, the stricture (narrowing) of the bile duct is caused by pancreatic cancer. Pancreatic tumor compresses the bile duct. Your mom's report says she doesn't have that. This is great news.
He stated later on in his notes, I cannot be certain that this is not an early Cholangiocarcinoma however there was nothing to be sampled by FNA.(?)
FNA = Fine Needle Aspiration. EUS doctor can extend a fine needle from the endoscopic probe and stick it into surrounding organs. They can use this fine needle to collect a tiny amount of tissue for biopsy. I don't understand why he wrote "there was nothing to be sampled by FNA". I don't know enough to even begin to speculate.
In my wife's case, the doctor noted that he had *chosen* not to sample the stricture by FNA. He was afraid to cross-contaminate the surrounding organs with cancer cells, if the stricture was truly cholangiocarcinoma.
I could not find where he had the size of the original stent, just that he had replaced it with the 10 French 5 cm long stent.
Sorry Teresa, I think I managed to confuse you. The sizes of the stents are not important. What's important is the size of the stricture (the narrowing of the bile duct).
Here's how our surgeon explained his plan. Do the first ERCP. Measure the stricture. How long and how tight it is. Wait 6-8 weeks. Do the second ERCP. Measure the stricture again. If the stricture is smaller on the second ERCP, it helps to rule out cancer. Cancerous strictures do not shrink between ERCPs. My wife didn't get to do the second ERCP. We did EUS after the first ERCP. EUS doctor was pretty sure that my wife had cholangiocarcinoma. So we decided to go to surgery without waiting for the second ERCP.
Any questions - please do not hesitate to ask.