Mhando / chiropa / murwere / bile-duct-kurapwa-pdq

Bile Duct Cancer (Cholangiocarcinoma) Kurapa

General Ruzivo nezve Bile Duct Kenza

PFUNGWA DZINOKOSHA

• Bile duct gomarara chirwere chisingawanzo mune maseru (gomarara) maseru anoumba mumaburi ducts.

• Kuva necolitis kana zvimwe zvirwere zvechiropa zvinogona kuwedzera njodzi yekenza yemukaka.

• Zviratidzo zvekenza duct kenza zvinosanganisira jaundice uye kurwadziwa mudumbu.

• Miedzo inoongorora iyo bile ducts uye nhengo dzepedyo dzinoshandiswa kuona (tsvaga), kuongorora, uye danho rekenza duct kenza.

• Maitiro akasiyana anogona kushandiswa kuwana sampuli yetishu uye kuongorora kenza yema bile duct.

• Zvimwe zvinhu zvinokanganisa kufungidzira (mukana wekupora) uye sarudzo dzekurapa.

Bile duct gomarara chirwere chisingawanzo mune maseru (gomarara) maseru anoumba mumaburi ducts.

Network yemachubhu, anonzi ma ducts, anobatanidza chiropa, nduru, uye ura hudiki. Iyi netiweki inotangira muchiropa umo madhivhuru madiki mazhinji anounganidza bile (chinoyerera chakagadzirwa nechiropa kuputsa mafuta panguva yekugaya). Madhiri madiki anouya pamwechete kuumba kurudyi uye kuruboshwe hepatic ducts, ayo anotungamira kunze kwechiropa. Madhiri maviri anobatana kunze kwechiropa uye anogadzira yakajairika hepatic duct. Iyo cystic duct inobatanidza iyo gallbladder kune yakajairika hepatic duct. Bhairi rinobva pachiropa rinopfuura nepane hepatic ducts, yakajairika hepatic duct, uye cystic duct uye inochengeterwa mudunduru.

Kana chikafu chiri kugayiwa, bile inochengeterwa munduru inoburitswa uye ichipfuura nemu cystic duct kuenda kune yakajairwa bile duct uye kupinda mudumbu ura.

Kenza dhayeti kenza inonziwo cholangiocarcinoma.

Iko kune maviri marudzi e bile duct cancer.

• Intrahepatic bile duct cancer: Rudzi urwu rwekenza mafomu mune bile ducts mukati mechiropa. Chete chiverengero chidiki che bile duct kenza ndeye intrahepatic. Intrahepatic bile duct kenza inonziwo intrahepatic cholangiocarcinomas.

Anatomy yeiyo intrahepatic bile ducts. Intrahepatic bile ducts inongedzo yetubhu diki dzinotakura bile mukati mechiropa. Nzira diki diki dzinodaidzwa kunzi ductule, dzinouya pamwechete kuti dzigadzire kurudyi hepatic bile duct uye kuruboshwe hepatic bile duct, iyo inoburitsa bile kubva pachiropa. Bira rinochengeterwa mudunduru uye rinoburitswa apo chikafu chiri kugayiwa.

• Extrahepatic bile duct cancer: Iyo yakawedzerahepatic bile duct inoumbwa nenharaunda ye hilum uye nzvimbo iri kure. Cancer inogona kuumba mune chero nharaunda:

• Perihilar bile duct cancer: Rudzi rwecancer rwunowanikwa munzvimbo yehilum, iyo nzvimbo iyo kurudyi uye kuruboshwe bile ducts inobuda muchiropa uye kujoinha kuita yakajairika hepatic duct. Perihilar bile duct cancer inonziwo Klatskin bundu kana perihilar cholangiocarcinoma.

• Yakapararira extrahepatic bile duct cancer: Rudzi urwu rwegomarara runowanikwa munzvimbo iri kure. Iyo distal dunhu inoumbwa neyakajairika bile duct iyo inopfuura nepancreas uye inoguma mune dumbu ura. Kenza yakasarudzika yeephephusi bile duct kenza inonziwo extrahepatic cholangiocarcinoma.

Anatomy yeiyo extrahepatic bile ducts. Extrahepatic bile ducts madiki machubhu anotakura bile kunze kwechiropa. Izvo zvinoumbwa neyakajairika hepatic duct (hilum dunhu) uye yakajairwa bile duct (distal dunhu). Bhairi inogadzirwa muchiropa uye inoyerera kuburikidza neyakajairika hepatic duct uye iyo cystic duct kuenda kune nduru, kwainochengeterwa. Bhiri rinosunungurwa kubva mudunduru apo chikafu chiri kugayiwa.

Kuva necolitis kana zvimwe zvirwere zvechiropa zvinogona kuwedzera njodzi yekenza yemukaka.

Chero chipi zvacho chinowedzera njodzi yako yekuwana chirwere chinonzi njodzi chinhu. Kuva nenjodzi hazvireve kuti uchawana gomarara; kusava nenjodzi hazvireve kuti hauzobatwe negomarara. Vanhu vanofunga kuti vanogona kunge vari panjodzi vanofanirwa kukurukura izvi nachiremba wavo.

Njodzi zvinhu zvegomarara re bile rinosanganisira anotevera mamiriro:

• Chekutanga sclerosing cholangitis (chirwere chinofambira mberi umo maidha bile anodzivirirwa nekuzvimba uye vanga).

• Chirwere ulcerative colitis.

• Ma cysts ari mu bile ducts (cysts inovhara kuyerera kwe bile uye inogona kukonzera kuzvimba bile ducts, kuzvimba, uye hutachiona).

• Kutapukirwa neChinese chiropa chinoputika hutachiona.

Zviratidzo zvekenza duct kenza zvinosanganisira jaundice uye kurwadziwa mudumbu.

Izvi uye zvimwe zviratidzo uye zviratidzo zvinogona kukonzerwa ne bile duct cancer kana nemamwe mamiriro. Tarisa nachiremba wako kana iwe uine chero chinotevera:

• Jaundice (yero yeganda kana machena eziso).

• Weti yakasviba.

• Clay stool yeruvara.

• Marwadzo mudumbu.

• Kupindwa nechando.

• Itchy ganda.

• Kusvotwa uye kurutsa.

• Kurera huremu nekuda kwechikonzero chisingazivikanwe.

Miedzo inoongorora iyo bile ducts uye nhengo dzepedyo dzinoshandiswa kuona (tsvaga), kuongorora, uye danho rekenza duct kenza.

Maitiro anogadzira mifananidzo yenyuchi ducts uye iyo iri padyo nharaunda anobatsira kuongorora kenza ye bile bile uye kuratidza kuti gomarara rapararira zvakadii. Maitiro anoshandiswa kutsvaga kana kenza maseru akapararira mukati nekukomberedza bile ducts kana kumativi ari kure emuviri anonzi staging.

Kuti uronge kurapwa, zvakakosha kuti uzive kana iyo bile duct cancer inogona kubviswa nekuvhiyiwa. Kuyedza uye maitiro ekuona, kuongorora, uye nhanho bile duct kenza inowanzoitwa panguva imwe chete.

Iyi inotevera bvunzo uye maitiro anogona kushandiswa:

• Kuongorora kwepanyama uye nhoroondo: Kuongororwa kwemuviri kutarisa zviratidzo zvehutano, kusanganisira kuongorora zviratidzo zvehosha, zvakadai semapundu kana chero chinhu chinoratidzika sechisina kujairika. Nhoroondo yemaitiro ehutano hwemurwere uye kurwara kwakapfuura uye kurapwa kuchatorwawo.

• Chiropa basa bvunzo: Maitiro umo muyero weropa unotariswa kuyera huwandu hwebilirubin uye alkaline phosphatase yakaburitswa muropa nechiropa. Iyo yakakwira kupfuura yakajairwa huwandu hweizvi zvinhu inogona kuve chiratidzo chechiropa chirwere icho chinogona kukonzerwa ne bile duct cancer.

• Miedzo yeLaborari: Maitiro ekurapa anoedza sampu yetishu, ropa, weti, kana zvimwe zvinhu mumuviri. Aya maedzo anobatsira kuongorora chirwere, kuronga uye kutarisa kurapwa, kana kuongorora chirwere ichi nekufamba kwenguva.

• Carcinoembryonic antigen (CEA) uye CA 19-9 bundu rekumaka bvunzo: Maitiro umo muyenzaniso weropa, weti, kana nyama inoongororwa kuyera huwandu hwezvimwe zvinhu zvinogadzirwa nenhengo, nyama kana tumarara masero mumuviri. Zvimwe zvinhu zvinosunganidzwa kune chaiwo marudzi ekenza kana akawanikwa mune akawedzera mwero mumuviri. Aya anonzi mamarara mamark. Yakakwirira kupfuura zvakajairika mazinga ecarcinoembryonic antigen (CEA) uye CA 19-9 zvinogona kureva kuti kune bile duct cancer.

• Ultrasound bvunzo: Maitiro ayo ane simba-ruzha mafungu (ultrasound) anodonhedzwa kubva mukati memukati matema kana nhengo, senge dumbu, uye kugadzira maungira. Maungira anoumba mufananidzo wemuviri munyama unonzi sonogram. Mufananidzo wacho unogona kudhindwa kuti utariswe gare gare.

• CT scan (CAT scan): Maitiro anoita akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, senge dumbu, rakatorwa kubva kumakona akasiyana. Mifananidzo yacho inogadzirwa nekombuta yakabatana neiyo x-ray muchina. Dhayi inogona kuiswa jekiseni kana kumedzwa kubatsira nhengo kana zvinyama kuratidza zvakajeka. Iyi nzira inonziwo computed tomography, computerized tomography, kana komputa axial tomography.

• MRI (magnetic resonance imaging): Maitiro anoshandisa magineti, masaisai eredhiyo, uye komputa kugadzira yakateedzana mifananidzo yakajeka yenzvimbo dziri mukati memuviri. Iyi nzira inonziwo nyukireya magnetic resonance imaging (NMRI).

• MRCP (magnetic resonance cholangiopancreatography): Maitiro anoshandisa magineti, masaisai eredhiyo, uye komputa kugadzira yakateedzana mifananidzo yakajeka yenzvimbo dziri mukati memuviri senge chiropa, ducts, nduru, chirwatata, uye pancreatic duct.

Maitiro akasiyana anogona kushandiswa kuwana sampuli yetishu uye kuongorora kenza yema bile duct.

Masero uye zvinyama zvinobviswa panguva yebiopsy kuitira kuti zvionekwe pasi pe microscope nachiremba wekutarisa zviratidzo zvecancer. Maitiro akasiyana anogona kushandiswa kuwana muyenzaniso wemasero uye nyama. Rudzi rwemaitiro anoshandiswa zvinoenderana nekuti murwere anokwana here kuvhiyiwa.

Mhando dze biopsy maitiro anosanganisira anotevera:

• Laparoscopy: Maitiro ekuvhiya kutarisa nhengo dziri mukati medumbu, senge maburi enyongo uye chiropa, kutarisa zviratidzo zvegomarara. Zvidiki zvidiki (kucheka) zvinogadzirwa mumadziro emimba uye laparoscope (mutete, turu turi) inoiswa mune chimwe cheicho chinochekwa. Zvimwe zviridzwa zvinogona kuiswa kuburikidza zvakafanana kana zvimwe zvinoitiswa kuti zviite maitiro sekutora masampuli etishu kuti aongororwe zviratidzo zvegomarara.

• Percutaneous transhepatic cholangiography (PTC): Maitiro anoshandiswa kuisa x-ray chiropa uye bile ducts. Tsono nhete inoiswa kuburikidza neganda riri pazasi pembabvu uye muchiropa. Dhayi inorowa muchiropa kana bile ducts uye x-ray inotorwa. Muenzaniso wetissue unobviswa woongororwa zviratidzo zvecancer. Kana iyo bile duct yakavharwa, chubhu, yakatetepa chubhu inonzi stent inogona kusiiwa muchiropa kuti inyurure bile mumatumbo madiki kana bhegi rekuunganidza kunze kwemuviri. Maitiro aya anogona kushandiswa kana murwere asingakwanise kuvhiyiwa.

• Endoscopic retrograde cholangiopancreatography (ERCP): Maitiro anoshandiswa ku-x-ray iyo ducts (machubhu) anotakura bile kubva pachiropa kuenda kune nduru uye kubva kune nduru kuenda kuura hudiki. Dzimwe nguva kenza yemukoko inokonzeresa kuti ma ducts aya adzike uye avhare kana kunonoka kuyerera kwe bile, zvichikonzera jaundice. Endoscope inopfuudzwa kuburikidza nemuromo uye mudumbu uye kupinda mudumbu ura. Dhayi inorowa kuburikidza neiyo endoscope (yakatetepa, chubhu-senge chiridzwa chine mwenje uye lens yekuona) mumaburi ducts uye x-ray inotorwa. Muenzaniso wetissue unobviswa woongororwa zviratidzo zvecancer. Kana iyo bile duct yakavharwa, chubhu yakatetepa inogona kuiswa mumugwagwa kuti uvhure. Iyi chubhu (kana stent) inogona kusiiwa munzvimbo kuti irambe nzira yakavhurika. Maitiro aya anogona kushandiswa kana murwere asingakwanise kuvhiyiwa.

• Endoscopic ultrasound (EUS): Maitiro umo endoscope inoiswa mumuviri, kazhinji kuburikidza nemuromo kana rectum. Endoscope chishoma, chubhu-senge chiridzwa chine mwenje uye lens yekuona. Probe panoperera endosikopu inoshandiswa kubaya mafungu ane simba-ruzha (ultrasound) kubva munyama dzemukati kana mitezo uye kuita maungira. Maungira anoumba mufananidzo wemuviri munyama unonzi sonogram. Muenzaniso wetissue unobviswa woongororwa zviratidzo zvecancer. Maitiro aya anonziwo endosonography.

Zvimwe zvinhu zvinokanganisa kufungidzira (mukana wekupora) uye sarudzo dzekurapa.

Kufungidzira (mukana wekupora) uye sarudzo dzekurapa dzinoenderana nezvinotevera:

• Kunyangwe kenza iri muchikamu chepamusoro kana chepasi cheiyo bile duct system.

• Iyo nhanho yekenza (ingave inobata chete ma ducts kana kuti yakapararira kuchiropa, lymph node, kana dzimwe nzvimbo mumuviri).

• Kunyangwe kenza yapararira kune tsinga kana mitsipa iri padyo.

• Kunyangwe kenza inogona kubviswa zvachose nekuvhiyiwa.

• Kunyangwe murwere aine mamwe mamiriro, akadai sekutanga sclerosing cholangitis.

• Kunyangwe iyo chikamu cheCA 19-9 chakakwirira kupfuura zvakajairwa.

• Kunyangwe kenza ichangobva kuongororwa kana kuti yadzokazve (dzoka).

Kurapa sarudzo dzinogona zvakare kuvimba nezviratidzo zvinokonzerwa nekenza. Bheri dhayeti kenza inowanzo kuwanikwa mushure mekunge yapararira uye haigone kubviswa zvachose nekuvhiyiwa. Kurapa kwekurapa kunogona kubvisa zviratidzo uye nekuvandudza hupenyu hwemurwere.

Matanho eBile Duct Kenza

PFUNGWA DZINOKOSHA

• Mhedzisiro yekuongorora uye staging bvunzo inoshandiswa kutsvaga kana kenza maseru yapararira.

• Pane nzira nhatu dzinopararira negomarara mumuviri.

• Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

• Matanho anoshandiswa kutsanangura dzakasiyana mhando dzekenza duct kenza.

• Intrahepatic bile duct kenza

• Perihilar bile duct kenza

• Yakapararira extrahepatic bile duct cancer

• Aya mapoka anotevera anoshandiswa kuronga kurapwa:

• Inogadziriswa (inowanikwa munzvimbo) kenza yemukaka bile

• Unresectable, metastatic, kana inowanzoitika bile duct cancer

Mhedzisiro yekuongorora uye staging bvunzo inoshandiswa kutsvaga kana kenza maseru yapararira.

Maitiro anoshandiswa kutsvaga kana gomarara rapararira kune dzimwe nhengo dzemuviri anonzi staging. Nezve kenza yenyuchi, ruzivo rwakaunganidzwa kubva pakuyedzwa uye maitiro anoshandiswa kuronga kurapwa, kusanganisira kana bundu racho rinogona kubviswa nekuvhiya

Pane nzira nhatu dzinopararira negomarara mumuviri.

Kenza inogona kupararira kuburikidza nematinji, iyo lymph system, uye neropa:

• Tishu. Kenza inopararira kubva kwayakatanga nekukura ichipinda munzvimbo dziri pedyo.

• Lymph maitiro. Kenza inopararira kubva kwayakatanga nekupinda muiyo lymph system. Kenza inofamba nemumidziyo yema lymph ichienda kune dzimwe nhengo dzemuviri.

• Ropa. Kenza inopararira kubva payakatanga nekupinda muropa. Kenza inofamba nemidzi yeropa ichienda kune dzimwe nhengo dzemuviri.

Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

Kana kenza ikapararira kune chimwe chikamu chemuviri, inonzi metastasis. Cancer maseru anotsemuka kubva kwaakatanga (iro bundu rekutanga) uye achifamba kuburikidza neye lymph system kana ropa.

• Lymph maitiro. Gomarara rinopinda mu "lymph system", rinofamba nemumidziyo ye "lymph", uye rinogadzira bundu (metastatic tumor) mune chimwe chikamu chemuviri.

• Ropa. Kenza inopinda muropa, inofamba nemutsinga dzeropa, yoita bundu (metastatic tumor) mune chimwe chikamu chemuviri.

Iyo metastatic bundu irwo rudzi rwecancer seyakanyanya bundu. Semuenzaniso, kana bile duct kenza ikapararira kuchiropa, maseru emukenza ari muchiropa ari chaiwo bile duct cancer maseru. Hosha iyi metastatic bile duct cancer, kwete chiropa cancer.

Matanho anoshandiswa kutsanangura dzakasiyana mhando dzekenza duct kenza.

Intrahepatic bile duct kenza

• Stage 0: Muchikamu che0 intrahepatic bile duct cancer, masero asina kujairika anowanikwa mukatikati memukati mechitunha chakakomberedza iyo intrahepatic bile duct. Aya maseru asina kujairika anogona kuva cancer uye achipararira mune zvinyama zviri pedyo. Chikamu 0 chinonziwo carcinoma in situ.

• Chikamu I: Chikamu I intrahepatic bile duct kenza yakakamurwa muzvikamu IA uye IB.

Saizi yemamota inowanzo kuyerwa mukati masendimita (cm) kana inches. Zvekudya zvakajairika zvinogona kushandiswa kuratidza kukura kwemarara mumasendimita zvinosanganisira: pizi (1 cm), nzungu (2 cm), mazambiringa (3 cm), walnuts (4 cm), lime (5 cm kana 2 masendimita), zai (6 cm), peach (7 cm), uye grapefruit (10 cm kana 4 inches).

• Muchikamu IA, kenza yakaumbwa mune intrahepatic bile duct uye bundu iri 5 masendimita kana diki.

• Muchikamu IB, kenza yakaumbwa mune intrahepatic bile duct uye bundu rakakura kupfuura masendimita mashanu.

• Stage II: Muchikamu chechipiri intrahepatic bile duct cancer, chero yeanotevera anowanikwa:

• bundu rakapararira kuburikidza nemadziro eiyo intrahepatic bile duct uye mukati meropa reropa; kana

• rinopfuura kamwe bundu rakaumbwa mukati meiyo intrahepatic bile duct uye inogona kunge yakapararira mukati meropa reropa.

• Chikamu chechitatu: Chikamu chechitatu intrahepatic bile duct kenza yakakamurwa muzvikamu IIIA uye IIIB.

• Muchikamu IIIA, bundu rakapararira kuburikidza necapsule (yekunze lining) yechiropa.

• Muchikamu IIIB, kenza yakapararira kunhengo kana zvinyama padyo nechiropa, senge duodenum, colon, mudumbu, yakajairika bile duct, mudumbu mudumbu, diaphragm, kana chikamu cheiyo vena cava kuseri kwechiropa, kana cancer yakapararira kusvika pedyo node node.

• Stage IV: Muchikamu IV intrahepatic bile duct cancer, cancer yakapararira kune zvimwe zvikamu zvemuviri, senge pfupa, mapapu, kure node node, kana turu yakanamatira madziro edumbu uye mazhinji mitezo mudumbu.

Perihilar bile duct kenza

• Stage 0: Muchikamu che0 perihilar bile duct cancer, masero asina kujairika anowanikwa mukatikati memukati mechitunha chakanamatira perihilar bile duct. Aya maseru asina kujairika anogona kuva cancer uye achipararira mune zvinyama zviri pedyo. Chikamu 0 chinonzi zvakare carcinoma in situ kana yepamusoro-giredhi dysplasia.

• Chikamu I: Muchikamu chekutanga perihilar bile duct cancer, kenza yakaumbwa mukati mepakati pechipfuva chakakomberedza iyo perihilar bile duct uye yakapararira mukati memhasuru yakatetepa kana fibrous tissue layer yeiyo perihilar bile duct wall.

• Stage II: Muchikamu chechipiri perihilar bile duct cancer, cancer yakapararira kuburikidza nemadziro eiyo perihilar bile duct kune iri pedyo mafuta mafuta kana kune chiropa tishu.

• Chikamu chechitatu: Chikamu chechitatu perihilar bile duct kenza yakakamurwa muzvikamu IIIA, IIIB, uye IIIC.

• Chikamu IIIA: kenza yakapararira kumatavi kune rimwe divi reiyo hepatic artery kana yeiyo portal vein.

• Chikamu IIIB: kenza yakapararira kune imwe kana kupfuura pane anotevera:

• iyo huru chikamu cheiyo portal vein kana matavi ayo pamativi ese maviri;

• tsinga yakajairika yehepatic;

• kurudyi hepatic dhayeti uye nebazi rekuruboshwe rehepatic artery kana yeiyo portal vein;

• iyo yekuruboshwe hepatic duct uye iro chairo bazi reiyo hepatic artery kana yeiyo portal vein.

• Chikamu chechipiri IIIC: kenza yakapararira kusvika kune 1 kusvika ku3 lymph nodes iri pedyo

• Chikamu IV: Chikamu IV perihilar bile duct kenza yakakamurwa muzvikamu IVA uye IVB.

• Chikamu IVA: Kenza yakapararira kusvika kune mana kana kupfuura mamwe ma lymph node.

• Chikamu IVB: Gomarara rakapararira kune zvimwe zvikamu zvemuviri, zvakaita sechiropa, mapapu, pfupa, huropi, ganda, lymph node dziri kure, kana zvinyama zvinonamira madziro emimba uye nhengo zhinji mudumbu.

Yakapararira extrahepatic bile duct cancer

• Stage 0: Muchikamu che 0 distal extrahepatic bile duct cancer, masero asina kujairika anowanikwa mukatikati memukati mechitunha chakanamatira distal extrahepatic bile duct. Aya maseru asina kujairika anogona kuva cancer uye achipararira mune zvinyama zviri pedyo. Chikamu 0 chinonzi zvakare carcinoma in situ kana yepamusoro-giredhi dysplasia.

Mamirimita (mm). Penzura yakapinza ingangoita 1 mm, krayoni nyowani ingangoita 2 mm, uye iripi yepenzura nyowani ingangoita 5 mm.

• Chikamu I: Muchikamu ini ndinoparadzanisa extrahepatic bile duct cancer, cancer yakaumba uye ikapararira mashoma kupfuura mashanu mamirimita mumadziro eiyo distal extrahepatic bile duct.

• Chikamu chechipiri: Chikamu chechipiri chinokonzera extrahepatic bile duct cancer inoparadzaniswa muzvikamu IIA uye IIB.

• Chikamu IIA: Kenza yakapararira:

• asingasviki mamirimita mashanu mumadziro eiyo distal extrahepatic bile duct uye yakapararira kune 1 kusvika ku3 lymph node dzepedyo; kana

• 5 kusvika 12 millimeter mumadziro eiyo distal extrahepatic bile duct.

• Chikamu IIB: Kenza yakapararira mamirimita mashanu kana kupfuura mumadziro eiyo distal extrahepatic bile duct. Kenza inogona kunge yakapararira kune 1 kusvika ku3 ma lymph node ari padyo.

• Stage III: Stage III distal extrahepatic bile duct cancer inokamurwa muzvikamu IIIA uye IIIB.

• Stage IIIA: Kenza yakapararira mumadziro eiyo distal extrahepatic bile duct uye kune mana kana anopfuura mamwe ma lymph node.

• Chikamu IIIB: Kenza yakapararira kumidziyo mikuru inotakura ropa kunhengo dziri mudumbu. Kenza inogona kunge yakapararira kune 1 kana anopfuura ma lymph node.

• Stage IV: Muchikamu IV inodzora extrahepatic bile duct cancer, cancer yakapararira kune zvimwe zvikamu zvemuviri, senge chiropa, mapapu, kana zvinyama zvinonamira madziro emudumbu uye mazhinji nhengo mudumbu.

Aya mapoka anotevera anoshandiswa kuronga kurapwa:

Inogadziriswa (inowanikwa munzvimbo) kenza yemukaka bile

Kenza iri mune imwe nzvimbo, senge chikamu chepazasi cheiyo yakajairika bile duct kana perihilar nzvimbo, uko inogona kubviswa zvachose nekuvhiyiwa.

Unresectable, metastatic, kana inowanzoitika bile duct cancer

Kenza isingadzoreki haigone kubviswa zvachose nekuvhiyiwa. Vazhinji varwere vane kenza ye bile duct havagone kubviswa kenza yavo nekuvhiyiwa.

Metastasis ndiko kupararira kwegomarara kubva kunzvimbo yekutanga (nzvimbo kwayakatanga) kune dzimwe nzvimbo mumuviri. Metastatic bile duct cancer inogona kunge yakapararira kuchiropa, zvimwe zvikamu zvemudumbu, kana kunzvimbo dziri kure dzomuviri.

Kazhinji kenza yemukaka kenza kenza yakadzokazve (kudzoka) mushure mekurapwa. Iyo cancer inogona kudzoka mune bile ducts, chiropa, kana nduru. Pasina kazhinji, inogona kudzoka mumativi ari kure emuviri.

Kurapa Sarudzo Kuongorora

PFUNGWA DZINOKOSHA

• Kune akasiyana marudzi ekurapa kwevarwere vane bile duct cancer.

• Mhando mitatu yekurapa kwakajairika inoshandiswa:

• Kuvhiya

• Radiation kurapa

• Chemotherapy

• Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

• Chiropa chinotamisa

• Kurapa kweiyo bile duct cancer kunogona kukonzera mhedzisiro.

• Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.

• Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.

• Yekutevera-bvunzo inogona kudikanwa.

Kune akasiyana marudzi ekurapa kwevarwere vane bile duct cancer.

Mhando dzakasiyana dzekurapa dzinowanikwa kune varwere vane bile duct cancer. Mamwe marapirwo akajairwa (iko kurapwa kwazvino kwashandiswa), uye kumwe kuedzwa mumakiriniki ekuedzwa A kurapwa kiriniki kuyedzwa chidzidzo chekutsvaga chakaitirwa kubatsira kuvandudza marapirwo azvino kana kuwana ruzivo marapirwo matsva evarwere vane gomarara. Kana kiriniki miedzo ikaratidza kuti kurapwa kutsva kuri nani pane kwese kurapwa, kurapwa kutsva kunogona kuve kwakajairwa kurapwa. Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki. Mimwe miedzo yekiriniki yakavhurwa chete kune varwere vasina kutanga kurapwa.

Mhando mitatu yekurapa kwakajairika inoshandiswa:

Kuvhiya

Aya anotevera marudzi ekuvhiya anoshandiswa kurapa bile duct cancer.

• Kubviswa kweiyo bile duct: Iyo yekuvhiya nzira yekubvisa chikamu cheiyo bile duct kana bundu iri diki uye mune bile duct chete. Lymph node dzinobviswa uye zvinyama kubva kune lymph node zvinotariswa pasi pe microscope kuti uone kana paine cancer.

• Chikamu hepatectomy: Maitiro ekuvhiya umo chikamu chechiropa panowanikwa kenza chinobviswa. Chikamu chakabviswa chingave chidimbu chemashuga, chiuno chakazara, kana chikamu chakakura chechiropa, pamwe nemamwe maturusi akajairwa.

• Maitiro eWhipipple: Maitiro ekuvhiya ayo musoro wepancreas, iyo nduru, chikamu chedumbu, chikamu chedumbu diki, uye duct re bile rinobviswa. Zvakaringana rwatata rwakasara kugadzira majuini ekugaya uye insulin.

Mushure mekunge chiremba abvisa kenza yese inoonekwa panguva yekuvhiyiwa, vamwe varwere vanogona kupihwa chemotherapy kana radiation radiation mushure mekuvhiyiwa kuuraya chero gomarara maseru akasara. Mushonga wakapihwa mushure mekuvhiyiwa, kudzikisa njodzi yekuti gomarara richadzoka, inonzi adjuvant therapy. Hazvisati zvazivikanwa kuti chemotherapy kana radiation radiation yakapihwa mushure mekuvhiyiwa inobatsira kuchengetedza cancer kuti isadzoke.

Aya anotevera marudzi ekuvhiya kunogonesa anogona kuitwa kudzikamisa zviratidzo zvinokonzerwa neyakavharwa bile duct uye nekuvandudza hupenyu hwehupenyu:

• Biliary inopfuura: Kana kenza ichivhara iyo bile duct uye bile iri kuvaka mukati meguruva, bheri inopfuura inogona kuitwa. Munguva yekuvhiya uku, chiremba achacheka gorosi kana bile duct munzvimbo isati yavhara uye kuisona kuchikamu chebonde rakapfuura kuvharika kana kumatumbo madiki kugadzira nzira nyowani yakatenderedza nzvimbo yakavharirwa.

• Endoscopic stent placement: Kana bundu racho richivhara bile duct, kuvhiyiwa kunogona kuitwa kuisa stent (chubhu chena) kudurura bile rakavaka munzvimbo iyi. Chiremba anogona kuisa stent kuburikidza necatheter iyo inodururira iyo bile muhomwe iri kunze kwemuviri kana iyo stent inogona kutenderera yakatenderedza nzvimbo uye ichidurura iyo bile kupinda mudumbu ura.

• Percutaneous transhepatic biliary drainage: Maitiro anoshandiswa kuisa x-ray chiropa uye bile ducts. Tsono nhete inoiswa kuburikidza neganda riri pazasi pembabvu uye muchiropa. Dhayi inorowa muchiropa kana bile ducts uye x-ray inotorwa. Kana iyo bile duct yakavharwa, chubhu, yakatetepa chubhu inonzi stent inogona kusiiwa muchiropa kuti inyurure bile mumatumbo madiki kana bhegi rekuunganidza kunze kwemuviri.

Radiation kurapa

Radiation kurapa kurapwa kenza iyo inoshandisa yakakwira-simba x-rays kana mamwe marudzi e radiation kuuraya cancer maseru kana kuachengeta iwo kuti asakure. Kune mhando mbiri dze radiation radiation:

• External radiation therapy inoshandisa muchina uri kunze kwemuviri kutumira radiation kune kenza.

• Yemukati radiation kurapwa kunoshandisa radioactive chinhu chakavharirwa mune tsono, mhodzi, waya, kana makateti anoiswa akananga mukati kana padyo nekenza.

Kunze uye kwemukati radiation kurapwa kunoshandiswa kurapa bile duct gomarara.

Izvo hazvisati zvazivikanwa kana ekunze radiation kurapwa kurapa kunobatsira mukurapa kweyakagadziriswa bile bile duct gomarara. Mune isingagadzirisike, metastatic, kana inodzokororwa bile duct cancer, nzira nyowani dzekuvandudza mhedzisiro yekunze radiation kurapwa pane cancer maseru ari kuongororwa.

• Hyperthermia therapy: Mushonga umo nyama yemuviri inoonekwa nekupisa kwakanyanya kuita kuti maseru egomarara anyanye kugadzikana nemhedzisiro yekurapa nemwaranzi uye mimwe mishonga inorwisa cancer.

• Radiosensitizers: Zvinodhaka zvinoita kuti maseru ekenza anyanye kunetseka kurapwa nemwaranzi. Kubatanidza radiation therapy ne radiosensitizers kunogona kuuraya mamwe maseru ekenza.

Chemotherapy

Chemotherapy mushonga wekenza unoshandisa mishonga kumisa kukura kwemasero ekenza, kungave nekuuraya maseru kana nekuamisa iwo kubva pakupatsanuka. Kana chemotherapy ikatorwa nemuromo kana kujowa mutsinga kana mhasuru, mishonga inopinda muropa uye inogona kusvika masero emukenza mumuviri wese (systemic chemotherapy). Kana chemotherapy ikaiswa yakanangana necerebrospinal fluid, nhengo, kana dumbu remuviri senge dumbu, iwo madhiragi anonyanya kukanganisa cancer maseru munzvimbo idzodzo (remunharaunda chemotherapy).

Systemic chemotherapy inoshandiswa kurapa kenza isingagadzirisike, metastatic, kana inowanzoitika kenza yemukaka. Hazvisati zvazivikanwa kana systemic chemotherapy inobatsira pakurapa kenza inogadziriswa bile duct.

Mune isingagadzirisike, metastatic, kana inowanzoitika bile duct cancer, intra-arterial embolization iri kuongororwa. Iyo maitiro ekuti ropa rinopa kune bundu rakavharwa mushure mekunge anticancer mishonga yapihwa mumidziyo yeropa padhuze nebundu. Dzimwe nguva, iyo anticancer mishonga inosungirirwa kune zvidiki zvidiki izvo zvinojowa mune tsinga inopa iyo bundu. Iwo marozari anovharidzira kuyerera kweropa kuenda kune iro bundu sezvavanosunungura mushonga. Izvi zvinobvumidza huwandu hwakawanda hwemushonga kuti usvike pabundu kwenguva yakareba, iyo inogona kuuraya mamwe maseru ekenza.

Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

Ichi chidimbu chikamu chinotsanangura kurapwa kuri kuongororwa mumakiriniki ekuedzwa. Zvinogona kusataura nezveese marapirwo matsva ari kuongororwa. Ruzivo nezve kiriniki miedzo inowanikwa kubva kuNCI webhusaiti.

Chiropa chinotamisa

Mukuchinjika kwechiropa, chiropa chose chinobviswa chotsiviwa nechiropa chakapihwa chine hutano. Kuiswa kwechiropa kunogona kuitwa mune varwere vane perihilar bile duct cancer. Kana murwere achifanira kumirira chiropa chakapihwa, kumwe kurapwa kunopihwa sekudikanwa.

Kurapa kweiyo bile duct cancer kunogona kukonzera mhedzisiro. Kuti uwane ruzivo nezve mhedzisiro inokonzerwa nekurapwa kwegomarara, ona yedu Side Mhedzisiro peji.

Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.

Kune vamwe varwere, kutora chikamu mumuedzo wekiriniki inogona kunge iri sarudzo yekurapa yakanyanya kunaka. Kliniki miedzo chikamu chekenza tsvagiridzo. Zvemakiriniki miedzo inoitwa kuti uone kana marapirwo matsva egomarara akachengeteka uye achishanda kana zvirinani pane akajairwa kurapwa.

Mazhinji emazuva ano marapirwo akajairwa ekenza akavakirwa pamavambo emakiriniki ekuedzwa. Varwere vanotora chikamu mukuyedzwa kwekiriniki vanogona kuwana kurapwa kwakaringana kana kuve pakati pevekutanga kurapwa kutsva.

Varwere vanotora chikamu mumiedzo yekiriniki zvakare vanobatsira kugadzirisa marapirwo achaitwa kenza mune ramangwana. Kunyangwe kana miedzo yemakiriniki isinga tangire kumarapirwo matsva anoshanda, anowanzo pindura mibvunzo yakakosha uye anobatsira kufambisira mberi kutsvagurudza.

Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.

Mimwe miedzo yekiriniki inosanganisira chete varwere vasati vagamuchira kurapwa. Mimwe miedzo yekuedza kurapwa kwevarwere vane kenza haina kuve nani. Kune mamwezve emakiriniki miedzo inoedza nzira nyowani dzekumisa cancer kubva kudzokororazve (kudzoka) kana kudzikisira mhedzisiro yemakenza kurapwa.

Kuedzwa kwemakiriniki kuri kuitika munzvimbo zhinji dzenyika. Ruzivo nezve kiriniki miedzo inotsigirwa neNCI inogona kuwanikwa paNCI yekiriniki miedzo yekutsvaga peji rewebhu. Kliniki miedzo inotsigirwa nemamwe masangano inogona kuwanikwa pane yeClinicalTrials.gov webhusaiti.

Yekutevera-bvunzo inogona kudikanwa.

Mimwe miedzo yakaitwa kuongorora gomarara kana kutsvaga danho rekenza inogona kudzokororwa. Dzimwe bvunzo dzinodzokororwa kuitira kuti vaone kuti kurapa kuri kushanda sei. Sarudzo nezvekuti uenderere mberi, shandura, kana kumisa kurapwa kunogona kunge kuchibva pamhedzisiro yeiyi bvunzo.

Mimwe bvunzo ichaenderera ichiitwa nguva nenguva mushure mekunge kurapwa kwapera. Mhedzisiro yeiyi bvunzo inogona kuratidza kana mamiriro ako achinja kana kana gomarara radzoka (dzoka). Iyi bvunzo dzimwe nguva inonzi yekuteedzera-bvunzo kana kuongorora-kumusoro.

Kurapa Sarudzo dzeBile Duct Cancer

Muchikamu chino

• Intrahepatic Bile Duct Kenza

• Inogadziriswa Intrahepatic Bile Duct Kenza

• Isingachinjiki, Inodzokororwa, kana Metastatic Intrahepatic Bile Duct Kenza

• Perihilar Bile Duct Kenza

• Inogadziriswa Perihilar Bile Duct Kenza

• Isingachinjiki, Inodzokororwa, kana Metastatic Perihilar Bile Duct Kenza

• Yakasarudzika Inowedzera Extrahepatic Bile Duct Kenza

• Inogadziriswa Yakapararira Yakasarudzika Epamusoro Bile Duct Kenza

• Isingachinjiki, Inodzokororwa, kana Metastatic Distal Extrahepatic Bile Duct Kenza

Kuti uwane ruzivo nezve marapirwo akanyorwa pazasi, ona iyo Chikamu Sarudzo Yekutarisa Chikamu.

Chinongedzo cherondedzero yezvazvino kiriniki miedzo inosanganisirwa kune yega yega chikamu chekurapa. Kune mamwe marudzi kana nhanho dzegomarara, panogona kusave nemimwe miedzo yakanyorwa. Tarisa nachiremba wako kumakiriniki ekuedzwa asina kunyorwa pano asi angave akakukodzera.

Intrahepatic Bile Duct Kenza

Inogadziriswa Intrahepatic Bile Duct Kenza

Kurapa kweanodzokororwa intrahepatic bile duct cancer inogona kusanganisira:

• Kuvhiya kubvisa kenza, iyo inogona kusanganisira chikamu hepatectomy. Embolization inogona kuitwa usati wavhiyiwa.

• Kuvhiya kunoteverwa nekemotherapy uye / kana radiation radiation.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Isingachinjiki, Inodzokororwa, kana Metastatic Intrahepatic Bile Duct Kenza

Kurapa kwechirwere chisingadzoreki, chinodzokororwa, kana metastatic intrahepatic bile duct kenza inogona kusanganisira zvinotevera:

• Kuiswa kwakasimba senzira yekurapa yekurapa kubvisa zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• Kunze kana kwemukati radiation kurapwa sekurapa kwekurapa kubvisa zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• Chemotherapy.

• Kuongororwa kwekiriniki kwekunze kwerapi kurapwa pamwe ne hyperthermia therapy, radiosensitizer zvinodhaka, kana chemotherapy.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Perihilar Bile Duct Kenza

Inogadziriswa Perihilar Bile Duct Kenza

Kurapa kwekenza inogadziriswa perihilar bile duct kenza inogona kusanganisira zvinotevera:

• Kuvhiya kubvisa kenza, iyo inogona kusanganisira chikamu hepatectomy.

• Kuiswa kwakasimba kana percutaneous transhepatic biliary drainage senge yekurapa kurapwa, kubvisa jaundice uye zvimwe zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• Kuvhiya kunoteverwa ne radiation kurapwa uye / kana chemotherapy.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Isingachinjiki, Inodzokororwa, kana Metastatic Perihilar Bile Duct Kenza

Kurapa kwechirwere chisingadzoreki, chinodzokororwa, kana metastatic perihilar bile duct kenza inogona kusanganisira zvinotevera:

• Kuiswa kwakasimba kana biliary kupfuura nekurapa kwekurapa kubvisa zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• Kunze kana kwemukati radiation kurapwa sekurapa kwekurapa kubvisa zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• Chemotherapy.

• Kuongororwa kwekiriniki kwekunze kwerapi kurapwa pamwe ne hyperthermia therapy, radiosensitizer zvinodhaka, kana chemotherapy.

• Kuongororwa kwekiriniki kwechemotherapy uye radiation radiation inoteverwa nechiropa chekuisa.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Yakasarudzika Inowedzera Extrahepatic Bile Duct Kenza

Inogadziriswa Yakapararira Yakasarudzika Epamusoro Bile Duct Kenza

Kurapa kwe resectable distal extrahepatic bile duct cancer inogona kusanganisira zvinotevera:

• Kuvhiya kubvisa cancer, iyo inogona kusanganisira nzira yeWhipple.

• Kuiswa kwakasimba kana percutaneous transhepatic biliary drainage senge yekurapa kurapwa, kubvisa jaundice uye zvimwe zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• Kuvhiya kunoteverwa ne radiation kurapwa uye / kana chemotherapy.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Isingachinjiki, Inodzokororwa, kana Metastatic Distal Extrahepatic Bile Duct Kenza

Kurapa kwechirwere chisingadzoreki, chinodzokororwa, kana metastatic distal extrahepatic bile duct kenza inogona kusanganisira zvinotevera:

• Kuiswa kwakasimba kana biliary kupfuura nekurapa kwekurapa kubvisa zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• External or internal radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.

• Chemotherapy.

• A clinical trial of external radiation therapy combined with hyperthermia therapy, radiosensitizer drugs, or chemotherapy.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

To Learn More About Bile Duct Cancer

For more information from the National Cancer Institute about bile duct cancer, see the following:

• Liver and Bile Duct Cancer Home Page

For general cancer information and other resources from the National Cancer Institute, see the following:

• About Cancer

• Staging

• Chemotherapy uye Iwe: Tsigiro Yevanhu Vane Kenza

• Radiation Therapy uye Iwe: Rutsigiro rweVanhu Vane Kenza

• Kurarama neCancer

• Mibvunzo Yekubvunza Wako Chiremba nezveCancer

• Kune Vakapona uye Vanotarisira