Iindidi / isibindi / isigulana / unyango lwenyongo-pdq

Unyango lweBile Duct (Cholangiocarcinoma) Unyango

Ulwazi ngokubanzi malunga noMhlaza weBile Duct

IINGONGOMA EZIPHAMBILI

• Umhlaza wesifo somhlaza sisifo esinqabileyo apho iiseli ezimbi (zomhlaza) zeeseli zenzeka kwimibhobho yenyongo.

• Ukuba ne-colitis okanye izifo ezithile zesibindi kunokunyusa umngcipheko wesifo somhlaza wenyongo.

• Iimpawu zomhlaza wenyongo zibandakanya i-jaundice kunye neentlungu esiswini.

• Uvavanyo oluvavanya imijelo yenyongo kunye nezitho ezikufuphi zisetyenziselwa ukufumanisa (ukufumana), ukufumanisa isifo, kunye nenqanaba lomhlaza wendlela yomhlaza.

• Iinkqubo ezahlukeneyo zinokusetyenziselwa ukufumana isampulu yethishu kunye nokufumanisa isifo somhlaza wenyongo.

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

Umhlaza wesifo somhlaza sisifo esinqabileyo apho iiseli ezimbi (zomhlaza) zeeseli zenzeka kwimibhobho yenyongo.

Inethiwekhi yemibhobho, ebizwa ngokuba yimibhobho, idibanisa isibindi, inyongo, kunye namathumbu amancinci. Le nethiwekhi iqala esibindini apho imibhobho emininzi emincinci iqokelela inyongo (ulwelo olwenziwe sisibindi ukwaphula amafutha ngexesha lokwetyisa). Imijelo emincinci iyahlangana ukuze yenze imibhobho yasekunene nasekhohlo, ekhokelela kwisibindi. Amacandelo amabini ajoyina ngaphandle kwesibindi kwaye enze indlela eqhelekileyo ye-hepatic. I-cystic duct idibanisa i-gallbladder kwi-hepatic duct. Ukubhabha kwesibindi kudlula kwimibhobho ye-hepatic, indlela eqhelekileyo ye-hepatic, kunye ne-cystic duct kwaye igcinwe kwi-gallbladder.

Xa ukutya kugaywa, i-bile egcinwe kwi-gallbladder iyakhululwa kwaye idlula kwi-cystic duct kwi-bile duct eqhelekileyo nakwisisu esincinci.

Umhlaza wamanzi obizwa ngokuba ngumhlaza ubizwa ngokuba yi-cholangiocarcinoma.

Zimbini iintlobo zomhlaza wenyongo:

• Umhlaza wediski we-bile we-intrahepatic: Olu hlobo lomhlaza lwenza imijelo yenyongo ngaphakathi kwesibindi. Inani elincinci kuphela lomhlaza we-bile duct are intrahepatic. I-Intrahepatic bile duct cancers ikwabizwa ngokuba yi-intrahepatic cholangiocarcinomas.

I-Anatomy ye-intrahepatic bile ducts. I-Intrahepatic bile ducts yinethiwekhi yeetyhubhu ezincinci ezithwala inyongo ngaphakathi kwesibindi. Ezona mibhobho zincinci zibizwa ngokuba zii-ductule, ziyahlangana ukuze zenze i-bile ye-bile ye-hepatic efanelekileyo kunye ne-bile ye-hepatic bile duct, ekhupha inyongo esibindini. Ibhili ligcinwa kwinyongo kwaye liyakhutshwa xa ukutya kugaywa.

• Umhlaza womhlaza we-bile we -Extrahepatic : Umgaqo we-bile we-extrahepatic wenziwe ngengingqi ye-hilum kunye nommandla we-distal. Umhlaza ungenza nokuba yeyiphi na ingingqi:

• Umhlaza wesifo se-Perihilar bile: Olu hlobo lomhlaza lufunyenwe kwingingqi ye-hilum, indawo apho i-bile kunye ne-left ducts iphuma kwisibindi kwaye ijoyine ukwenza i-hepatic duct. Umhlaza we-Perihilar bile duct ubizwa ngokuba yi-Klatskin tumor okanye i-perihilar cholangiocarcinoma.

• Umhlaza womhlaza we-bile we-extrhepatic bile: Olu hlobo lomhlaza lufumaneka kwingingqi ekude. Ummandla we-distal wenziwe nge-bile duct eqhelekileyo edlula kwi-pancreas kwaye iphele emathunjini amancinci. Umhlaza webala we-bile we-extrhepatic bile ubizwa ngokuba yi-extrahepatic cholangiocarcinoma.

I-Anatomy yemibhobho ye-bile ye-extrahepatic. Imijelo yenyongo eyongezelelweyo ziibhubhu ezincinci ezithwala inyongo ngaphandle kwesibindi. Zenziwe ngendlela eqhelekileyo ye-hepatic duct (indawo ye-hilum) kunye ne-bile duct eqhelekileyo (indawo ye-distal). Ibhayile yenziwe esibindini kwaye iqukuqele kwi-hepatic duct eqhelekileyo kunye ne-cystic duct kwi-gallbladder, apho igcinwa khona. I-Bile ikhutshwa kwi-gallbladder xa ukutya kugaywa.

Ukuba ne-colitis okanye izifo ezithile zesibindi kunokunyusa umngcipheko wesifo somhlaza wenyongo.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Abantu abacinga ukuba banokuba semngciphekweni kufuneka baxoxe ngale nto nogqirha wabo.

Imiba yomngcipheko womhlaza wenyongo ibandakanya le miqathango ilandelayo:

• I-primary sclerosing cholangitis (isifo esiqhubela phambili apho imibhobho ye-bile ivalwe kukudumba kunye nokuqunjelwa).

• Ulcerative colitis.

• Ii-cysts kwimibhobho ye-bile (ii-cysts zithintela ukuhamba kwe-bile kwaye kunokubangela ukudumba kwe-bile ducts, ukudumba kunye nosulelo).

• Usulelo ngesifo saseTshayina sesibindi.

Iimpawu zomhlaza wenyongo zibandakanya i-jaundice kunye neentlungu esiswini.

Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa ngumhlaza wenyongo okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• IJaundice (ukuba tyheli kolusu okanye abamhlophe bamehlo).

• Umchamo omnyama.

• Isitulo esinemibala yodongwe.

• Intlungu esiswini.

• Ifiva.

• Ulusu olurhawuzayo.

• Isicaphucaphu nokugabha.

• Ukwehla kwesisindo ngesizathu esingaziwayo.

Uvavanyo oluvavanya imijelo yenyongo kunye nezitho ezikufuphi zisetyenziselwa ukufumanisa (ukufumana), ukufumanisa isifo, kunye nenqanaba lomhlaza wendlela yomhlaza.

Iinkqubo ezenza imifanekiso yemibhobho yenyongo kunye nommandla okufuphi kunceda ekufumaniseni umhlaza wendlela yenyongo kwaye ubonise ukuba umhlaza usasazeke kangakanani. Inkqubo esetyenziselwa ukufumanisa ukuba ngaba iiseli zomhlaza zisasazekile ngaphakathi nangaphaya kwemijelo yenyongo okanye kwiindawo ezikude zomzimba kuthiwa yistage.

Ukuze ucwangcise unyango, kubalulekile ukuba wazi ukuba umhlaza wenyongo ungasuswa ngotyando. Uvavanyo kunye neenkqubo zokufumanisa, ukufumanisa isifo, kunye nenqanaba lomhlaza wamanzi omhlaza 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 isixa se-bilirubin kunye ne-alkaline phosphatase ekhutshwe egazini sisibindi. Ixabiso elingaphezulu kwesiqhelo kwezi zinto linokuba luphawu lwesifo sesibindi esinokubangelwa ngumhlaza wenyongo.

• Uvavanyo lwelabhoratri: Iinkqubo zonyango ezivavanya iisampulu zethishu, igazi, umchamo, okanye ezinye izinto emzimbeni. Ezi mvavanyo zinceda ukufumanisa isifo, ukucwangcisa kunye nokujonga unyango, okanye ukubeka esweni isifo ekuhambeni kwexesha.

• ICarcinoembryonic antigen (CEA) kunye ne-CA 19-9 yovavanyo lwethumba: Inkqubo apho isampulu yegazi, umchamo, okanye izicwili zijongwa ukulinganisa inani lezinto ezithile ezenziwe ngamalungu, izicwili, okanye iiseli zesisu emzimbeni. Izinto ezithile zinxulunyaniswa neentlobo ezithile zomhlaza xa zifunyenwe kumanqanaba anyukayo emzimbeni. Oku kubizwa ngokuba kukuphawula amathumba. Ngaphezulu kwamanqanaba aqhelekileyo e-carcinoembryonic antigen (i-CEA) kunye ne-CA 19-9 kunokuthetha ukuba kukho umhlaza we-bile duct.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho, ezinje ngesisu, kwaye zenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesisu, esithathwe kwii-engile 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.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• I-MRCP (i-magnetic resonance cholangiopancreatography): Inkqubo esebenzisa umazibuthe, amaza erediyo, kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni ezifana nesibindi, imibhobho ye-bile, i-gallbladder, i-pancreas kunye ne-pancreatic

Iinkqubo ezahlukeneyo zinokusetyenziselwa ukufumana isampulu yethishu kunye nokufumanisa isifo somhlaza wenyongo.

Iiseli kunye nezicubu ziyasuswa ngexesha le-biopsy ukuze zibonwe phantsi kwemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Iinkqubo ezahlukeneyo zinokusetyenziselwa ukufumana isampulu yeeseli kunye nezicubu. Uhlobo lwenkqubo esetyenzisiweyo luxhomekeke ekubeni isigulana sanele ngokwaneleyo na ukuba senziwe utyando.

Iindidi zenkqubo ye-biopsy zibandakanya oku kulandelayo:

• I-Laparoscopy: Inkqubo yotyando yokujonga amalungu ngaphakathi esiswini, anje ngemibhobho yenyongo kunye nesibindi, ukujonga iimpawu zomhlaza. 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 ngokuthatha iisampulu zethishu ukuze zihlolwe iimpawu zomhlaza.

• I-Percutaneous transhepatic cholangiography (PTC): 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. Isampulu yethishu iyasuswa kwaye ihlolwe iimpawu zomhlaza. Ukuba i-bile duct ivaliwe, ityhubhu ecekeceke, eguqukayo ebizwa ngokuba yi-stent inokushiywa esibindini ukukhupha ibongo kumathumbu amancinci okanye kwingxowa yokuqokelela ngaphandle komzimba. Le nkqubo inokusetyenziswa xa isigulana singenakho utyando.

• I-Endoscopic retrograde cholangiopancreatography (ERCP): Inkqubo esetyenziselwa i-x-ray imibhobho (iityhubhu) ezithwala inyongo ukusuka kwisibindi ukuya kwi-gallbladder nakwi-gallbladder ukuya kumathumbu amancinci. Ngamanye amaxesha umhlaza we-bile duct ubangela ukuba le mibhobho inciphise kwaye ibhloke okanye icothe ukuhamba kwe-bile, ibangele i-jaundice. I-endoscope idlula ngomlomo kunye nesisu kunye nethumbu elincinci. Idayi itofwe nge-endoscope (isixhobo esincinci, esifana netyhubhu esifana nokukhanya kunye nelensi yokujonga) kwimibhobho ye-bile kunye ne-x-ray ithathwa. Isampulu yethishu iyasuswa kwaye ihlolwe iimpawu zomhlaza. Ukuba i-bile duct ivaliwe, ityhubhu encinci inokufakwa kwi-duct ukuyivula. Le ityhubhu (okanye i-stent) inokushiywa endaweni yokugcina indlela ivulekile. Le nkqubo inokusetyenziswa xa isigulana singenakho utyando.

• 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 aphakamileyo amandla (i-ultrasound) kwizicubu zangaphakathi okanye kwizitho kunye nokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Isampulu yethishu iyasuswa kwaye ihlolwe iimpawu zomhlaza. Le nkqubo ikwabizwa ngokuba yi-endosonografi.

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

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

• Nokuba umhlaza ukwindawo ephezulu okanye esezantsi yenkqubo ye-bile duct.

• Isigaba somhlaza (nokuba sichaphazela kuphela i-bile ducts okanye sisasazekile kwisibindi, i-lymph node, okanye ezinye iindawo emzimbeni).

• Nokuba umhlaza unwenwele kwimithambo okanye kwimithambo ekufuphi.

• Nokuba umhlaza ungasuswa ngokupheleleyo ngotyando.

• Nokuba isigulana sinazo ezinye iimeko, ezinje nge-primary sclerosing cholangitis.

• Nokuba inqanaba le-CA 19-9 liphezulu kunesiqhelo.

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

Ukhetho lonyango lunokuxhomekeka kwiimpawu ezibangelwa ngumhlaza. Umhlaza wamanzi obomvu ufumaneka emva kokuba usasazekile kwaye kunqabile ukuba ususwe ngokupheleleyo ngotyando. Unyango lokunyanga kunokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi wesigulana.

Amanqanaba oMhlaza weDreyini yoMhlaza

IINGONGOMA EZIPHAMBILI

• Iziphumo zovavanyo lokuqonda isifo kunye nesiteji zisetyenziselwa ukufumanisa ukuba iiseli zomhlaza zisasazekile na.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• Amanqanaba asetyenziselwa ukuchaza iintlobo ezahlukeneyo zomhlaza wenyongo.

• Intrahepatic bile duct umhlaza

• Umhlaza wedreyini wederi we-Perihilar

• Umhlaza wobuchwephesha be-bile okhoyo okhethekileyo

• La maqela alandelayo asetyenziselwa ukucwangcisa unyango:

• Umhlaza obonakalayo (okhoyo)

• Umhlaza ongapheliyo, we-metastatic, okanye ophindaphindiweyo womhlaza wenyongo

Iziphumo zovavanyo lokuqonda isifo kunye nesiteji zisetyenziselwa ukufumanisa ukuba iiseli zomhlaza zisasazekile na.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza sele usasazekile na kwamanye amalungu omzimba kuthiwa yi-staging. Ngomhlaza wenyongo, ulwazi oluqokelelwe kuvavanyo kunye neenkqubo lusetyenziselwa ukucwangcisa unyango, kubandakanya ukuba ngaba eli thumba linokususwa ngotyando.

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 wenyongo usasazeka esibindini, iiseli zomhlaza esibindini ziyinyani yomhlaza weseli. Esi sifo ngumhlaza we-bile metastatic bile, hayi umhlaza wesibindi.

Amanqanaba asetyenziselwa ukuchaza iintlobo ezahlukeneyo zomhlaza wenyongo.

Intrahepatic bile duct umhlaza

• Isigaba 0: Kwinqanaba le-0 le-intrahepatic bile duct cancer, iiseli ezingaqhelekanga zifumaneka kwinqanaba elingaphakathi leethambo ezifake i-intrahepatic bile duct. Ezi seli zingaqhelekanga zinokuba ngumhlaza kwaye zisasazeke kwizicubu eziqhelekileyo ezikufutshane. Inqanaba 0 likwabizwa ngokuba yi-carcinoma in situ.

• Isigaba I: Isigaba I-intrahepatic bile duct cancer ihlukaniswe ngamanqanaba IA kunye ne-IB.

Ubungakanani beethumba zihlala zilinganiswa ngeesentimitha (cm) okanye ii-intshi. Ukutya okuqhelekileyo okunokusetyenziselwa ukubonisa ubungakanani bethumba nge-cm kubandakanya: ipea (1 cm), ipeanut (2 cm), umdiliya (3 cm), i-walnut (4 cm), ikalika (5 cm okanye 2) I-intshi), iqanda (i-6 cm), ipesika (i-7 cm), kunye ne-grapefruit (i-10 cm okanye ii-intshi ezine).

• Kwinqanaba le-IA, umhlaza ubunjwe kwi-intrahepatic bile duct kwaye ithumba liziisentimitha ezi-5 okanye zincinci.

• Kwinqanaba le-IB, umhlaza ubunjwe kwi-intrahepatic bile duct kwaye ithumba likhulu kuneesentimitha ezi-5.

• Isigaba II: Kwinqanaba lesi-II somhlaza we-bile duct cancer, enye yezi zinto zilandelayo zifunyenwe:

• ithumba lisasazeke eludongeni lwe-intrahepatic bile duct kunye nomthambo wegazi; okanye

• ngaphezulu kwesinye ithumba lenziwe kwi-intrahepatic bile duct kwaye inokuthi isasazeke kwisitya segazi.

• Isigaba se-III: Isigaba se-III somhlaza we-bile duct cancer uhlukaniswe ngamanqanaba e-IIIA kunye ne-IIIB.

• Kwinqanaba le-IIIA, ithumba lisasazekile ngapha komgubo (ulwelo lwangaphandle) lwesibindi.

• Kwinqanaba le-IIIB, umhlaza usasazeke kwizitho okanye izicubu ezikufuphi nesibindi, njenge-duodenum, ikholoni, isisu, indlela eqhelekileyo yenyongo, udonga lwesisu, uvalo, okanye inxenye ye-vena cava emva kwesibindi, okanye umhlaza usasazekile iindawo nkovu ezikufuphi.

• Isigaba IV: Kwinqanaba le-IV lomhlaza we-bile duct cancer, umhlaza usasazeke kwamanye amalungu omzimba, anje ngethambo, imiphunga, ii-lymph node ezikude, okanye izicwili ezixhoma udonga lwesisu kunye namalungu amaninzi esiswini.

Umhlaza wedreyini wederi we-Perihilar

• Isigaba 0: Kwinqanaba le-0 le-perihilar bile duct cancer, iiseli ezingaqhelekanga zifumaneka kwinqanaba elingaphakathi leethambo ezifake i-perihilar bile duct. Ezi seli zingaqhelekanga zinokuba ngumhlaza kwaye zisasazeke kwizicubu eziqhelekileyo ezikufutshane. Inqanaba 0 ikwabizwa ngokuba yi-carcinoma in situ okanye i-dysplasia ekumgangatho ophezulu.

• Isigaba I: Kwinqanaba I-perihilar bile umhlaza womhlaza, umhlaza ubunjwe ngaphakathi ngaphakathi kwithishu efake i-perihilar bile duct kwaye isasazeke kumaleko wemisipha okanye ulusu lwethishu yeferihilar bile duct.

• Isigaba II: Kwinqanaba lesibini lomhlaza we-bile duct cancer, umhlaza usasazeke eludongeni lwe-perihilar bile duct ukuya kwizicubu ezinamafutha ezikufutshane okanye kwizicubu zesibindi.

• Isigaba sesi-III: Isigaba somhlaza se-perihilar bile umhlaza uhlukaniswe ngamanqanaba e-IIIA, IIIB, kunye ne-IIIC.

• Isigaba IIIA: umhlaza usasazeke waya kumasebe kwelinye icala lomthambo we-hepatic okanye we-portal vein.

• Isigaba IIIB: umhlaza usasazeke kwenye okanye nangaphezulu koku kulandelayo:

• icandelo eliphambili le-portal vein okanye amasebe alo kumacala omabini;

• umthambo eqhelekileyo hepatic;

• i-duct efanelekileyo ye-hepatic kunye nesebe lasekhohlo lomthambo we-hepatic okanye we-portal vein;

• umgca we-hepatic wasekhohlo kunye nesebe lasekunene lomthambo we-hepatic okanye we-portal vein.

• Isigaba IIIC: umhlaza usasazeke kwi-1 ukuya kwi-3 ye-lymph node ezikufutshane.

• Isigaba IV: Isigaba somhlaza se-bile perihilar bile umhlaza uhlukaniswe ngamanqanaba e-IVA kunye ne-IVB.

• Isigaba se-IVA: I-Cancer isasazeke kwi-4 okanye ngaphezulu kwee-lymph node.

• Isigaba IVB: Umhlaza usasazeke kwamanye amalungu omzimba, anjengesibindi, imiphunga, ithambo, ingqondo, ulusu, iindawo ezikude nkovu, okanye izicwili ezixhome eludongeni lwesisu nakumalungu amaninzi esiswini.

Umhlaza wobuchwephesha be-bile okhoyo okhethekileyo

• Isigaba 0: Kwinqanaba le-0 distal extrahepatic cancer duct cancer, iiseli ezingaqhelekanga zifumaneka kumaleko angaphakathi wezicubu ezifaka i-distal extrahepatic bile duct. Ezi seli zingaqhelekanga zinokuba ngumhlaza kwaye zisasazeke kwizicubu eziqhelekileyo ezikufutshane. Inqanaba 0 ikwabizwa ngokuba yi-carcinoma in situ okanye i-dysplasia ekumgangatho ophezulu.

Iimilimitha (mm). Indawo ebukhali yepensile imalunga ne-1 mm, indawo entsha yekhrayoni imalunga ne-2 mm, kwaye irabha entsha yeepensile imalunga ne-5 mm.

• Isigaba I: Kwinqanaba I distal extrahepatic bile duct cancer, cancer has formed and spread less than 5 millimeters into the wall of the distal extrahepatic bile duct.

• Isigaba II: Isigaba II distal extrahepatic bile duct cancer ihlukaniswe ngamanqanaba IIA kunye ne-IIB.

• Isigaba IIA: Umhlaza usasazekile:

• ngaphantsi kweemilimitha ezi-5 eludongeni lwe-distal extrahepatic bile duct kwaye yasasazeka kwi-1 ukuya kwi-3 ye-lymph node ezikufutshane; okanye

• I-5 ukuya kwi-12 millimeters eludongeni lwe-distal extrahepatic bile duct.

• Isigaba IIB: I-Cancer isasazeke i-5 millimeters okanye ngaphezulu eludongeni lwe-distal extrahepatic bile duct. Umhlaza unokusasazeka ukuya kwi-1 ukuya kwi-3 ye-lymph node ezikufutshane.

• Isigaba se-III: Isigaba se-III distal extrahepatic bile duct cancer ihlukaniswe ngamanqanaba IIIA kunye ne-IIIB.

• Isigaba IIIA: Umhlaza usasazeke eludongeni lwe-distal extrahepatic bile duct nakwi-4 okanye nangaphezulu kwee-lymph node.

• Isigaba IIIB: Umhlaza usasazekile kwimithambo emikhulu ephethe igazi ukuya kumalungu esiswini. Umhlaza usenokusasazeka kwi-1 okanye nangaphezulu kwee-lymph node.

• Isigaba IV: Kwinqanaba le-IV distal extrahepatic bile duct cancer, umhlaza usasazeke kwamanye amalungu omzimba, anjengesibindi, imiphunga, okanye izicwili ezixhoma udonga lwesisu kunye namalungu amaninzi esiswini.

La maqela alandelayo asetyenziselwa ukucwangcisa unyango:

Umhlaza obonakalayo (okhoyo)

Umhlaza ukwindawo, njengasezantsi kwendlela eqhelekileyo ye-bile okanye indawo ye-perihilar, apho inokususwa ngokupheleleyo ngotyando.

Umhlaza ongapheliyo, we-metastatic, okanye ophindaphindiweyo womhlaza wenyongo

Umhlaza ongafunekiyo awunakususwa ngokupheleleyo ngotyando. Uninzi lwezigulana ezinomhlaza wenyongo kwi-bile azinakususwa ngokupheleleyo ngumhlaza ngotyando.

I-Metastasis kukusasazeka komhlaza kwindawo yokuqala (indawo eyaqala kuyo) ukuya kwezinye iindawo emzimbeni. Umhlaza wesifo se-metastatic bile umhlaza usenokusasazeka esibindini, kwezinye iindawo zesisu esiswini, okanye kwiindawo ezikude zomzimba.

Umhlaza we-bile duct umhlaza ngumhlaza ophindaphindiweyo (ubuyile) emva kokuba unyangiwe. Umhlaza ungabuyela kwimibhobho yenyongo, isibindi, okanye inyongo. Ngaphantsi kakhulu, inokuphinda ibuye kwiindawo ezikude zomzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza wenyongo.

• Zintathu iintlobo zonyango olusetyenziswayo:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Ukufakelwa kwesibindi

• Unyango lwe-bile duct cancer 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 wenyongo.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza wenyongo. 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

Ezi ntlobo zilandelayo zotyando zisetyenziselwa ukunyanga umhlaza wenyongo yendlela:

• Ukususwa kwendlela yokuhambisa inyongo: Inkqubo yotyando yokususa inxenye yendlela yenyongo ukuba ithumba lincinci kwaye likwindlela yenyongo kuphela. Ii-lymph node ziyasuswa kwaye izicwili ezivela kwii-lymph node zijongwa phantsi kwemicroscope ukubona ukuba ukhona na umhlaza.

• Inxalenye ye-hepatectomy: Inkqubo yotyando apho icandelo lesibindi apho umhlaza ufumaneka khona lisuswe. Inxalenye esusiweyo inokuba sisuntswana leethishu, ilobe iphelele, okanye inxenye enkulu yesibindi, kunye nezicubu ezithile ezisingqongileyo.

• Inkqubo yeWhipple: Inkqubo yotyando apho intloko yepancreas, inyongo, inxenye yesisu, inxenye yamathumbu amancinci, kunye nomgudu wenyongo. Kwanele ipancreas kushiyeke ukwenza iijusi zokwetyisa kunye ne-insulin.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa ichemotherapy okanye unyango lweradiation emva kotyando lokubulala naziphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo. Akukaziwa ukuba i-chemotherapy okanye unyango lwe-radiation olunikezwe emva kotyando luyanceda ukugcina umhlaza ungabuyi.

Ezi ntlobo zilandelayo zotyando olululo zinokwenziwa ukunciphisa iimpawu ezibangelwa kukuvalwa kwendlela yenyongo kunye nokuphucula umgangatho wobomi:

• I-Biliary bypass: Ukuba umhlaza uvimba i-bile duct kwaye i-bile iyakha kwi-gallbladder, i-biliary byass ingenziwa. Ngethuba lo msebenzi, ugqirha uya kusika i-gallbladder okanye i-bile duct kwindawo ephambi kokuvaleka kwaye ayithunge kwinxalenye ye-bile duct edlulileyo ekuvaleni okanye emathunjini 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 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 i-bile duct ivinjiwe, ityhubhu ecekeceke, eguqukayo ebizwa ngokuba yi-stent inokushiywa esibindini ukuze ikhuphe inyongo emathunjini amancinci okanye kwingxowa yokuqokelela ngaphandle komzimba.

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.

Unyango lwangaphandle kunye nolwangaphakathi lwasetyenziselwa ukunyanga umhlaza we-bile duct.

Akukaziwa ukuba ngaba unyango lwangaphandle lwemitha luyanceda na kunyango lomhlaza wendlela efumanekayo. Ngomhlaza ongafunekiyo, we-metastatic, okanye ophindaphindiweyo we-bile duct cancer, iindlela ezintsha zokuphucula iziphumo zonyango lwangaphandle lwemitha kwiiseli zomhlaza ziyafundwa:

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

• Radiosensitizers: Iziyobisi ezenza ukuba iiseli zomhlaza zibuthathaka kunyango lwe radiation. Ukudibanisa unyango ngemitha kunye neeradiosensitizers kunokubulala iiseli zomhlaza ezingaphezulu.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. 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).

Inkqubo ye-chemotherapy isetyenziselwa ukunyanga umhlaza ongafumanekiyo, we-metastatic, okanye we-bile duct cancer. Akukaziwa ukuba ngaba ichemotherapy yenkqubo iyanceda na kunyango lomhlaza wenyongo efumanekayo.

Ngomhlaza ongafunekiyo, we-metastatic, okanye ophindaphindiweyo we-bile duct cancer, kufundwa ngaphakathi. Yinkqubo apho unikezelo lwegazi kwi-tumor luvaliwe emva kokuba iziyobisi ze-anticancer zinikwe kwimithambo yegazi kufutshane nethumba. Ngamanye amaxesha, amayeza anticancer ancanyathiselwe kumaso amancinci atofelwe kwimithambo eyondla ithumba. Amaso athintela ukuhamba kwegazi ukuya kwithumba njengoko bekhupha ichiza. Oku kuvumela inani eliphezulu leziyobisi ukufikelela kwi-tumor ixesha elide, elinokubulala iiseli zomhlaza ezingaphezulu.

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.

Ukufakelwa kwesibindi

Kufakelo lwesibindi, isibindi sonke siyasuswa kwaye kufakwe isibindi esisempilweni esisikelweyo. Ukufakelwa kwesibindi kungenziwa kwizigulane ezine-perihilar bile duct cancer. Ukuba isigulana kufuneka silinde isibindi esinikelwe, olunye unyango luyanikwa xa kufuneka njalo.

Unyango lwe-bile duct cancer 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 lweCancer Bile Duct

Kweli Candelo

• I-Intrahepatic Bile Duct Umhlaza

• Umhlaza obonakalayo we-Intrahepatic Bile Duct Cancer

• Unresectable, Recurrent, okanye Metastatic Intrahepatic Bile Duct Cancer

• Umhlaza wedreyini yePerihilar Bile

• Umhlaza oBonakalayo wePerihilar Bile Duct

• Umhlaza ongafumanekiyo, oPhindaphindwayo, okanye iMetastatic Perihilar Bile Duct Cancer

• Umhlaza oSebenzayo we-Extrahepatic Bile Duct

• Umhlaza oBonakalayo we-Distra Extatichepatic Bile Duct

• Umhlaza ongafumanekiyo, ophindaphindiweyo, okanye weMetastatic Distal Extrahepatic Bile Duct Cancer

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

Ikhonkco kuluhlu lwezilingo zangoku zonyango zibandakanyiwe kwicandelo ngalinye lonyango. Kwezinye iintlobo okanye amanqanaba omhlaza, akunakubakho naziphi na izilingo ezidwelisiweyo. Jonga ugqirha wakho kuvavanyo lweklinikhi olungadweliswanga apha kodwa kunokuba kukulungele.

I-Intrahepatic Bile Duct Umhlaza

Umhlaza obonakalayo we-Intrahepatic Bile Duct Cancer

Unyango lwe-cancer ye-bile ye-intrahepatic bile engabandakanya:

• Ugqirha lokususa umhlaza, onokuthi ubandakanye i-hepatectomy. Ukudibanisa kunokwenziwa ngaphambi kotyando.

• Utyando olulandelwa yichemotherapy kunye / okanye unyango ngemitha.

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 Intrahepatic Bile Duct Cancer

Unyango lwe-cancer engapheliyo ye-bile ye-intrahepatic ye-bile engabandakanya oku kulandelayo:

• Ukubekwa ngokuqinileyo kunyango lokunyanga ukukhupha iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango lwangaphandle okanye lwangaphakathi lonyango njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango ngamayeza.

• Uvavanyo lweklinikhi yonyango lwangaphandle lwemitha oludibene nonyango lwehyperthermia, amayeza e-radiosensitizer, okanye i-chemotherapy.

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.

Umhlaza wedreyini yePerihilar Bile

Umhlaza oBonakalayo wePerihilar Bile Duct

Unyango lwe-perihilar bile duct cancer enokuphinda ibekho inokubandakanya oku kulandelayo:

• Ugqirha lokususa umhlaza, onokuthi ubandakanye i-hepatectomy.

• Ukubekwa ngokuqinileyo okanye i-transhepatic biliary drainage engagungqiyo njengonyango lokunyanga, ukunciphisa i-jaundice kunye nezinye iimpawu kunye nokuphucula umgangatho wobomi.

• Utyando olulandelwa lonyango lwe radiation kunye / okanye chemotherapy.

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.

Umhlaza ongafumanekiyo, oPhindaphindwayo, okanye iMetastatic Perihilar Bile Duct Cancer

Unyango lwe-perihilar bile umhlaza wesifo somhlaza ongafumanekiyo, ongaphindaphindekiyo, unokubandakanya oku kulandelayo:

• Ukubekwa kwesitendi okanye ukudlula kwi-biliary njengonyango olunyangayo lokunciphisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango lwangaphandle okanye lwangaphakathi lonyango njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango ngamayeza.

• Uvavanyo lweklinikhi yonyango lwangaphandle lwemitha oludibene nonyango lwehyperthermia, amayeza e-radiosensitizer, okanye i-chemotherapy.

• Uvavanyo lweklinikhi lwe-chemotherapy kunye nonyango lwe-radiation olulandelwa kukufakelwa kwesibindi.

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.

Umhlaza oSebenzayo we-Extrahepatic Bile Duct

Umhlaza oBonakalayo we-Distra Extatichepatic Bile Duct

Unyango lwe-distalablehephepatic bile bile cancer cancer enokubandakanya oku kulandelayo:

• Utyando lokususa umhlaza, onokuthi ubandakanye inkqubo yeWhipple.

• Ukubekwa ngokuqinileyo okanye i-transhepatic biliary drainage engagungqiyo njengonyango lokunyanga, ukunciphisa i-jaundice kunye nezinye iimpawu kunye nokuphucula umgangatho wobomi.

• Utyando olulandelwa lonyango lwe radiation kunye / okanye chemotherapy.

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.

Umhlaza ongafumanekiyo, ophindaphindiweyo, okanye weMetastatic Distal Extrahepatic Bile Duct Cancer

Unyango lwe-cancer ye-bile ye-bile ye-disteplicable, ephindaphindayo, okanye ye-metastatic distal extrahepatic bile ingaquka oku kulandelayo:

• Ukubekwa kwesitendi okanye ukudlula kwi-biliary njengonyango olunyangayo lokunciphisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango lwangaphandle okanye lwangaphakathi lonyango njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango ngamayeza.

• Uvavanyo lweklinikhi yonyango lwangaphandle lwemitha oludibene nonyango lwehyperthermia, amayeza e-radiosensitizer, okanye i-chemotherapy.

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.

Ukufunda ngakumbi malunga nomhlaza weBile Duct

Ngolwazi oluthe kratya kwiZiko leSizwe likaMhlaza malunga nomhlaza wenyongo, bona oku kulandelayo:

• Iphepha lasekhaya lesifo somhlaza kunye nesibilini

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