Iindidi / i-gallbladder / isiguli / unyango lwe-gallbladder-pdq

Inguqulelo yoNyango lweCarbladder Cancer

Ulwazi ngokubanzi malunga nomhlaza we-Gallbladder

IINGONGOMA EZIPHAMBILI

• Umhlaza we-gallbladder sisifo apho umhlaza (umhlaza) weeseli zenzeka kwizicubu ze-gallbladder.

• Ukuba ngumfazi kunokunyusa umngcipheko wokuba nomhlaza we-gallbladder.

• Iimpawu kunye neempawu zesifo somhlaza we-gallbladder kubandakanya i-jaundice, umkhuhlane kunye nentlungu.

• Umhlaza we-gallbladder kunzima ukuwufumanisa (ukuwufumana) kunye nokuchonga kwangoko.

• Uvavanyo oluvavanya i-gallbladder kunye namalungu akufutshane asetyenziselwa ukukhangela (fumana), ukufumanisa isifo, kunye nenqanaba lomhlaza we-gallbladder.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Umhlaza we-gallbladder sisifo apho umhlaza (umhlaza) weeseli zenzeka kwizicubu ze-gallbladder.

Umhlaza we-gallbladder sisifo esinqabileyo apho iiseli ezimbi (zomhlaza) zifunyenwe kwizicubu ze-gallbladder. I-gallbladder lilungu elimile okwepere elilele phantsi kwesibindi esiswini esingaphezulu. I-gallbladder igcina inyongo, ulwelo olwenziwe sisibindi ukwetyisa amanqatha. Xa ukutya kusaphulwa esiswini nasemathunjini, inyongo ikhutshwa kwinyongo ityhubhu ebizwa ngokuba yi-bile duct, edibanisa inyongo kunye nesibindi kwinxalenye yokuqala yamathumbu amancinci.

I-anatomy ye-gallbladder. I-gallbladder ingaphantsi kwesibindi. Ibile igcinwe kwinyongo kwaye ibaleka kumjelo wecystic kunye nomgudu wenyongo oqhelekileyo ungene emathunjini amancinci xa ukutya kugaywa.

Udonga lwe-gallbladder lunee-4 eziphambili zethishu.

• Uluhlu lweMucosal (ngaphakathi).

• Uluhlu lwemisipha.

• Uluhlu lwezicubu ezinxibelelanayo.

• Umaleko weSerosal (wangaphandle).

Umhlaza webhola oyintloko we-gallbladder uqala kumaleko angaphakathi kwaye usasazeke kumaleko angaphandle njengoko ikhula.

Ukuba ngumfazi kunokunyusa umngcipheko wokuba nomhlaza we-gallbladder.

Nantoni na eyandisa amathuba akho okufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba usengozini. Imiba yomngcipheko womhlaza we-gallbladder ibandakanya oku kulandelayo:

• Ukuba ngumfazi.

• Ukuba ngumthonyama waseMelika.

• Iimpawu kunye neempawu zesifo somhlaza we-gallbladder kubandakanya i-jaundice, umkhuhlane kunye nentlungu.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa ngumhlaza we-gallbladder okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• IJaundice (ukuba tyheli kolusu kunye namhlophe ngamehlo).

• Intlungu ngaphezu kwesisu.

• Ifiva.

• Isicaphucaphu nokugabha.

• Ukuqhawula.

• Amaqhuma esiswini.

Umhlaza we-gallbladder kunzima ukuwufumanisa (ukuwufumana) kunye nokuchonga kwangoko.

Umhlaza we-gallbladder kunzima ukufumanisa nokuchonga kwezi zizathu zilandelayo:

• Akukho zimpawu okanye zimpawu kumanqanaba okuqala omhlaza we-gallbladder.

• Iimpawu zomhlaza we-gallbladder, xa zikhona, zifana neempawu zezinye izifo ezininzi.

• I-gallbladder ifihliwe emva kwesibindi.

Umhlaza we-gallbladder ngamanye amaxesha ufunyanwa xa i-gallbladder isuswe ngezinye izizathu. Izigulana ezinama-gallstones kunqabile ukuba zikhule zibe nomhlaza we-gallbladder.

Uvavanyo oluvavanya i-gallbladder kunye namalungu akufutshane asetyenziselwa ukukhangela (fumana), ukufumanisa isifo, kunye nenqanaba lomhlaza we-gallbladder.

Iinkqubo ezenza imifanekiso ye-gallbladder kunye nendawo ejikeleze kuyo inceda ukuxilonga umhlaza we-gallbladder kwaye ibonise ukuba umhlaza usasazeke kangakanani. Inkqubo esetyenziselwa ukufumanisa ukuba ngaba iiseli zomhlaza zisasazekile ngaphakathi kwaye zijikeleze i-gallbladder ibizwa ngokuba yistage.

Ukucwangcisa unyango, kubalulekile ukwazi ukuba umhlaza we-gallbladder ungasuswa ngotyando. Uvavanyo kunye neenkqubo zokufumanisa, ukufumanisa isifo, kunye nenqanaba lomhlaza we-gallbladder zihlala zenziwa ngaxeshanye. Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lomsebenzi wesibindi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini sisibindi. Ixabiso elingaphezulu kwesiqhelo kwento inokuba luphawu lwesifo sesibindi esinokubangelwa ngumhlaza we-gallbladder.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesifuba, isisu, kunye nesinqe, esithathwe kwiimbombo ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho zokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Isisu esiswini senziwa ukufumanisa umhlaza we-gallbladder.

• I-PTC (i-percutaneous transhepatic cholangiography): Inkqubo esetyenziselwa i-x-ray isibindi kunye ne-bile ducts. Inaliti ebhityileyo ifakwa kulusu olungezantsi kweembambo nakwisibindi. Idayi ifakwe kwisibindi okanye kwimibhobho ye-bile kwaye i-x-ray ithathwa. Ukuba kufunyenwe ukuvaleka, ityhubhu ecekeceke, eguqukayo ebizwa ngokuba yi-stent ngamanye amaxesha ishiyeka esibindini ukuze ikhuphe inyongo emathunjini amancinci okanye kwingxowa yokuqokelela ngaphandle komzimba.

• I-ERCP (i-endoscopic retrograde cholangiopancreatography): Inkqubo esetyenziselwa i-x-ray imibhobho (iityhubhu) ezithwala inyongo ukusuka kwisibindi ukuya kwi-gallbladder nakwi-gallbladder ukuya kumathumbu amancinci. Ngamanye amaxesha umhlaza we-gallbladder ubangela ukuba le mibhobho inciphise kwaye ivimbe okanye icothe ukuhamba kwenyongo, ibangele i-jaundice. I-endoscope (ityhubhu ebhityileyo, ekhanyisiweyo) idlula ngomlomo, ngomqala, nakwisisu kwindawo yokuqala yamathumbu amancinci. I-catheter (ityhubhu encinci) emva koko ifakwe nge-endoscope kwimibhobho ye-bile. Idayi itofwa nge-catheter ukuya kwimibhobho kwaye kuthathwa i-x-ray. Ukuba imibhobho ivaliwe ngethumba, ityhubhu entle inokufakwa kumbhobho ukuze uyivule. Le ityhubhu (okanye i-stent) inokushiywa endaweni yokugcina indlela ivulekile. Iisampulu zeethishu nazo zinokuthathwa.

• I-MRI (imaging resonance imaging) enegadolinium: Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha yeendawo ezingaphakathi komzimba. Into ebizwa ngokuba yi-gadolinium itofelwe emthanjeni. I-gadolinium iqokelela malunga neeseli zomhlaza ukuze zibonakale zikhanya emfanekisweni. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• I-Endoscopic ultrasound (EUS): Inkqubo apho i-endoscope ifakwe khona emzimbeni, ngesiqhelo ngomlomo okanye ngexande. I-endoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Iprojekhthi ekupheleni kwe-endoscope isetyenziselwa ukubuyisa amaza esandi aphezulu (i-ultrasound) kwizicubu zangaphakathi okanye kwizitho kunye nokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Le nkqubo ikwabizwa ngokuba yi-endosonografi.

• I-Laparoscopy: Inkqubo yotyando yokujonga amalungu ngaphakathi kwesisu ukukhangela iimpawu zesifo. Ukucuthwa okuncinci (ukusika) kwenziwa eludongeni lwesisu kunye ne-laparoscope (ityhubhu encinci, ekhanyisiweyo) ifakwe kwenye yeendlela. Ezinye izixhobo zinokufakwa ngendlela efanayo okanye ezinye iindlela zokwenza iinkqubo ezinje ngokususa amalungu okanye ukuthatha iisampulu zethishu kwi-biopsy. I-laparoscopy inceda ukufumanisa ukuba umhlaza ungaphakathi kwenyongo kuphela okanye unwenwele kwizicubu ezikufutshane kwaye ukuba unokususwa ngotyando.

• Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. I-biopsy inokwenziwa emva kotyando ukususa ithumba. Ukuba ithumba ngokucacileyo ayinakususwa ngotyando, i-biopsy inokwenziwa kusetyenziswa inaliti entle ukususa iiseli kwi-tumor.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Inqanaba lomhlaza (nokuba umhlaza usasazekile ukusuka kwinyongo ukuya kwezinye iindawo emzimbeni).

• Nokuba umhlaza ungasuswa ngokupheleleyo ngotyando.

• Uhlobo lomhlaza we-gallbladder (indlela iseli yomhlaza ebonakala ngayo phantsi kwemicroscope).

• Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona (buyela).

Unyango lunokuxhomekeka kubudala nakwimpilo ngokubanzi yesigulana nokuba umhlaza ubangela iimpawu okanye iimpawu.

Umhlaza we-gallbladder unokunyangeka kuphela ukuba ufunyenwe ungekasasazeki, xa unokususwa ngotyando. Ukuba umhlaza usasazekile, unyango oludlamkileyo lunokuphucula umgangatho wobomi besigulana ngokulawula iimpawu kunye nobunzima besi sifo.

Ukuthatha inxaxheba kolunye lonyango olwenziwayo ukuphucula unyango kufuneka kuthathelwe ingqalelo. Ulwazi malunga novavanyo oluqhubekayo lwezonyango luyafumaneka kwiwebhusayithi ye-NCI.

Amanqanaba omhlaza we-Gallbladder

IINGONGOMA EZIPHAMBILI

• Uvavanyo kunye neenkqubo zokubeka umhlaza we-gallbladder zihlala zenziwa ngaxeshanye nokuxilongwa.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manqanaba alandelayo asetyenziselwa umhlaza we-gallbladder:

• Inqanaba 0 (iCarcinoma kwiSitu)

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Ngomhlaza we-gallbladder, amanqanaba nawo aqokelelwe ngokwendlela umhlaza onokuthi uphathwe ngayo. Kukho amaqela onyango amabini:

• Yasekhaya (Inqanaba I)

• Ukungabonakali, ukuphindaphinda, okanye i-metastatic (iSigaba II, iSigaba III, kunye neSigaba IV)

Uvavanyo kunye neenkqubo zokubeka umhlaza we-gallbladder zihlala zenziwa ngaxeshanye nokuxilongwa.

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukukhangela, ukufumanisa isifo, kunye nenqanaba lomhlaza webhongo.

Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

Umhlaza unokusasazeka ngezicubu, inkqubo ye-lymph, kunye negazi:

• Izicubu. Umhlaza usasazeka ukusuka apho waqala ngokukhula waya kwiindawo ezikufuphi.

• Inkqubo yeLymph. Umhlaza usasazeka ukusuka apho waqala ngokungena kwinkqubo ye-lymph. Umhlaza uhamba ngemithambo ye-lymph ukuya kwamanye amalungu omzimba.

• Igazi. Umhlaza usasazeka ukusuka apho waqala ngokungena egazini. Umhlaza uhamba ngemithambo yegazi uye kwamanye amalungu omzimba.

Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Xa umhlaza usasazeka kwelinye ilungu lomzimba, ubizwa ngokuba yi-metastasis. Iiseli zomhlaza ziyaphuma apho ziqale khona (ithumba lokuqala) kwaye zihamba ngenkqubo ye-lymph okanye igazi.

• Inkqubo yeLymph. Umhlaza ungena kwinkqubo ye-lymph, uhamba kwiinqanawa ze-lymph, kwaye wenze i-tumor (i-metastatic tumor) kwenye indawo yomzimba.

• Igazi. Umhlaza ungena egazini, uhambe kwimithambo yegazi, kwaye wenze ithumba (metastatic tumor) kwelinye ilungu lomzimba.

I-tumor ye-metastatic yinto efanayo yomhlaza njenge-tumor yokuqala. Umzekelo, ukuba umhlaza we-gallbladder usasazeka esibindini, iiseli zomhlaza esibindini ziyinyani yomhlaza wesibindi. Esi sifo ngumhlaza we-gallbladder yomhlaza, hayi umhlaza wesibindi.

La manqanaba alandelayo asetyenziselwa umhlaza we-gallbladder:

Inqanaba 0 (iCarcinoma kwiSitu)

Kwinqanaba le-0, iiseli ezingaqhelekanga zifumaneka kwi-mucosa (ungaphakathi ngaphakathi) wodonga lwenyongo. Ezi seli zingaqhelekanga zinokuba ngumhlaza kwaye zisasazeke kwizicubu eziqhelekileyo ezikufutshane. Inqanaba 0 likwabizwa ngokuba yi-carcinoma in situ.

Inqanaba I

Kwinqanaba I, umhlaza ubunjwe kwi-mucosa (ungaphakathi ngaphakathi) wodonga lwenyongo kwaye inokuba isasazeke kuludwe lwezihlunu lwodonga lwenyongo.

Inqanaba II

Isigaba II sahlulwe sangamanqanaba IIA kunye ne-IIB, kuxhomekeka apho umhlaza usasazeke khona kwi-gallbladder.

• Kwinqanaba le-IIA, umhlaza usasazekile ngapha kothotho lwezihlunu ukuya kulungelelwaniso lwethishu eludongeni lwe-gallbladder kwicala le-gallbladder engekho kufutshane nesibindi.

• Kwinqanaba le-IIB, umhlaza usasazekile ngapha kongqameko lwezihlunu kuludwe lwethishu edityanisiweyo yodonga lwenyongo kwelinye icala njengesibindi. Umhlaza awusasazekanga esibindini.

Inqanaba III

Inqanaba III lahlulwe ngokwamanqanaba e-IIIA kunye ne-IIIB, kuxhomekeke kwindawo osasazeke kuyo umhlaza.

• Kwinqanaba le-IIIA, umhlaza usasazekile kuludwe lweethishu edibeneyo kwaye enye okanye ezingaphezulu kwezi zilandelayo ziyinyani:

• Umhlaza unwenwele kwi-serosa (umaleko wethishu egubungele i-gallbladder).

• Umhlaza unwenwele esibindini.

• Umhlaza usasazeke kwilungu elinye elikufutshane okanye kwisakhiwo (esifana nesisu, ithumbu elincinci, ikholoni, injeke, okanye imibhobho yenyongo engaphandle kwesibindi).

• Kwinqanaba le-IIIB, umhlaza ubunjwe kwi-mucosa (ungaphakathi ngaphakathi) wodonga lwenyongo kwaye inokuba isasazeke kwimisipha, izihlunu ezihlangeneyo, okanye i-serosa (umaleko wethishu egubungele inyongo) kwaye isenokusasazeka kwisibindi okanye ilungu elinye elikufutshane okanye ulwakhiwo (njengesisu, ithumbu elincinci, ikholoni, injeke, okanye imibhobho yenyongo engaphandle kwesibindi). Umhlaza uye wasasazeka kwindawo enye ukuya kwezintathu ezikufuphi ne-lymph node.

Inqanaba IV

Isigaba IV sahlulwe sangamanqanaba e-IVA kunye ne-IVB.

• Kwinqanaba le-IVA, umhlaza usasazeke kwi-portal vein okanye i-hepatic artery okanye kumalungu amabini okanye nangaphezulu okanye izakhiwo ngaphandle kwesibindi. Umhlaza unokusasazeka ukuya kwi-lymph node ezikufutshane.

• Kwinqanaba le-IVB, umhlaza usenokusasazeka kwizitho ezikufuphi okanye izakhiwo. Umhlaza usasazekile:

• kwii-lymph node ezine okanye ngaphezulu ezikufutshane; okanye

• kwamanye amalungu omzimba, njenge-peritoneum kunye nesibindi.

Ngomhlaza we-gallbladder, amanqanaba nawo aqokelelwe ngokwendlela umhlaza onokuthi uphathwe ngayo. Kukho amaqela onyango amabini:

Yasekhaya (Inqanaba I)

Umhlaza ufumaneka eludongeni lwenyongo kwaye unokususwa ngokupheleleyo ngotyando.

Ukungabonakali, ukuphindaphinda, okanye i-metastatic (iSigaba II, iSigaba III, kunye neSigaba IV)

• Umhlaza ongafunekiyo awunakususwa ngokupheleleyo ngotyando. Uninzi lwezigulana ezinomhlaza we-gallbladder zinomhlaza ongafunekiyo.

Umhlaza ophindaphindiweyo ngumhlaza obuye wabuya (ubuye) emva kokuba unyangiwe. Umhlaza we-gallbladder ungabuyela kwi-gallbladder okanye kwamanye amalungu omzimba.

I-Metastasis kukusasazeka komhlaza kwindawo yokuqala (indawo eyaqala kuyo) ukuya kwezinye iindawo emzimbeni. Umhlaza wesifo se-gallbladder unokusasazeka kwizicubu ezijikelezileyo, kwizitho, kwisisu esiswini, okanye kwiindawo ezikude zomzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza we-gallbladder.

• Zintathu iintlobo zonyango olusetyenziswayo:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Izilumkiso zemitha

• Unyango lomhlaza we-gallbladder lunokubangela iziphumo ebezingalindelekanga.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza we-gallbladder.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza we-gallbladder. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Zintathu iintlobo zonyango olusetyenziswayo:

Ugqirha

Umhlaza we-gallbladder unokunyangwa nge-cholecystectomy, utyando lokususa i-gallbladder kunye nezinye izicwili eziyingqongileyo. I-lymph node ezikufutshane zingasuswa. Ngamanye amaxesha i-laparoscope isetyenziselwa ukukhokela utyando lwe-gallbladder. I-laparoscope iqhotyoshelwe kwikhamera yevidiyo kwaye ifakwe kwi-incision (port) esiswini. Izixhobo zotyando zifakwa kwamanye amazibuko ukwenza utyando. Kungenxa yokuba kukho umngcipheko wokuba iiseli zomhlaza wesinyongo zinokusasazeka kwezi zibuko, izicwili ezijikeleze iisayithi zezibuko zinokususwa.

Ukuba umhlaza usasazekile kwaye awunakususwa, ezi ntlobo zilandelayo zotyando lokuthomalalisa zinokuthomalalisa iimpawu:

• I-Biliary bypass: Ukuba ithumba ibhloka i-bile duct kwaye i-bile iyakha kwi-gallbladder, kungenziwa ngokudlula kwe-biliary. Ngexesha lotyando, ugqirha uya kusika i-gallbladder okanye i-bile duct kuloo ndawo ngaphambi kokuvaleka kwaye ayithungele kumathumbu amancinci ukwenza indlela entsha ejikeleze indawo evaliweyo.

• Ukufakwa kwe-Endoscopic stent: Ukuba i-tumor ivimbela i-bile duct, utyando lunokwenziwa ukubeka i-stent (ityhubhu encinci) ukukhupha i-bile eyakhiwe kuloo ndawo. Ugqirha unokubeka i-stent ngokusebenzisa i-catheter ekhupha i-bile kwisikhwama ngaphandle komzimba okanye i-stent inokujikeleza indawo evaliweyo kwaye ikhuphe i-bile emathunjini amancinci.

• I-Percutaneous transhepatic biliary drainage: Inkqubo eyenziweyo ukukhupha i-bile xa kukho ukubhloka kunye nokubekwa kwe-endoscopic stent akunakwenzeka. IX-reyi yesibindi kunye nemibhobho yenyongo yenziwa ukufumana ukubhloka. Imifanekiso eyenziwe nge-ultrasound isetyenziselwa ukukhokela ukubekwa kwe-stent, eshiyekileyo esibindini ukukhupha i-bile emathunjini amancinci okanye kwingxowa yokuqokelela ngaphandle komzimba. Le nkqubo inokwenziwa ukukhupha i-jaundice ngaphambi kotyando.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ngaphandle komzimba ukuthumela imitha kumhlaza.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga umhlaza we-gallbladder.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba kungokubulala iiseli okanye kukumisa iiseli zahlule. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy). Xa i-chemotherapy ibekwa ngqo kwi-cerebrospinal fluid, ilungu, okanye indawo yomzimba efana nesisu, iziyobisi zichaphazela kakhulu iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi). Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Eli candelo lesishwankathelo lichaza unyango olufundwayo kuvavanyo lweklinikhi. Isenokungakhankanyi lonke unyango olutsha olufundwayo. Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Izilumkiso zemitha

Uvavanyo lweklinikhi lufunda ngeendlela zokuphucula isiphumo sonyango lwemitha kwiiseli zethumba, kubandakanya oku kulandelayo:

• Unyango lwehyperthermia: Unyango apho izicwili zomzimba zichaphazeleka kumaqondo obushushu aphezulu ukonakalisa nokubulala iiseli zomhlaza okanye ukwenza iiseli zomhlaza zibuthathaka ngakumbi kwiziphumo zonyango lwemitha kunye neziyobisi ezithile ze-anticancer.

• Radiosensitizers: Iziyobisi ezenza iiseli zethumba ukuba zibuthathaka ngakumbi kunyango lwemitha. Ukunika unyango ngemitha kunye neeradiosensitizers kunokubulala iiseli ezininzi zethumba.

Unyango lomhlaza we-gallbladder lunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Ukhetho kunyango lweCarbladder Cancer

Kweli Candelo

• Umhlaza weGallbladder ekuhlaleni

• Unresectable, Recurrent, okanye Metastatic Gallbladder Cancer

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Umhlaza weGallbladder ekuhlaleni

Unyango lomhlaza wendawo ye-gallbladder inokubandakanya oku kulandelayo:

• Utyando lokususa i-gallbladder kunye nezinye izicubu ezijikelezileyo. Icandelo lesibindi kunye ne-lymph node ezikufutshane nazo zingasuswa. Unyango lwe-radiation kunye okanye ngaphandle kwe-chemotherapy lunokulandela utyando.

• Unyango lwe-radiation kunye okanye ngaphandle kwe-chemotherapy.

• Uvavanyo lweklinikhi yonyango lwemitha kunye neeradiosensitizers.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unresectable, Recurrent, okanye Metastatic Gallbladder Cancer

Unyango lwesifo somhlaza esinganyangekiyo, esiphindaphindayo, okanye se-metastatic gallbladder sihlala sikwilingo leklinikhi. Unyango lunokubandakanya oku kulandelayo:

• Umjelo wamanzi we-biliary translicatic biliary drainage okanye ukubekwa kweentente ukuze kunciphise iimpawu ezibangelwa yimibhobho ye-bile evaliweyo. Oku kunokulandelwa ngonyango lwe-radiation njengonyango lokunyanga.

• Utyando njengonyango oludambisayo lokukhupha iimpawu ezibangelwa kukuvalwa kwembhobho.

• Unyango ngamayeza.

• Uvavanyo lweklinikhi lweendlela ezintsha zokunika unyango lweradiation, njengokuyinika kunye nonyango lwehyperthermia, iiradiosensitizers, okanye ichemotherapy.

• Uvavanyo lweklinikhi lwamachiza amatsha kunye nokudityaniswa kweziyobisi.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukuze ufunde okungakumbi malunga nomhlaza we-Gallbladder

Ngolwazi oluthe kratya kwiZiko likaZwelonke loMhlaza malunga nomhlaza wamathumbu enyongo, bona iGallbladder Cancer Home Page.

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli