Topic: Rate of bilirubin regression after stent placement

I found an article about a study done at MD Anderson about the length of time for the bilirubin to regress after a stent is placed. In the article, it says that if the bilirubin rate is < 10, it usually takes around 3 weeks and >10 about 6 weeks. My brother's bilirubin rate was 28 at the time of his first stent placement and it took about 7 weeks to get down to 2, so that he could have chemo. Before he could get in for the chemo, however, his stent clogged and within a week from the reading of 2, his level was 15. Another stent has been placed, but I'm concerned about how long it will take for his bilirubin rate to go down enough so that he can get started on the chemo. According to that study, it would seem like it might take another 6 weeks, but wondered what others have experienced. Are the results different if it is the first stent or subsequent stents? I know that he is eager to get going on treatment...as it is now 2 months post diagnosis.
Thanks! Peggy

Re: Rate of bilirubin regression after stent placement

Peggy...sorry, I can't answer this and I don't recall anyone on commenting on this subject.  Hopefully others will come around real soon to help us out.  Of course, I wish for the new stent to accelerate the drop in bilirubin to a few days only.
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: Rate of bilirubin regression after stent placement

Hi,
Can you find the  link for the article you saw" about a study done at MD Anderson about the length of time for the bilirubin to regress after a stent is placed."

I only know that the bilirubin excretion is related to the the breakdown of the hemoglobin which >120 days old(10-15%); and the  production of bile is between 500-1000 ml daily.
I think the bilirubin level is depended on how effective the liver can process the fat in food, remove the toxins, and recycle  the bile acid  through gluconjugation and the disease state of the liver.(ie: liver tumor burden etc.)

I think the rate is different for each individual. and most of the time, you have to change the plastic stent in 45-90 days depend on the individual. My sister-in- law changed hers every 60days most of the time. It is more related to the function of the liver(the bile flow) rather than the changing of the stent.
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: Rate of bilirubin regression after stent placement

Hi Peggy,

My bilirubin was 22.1 the beginning of May 2013.  I had a metal stent put in on May 21, 2013 and immediately my bilirubin started to go down.  As of 7/19 it is 1.2.  The doctors are quite surprised it went down so much and so quickly. Because it did I was able to start chemo on 7/12.  My prognosis is not good - I only have a small part of my liver that is functioning - but the doctors continue to be surprised at how well I am doing.  The tumor is in my bile duct in my liver and also outside my liver.  I also have metastasis to my celiac trunk.  I've had a number of chemos since diagnosis in August 2011 and traditional radiation.  I also had 5 treatments of Stereostatic Body Radiation Therapy (SBRT) in May of this year.  I hope your brother's bilirubin goes down so he can start chemo.  I know how stressful it can be when you're not doing any treatment.  Stay positive!  Over the past few months I have gone through some dark times and am amazed how things can change for the positive. I will keep you and your brother in my prayers.

Mary

Re: Rate of bilirubin regression after stent placement

Here is the link to the article: http://onlinelibrary.wiley.com/doi/10.1 … .23454/pdf

According to the article, it sounds like it would probably be 4-6 weeks, but had wondered if some of you had better results than that.

Thank you, Mary, for your prayers. I will keep you in mine, as well! The doctors at Mayo have said that he isn't eligible for radiation, but we're not really sure why. So, since chemo is the only treatment he is being offered, we are quite anxious to have him get started. His second stent placement didn't go well, and he is being sent back to Mayo. I hope that they get him in quickly.

Re: Rate of bilirubin regression after stent placement

Hi,
Thanks for the article.
I hope the stent works well enough for your brother to have the chemotherapy.
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: Rate of bilirubin regression after stent placement

Hi. we just received the news that the doctors wouldn't be able to install a stent for my father, because his tumor is actually blocking the small liver holes, instead of the bile ducts. i wanted to know if theyres anything else they can actually do to reduce its bilirubin? (im in canada, but my dad is getting treated in AZ so i get the updates a lil later). they have to consult and get back to my family in the AM. my father had already started 3 rounds of chemo. but they dont want to give him anymore, because he is so tired. i feel like he's slowly going everytime i talk to him... should i be getting ready for the worst news of my life?

Re: Rate of bilirubin regression after stent placement

Dear simoulah, welcome to our extraordinary family but sorry you had to find us. I live in Phoenix so if you can tell me where your Dad is being treated and by whom I would be happy if he would want me to, to go see him if he is in Phoenix. I have not heard of this situation before where the tumor is blocking holes to the liver. Can you tell us a little about his diagnosis and how old he is? Once we have a little more information we hopefully would be able to help more. His tiredness could also be from the chemo. I know we will be getting more responses for you in the morning. Hang in there 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: Rate of bilirubin regression after stent placement

thanks for your answer Lainy.  He's been treated at UMC in Tucson. im not sure about the exact terms, but i know that the MRI showed that they wouldn't be able to install a stent.  My dad is 67 was diagnosed on July 13th 2013. stage IV Intrahepathetic CC. He has done 3 rounds of Chemo with Cisplatin and Gemcitabine. The treatment had stopped the tumors growth. But last week when he went to have it, they didnt like his test numbers. Bilirubin was too high. He was admitted into the hospital on Monday for close monitoring, and they also observed some renal issues. He had showed signs of fatigue due to the chemo before, but this time its just worse...

Re: Rate of bilirubin regression after stent placement

Oh, he is 90 minutes from me. Does the ONC have permission from Dad to speak to you? Then you could ask him where you are with this and what to expect next. While we don't like to put time lines on anything I do have a 1 page article called "10 Signs the End is Near" I would email it to you but not sure he is at that point yet and that it is from the Chemo. Gem/Cis is the popular chemo cocktail lately and seems to work well and I know others were taken off chemo when the Bilirubin gets too high then once that is brought down they resume the treatment. Sounds like some family is there and will meet with the DOCs in the morning. You might want someone to take notes for you so they can relay to you exactly what is said/happening. Please keep us informed as we truly care.

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.