Izinhlobo / i-gallbladder / isiguli / i-gallbladder-treatment-pdq

Inguqulo Yokwelapha Umdlavuza We-Gallbladder

Imininingwane Ejwayelekile Mayelana Nomdlavuza We-Gallbladder

AMAPHUZU ASEMQOKA

• Umdlavuza we-gallbladder yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ze-gallbladder.

• Ukuba ngowesifazane kungakhuphula ubungozi bokuba nomdlavuza we-gallbladder.

• Izimpawu nezimpawu zomdlavuza we-gallbladder zifaka i-jaundice, umkhuhlane, nobuhlungu.

• Umdlavuza we-gallbladder kunzima ukuwuthola (ukuwuthola) nokuwuthola kusenesikhathi.

• Ukuhlolwa okuhlola i-gallbladder nezitho eziseduze kusetshenziselwa ukuthola (ukuthola), ukuxilonga, kanye nomdlavuza wesiteji se-gallbladder.

• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Umdlavuza we-gallbladder yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ze-gallbladder.

Umdlavuza we-gallbladder yisifo esingajwayelekile lapho kutholakala khona amangqamuzana abulalayo (umdlavuza) ezicutshini ze-gallbladder. I-gallbladder isitho esime njengepheya esilele ngaphansi kwesibindi esiswini esingenhla. Inyongo igcina inyongo, uketshezi olwenziwe isibindi ukugaya amafutha. Lapho kudilizwa ukudla esiswini nasemathunjini, inyongo ikhishwa enyongweni ngebhubhu ebizwa nge-bile bile duct, exhuma i-gallbladder nesibindi engxenyeni yokuqala yamathumbu amancane.

I-anatomy ye-gallbladder. Inyongo ingezansi kwesibindi nje. Ibhali ligcinwa enyongweni futhi ligeleza emgudwini we-cystic kanye nomgudu ovamile we-bile ungene emathunjini amancane lapho kudliwa ukudla.

Udonga lwenyongo lunezingqimba eziyisi-4 zezicubu.

• Isendlalelo se-Mucosal (ngaphakathi).

• Isendlalelo semisipha.

• Isendlalelo sezicubu ezixhuma.

• Isendlalelo se-Serosal (sangaphandle).

Umdlavuza oyinhloko we-gallbladder uqala ungqimba lwangaphakathi futhi usabalale ungqimba lwangaphandle njengoba lukhula.

Ukuba ngowesifazane kungakhuphula ubungozi bokuba nomdlavuza we-gallbladder.

Noma yini eyandisa amathuba akho okuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wakho uma ucabanga ukuthi ungaba sengozini. Izici ezinobungozi zomdlavuza we-gallbladder zifaka okulandelayo:

• Ukuba ngowesifazane.

• Ukuba ngumdabu waseMelika.

• Izimpawu nezimpawu zomdlavuza we-gallbladder zifaka i-jaundice, umkhuhlane, nobuhlungu.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa umdlavuza we-gallbladder noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• I-jaundice (kuphuzi kwesikhumba nabamhlophe bamehlo).

• Ubuhlungu ngaphezu kwesisu.

• Imfiva.

• Isicanucanu nokuhlanza.

• Ukuqhakaza.

• Izigaxa esiswini.

Umdlavuza we-gallbladder kunzima ukuwuthola (ukuwuthola) nokuwuthola kusenesikhathi.

Umdlavuza we-Gallbladder kunzima ukuwuthola nokuwuthola ngenxa yezizathu ezilandelayo:

• Azikho izimpawu noma izimpawu ezinyathelweni zokuqala zomdlavuza we-gallbladder.

• Izimpawu zomdlavuza we-gallbladder, uma zikhona, zifana nezimpawu zezinye izifo eziningi.

• Inyongo ifihliwe ngemuva kwesibindi.

Umdlavuza we-gallbladder kwesinye isikhathi utholakala lapho kukhishwa i-gallbladder ngezinye izizathu. Iziguli ezinama-gallstones azivamile ukuba nomdlavuza we-gallbladder.

Ukuhlolwa okuhlola i-gallbladder nezitho eziseduze kusetshenziselwa ukuthola (ukuthola), ukuxilonga, kanye nomdlavuza wesiteji se-gallbladder.

Izinqubo ezenza izithombe ze-gallbladder nendawo ezungezile zisiza ukuxilonga umdlavuza we-gallbladder futhi zibonise ukuthi umdlavuza ususabalale kangakanani. Inqubo esetshenziselwe ukuthola ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi nangaphakathi kwe-gallbladder ibizwa nge-staging.

Ukuze uhlele ukwelashwa, kubalulekile ukwazi ukuthi umdlavuza we-gallbladder ungasuswa ngokuhlinzwa. Ukuhlolwa nezinqubo zokuthola, ukuxilonga, kanye nomdlavuza wesiteji senyongo kuvame ukwenziwa ngasikhathi sinye. Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• Ukuhlolwa kokusebenza kwesibindi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini yisibindi. Inani eliphakeme kunelejwayelekile lezinto kungaba uphawu lwesifo sesibindi esingahle sidalwe ngumdlavuza we-gallbladder.

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, ezifana nesifuba, isisu, nesikhumba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. I-ultrasound yesisu yenziwa ukuthola umdlavuza we-gallbladder.

• I-PTC (i-percutaneous transhepatic cholangiography): Inqubo esetshenziselwa ukuxilonga imithambo yesibindi neye-bile. Inaliti ezacile ifakwa esikhunjeni ngaphansi kwezimbambo nasesibindi. Idayi ijojowe emgodini wesibindi noma we-bile bese kuthathwa i-x-ray. Uma kutholakala ukuvinjelwa, ishubhu elincane, eliguquguqukayo elibizwa ngokuthi i-stent kwesinye isikhathi lishiywa esibindini ukukhipha inyongo emathunjini amancane noma esikhwameni sokuqoqa ngaphandle komzimba.

• I-ERCP (i-endoscopic retrograde cholangiopancreatography): Inqubo esetshenziselwa ukufaka i-x-ray amapayipi (amashubhu) athwala inyongo isuka esibindini iye enyongweni kanye nasenyameni iye emathunjini amancane. Kwesinye isikhathi umdlavuza we-gallbladder ubangela ukuthi la mapayipi anciphise futhi avimbe noma anciphise ukuhamba kwe-bile, kubangele i-jaundice. I-endoscope (ishubhu elincanyana, elikhanyisiwe) idluliselwa emlonyeni, esophagus, nasesiswini engxenyeni yokuqala yamathumbu amancane. Ipayipi (ithubhu elincane) bese lifakwa nge-endoscope lingene emigudwini yenyongo. Idayi ijojowe nge-catheter emapayipini bese kuthathwa i-x-ray. Uma amapayipi evinjelwe isimila, ithubhu enhle ingafakwa emgodini ukuze ivulwe. Le tube (noma i-stent) ingashiywa endaweni ukuze kugcinwe umsele uvulekile. Amasampula amathishu nawo angathathwa.

• I-MRI (imaging resonance imaging) ene-gadolinium: Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Into ebizwa ngokuthi i-gadolinium ijojowe emthanjeni. I-gadolinium iqoqa izungeze amangqamuzana omdlavuza ukuze akhanye ngokugqamile esithombeni. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• I-endoscopic ultrasound (EUS): Inqubo lapho kufakwa khona i-endoscope emzimbeni, imvamisa ngomlomo noma nge-rectum. I-endoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Iphenyo ekugcineni kwe-endoscope isetshenziselwa ukuqhuma amaza omsindo wamandla aphezulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni futhi enze ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Le nqubo ibizwa nangokuthi i-endosonography.

• I-Laparoscopy: Inqubo yokuhlinza ukubheka izitho ezingaphakathi esiswini ukubheka izimpawu zesifo. Ukusikeka okuncane (ukusikeka) kwenziwa odongeni lwesisu bese kufakwa i-laparoscope (ithubhu elincane elikhanyisiwe) kokunye okusikiwe. Ezinye izinsimbi zingafakwa ngokusebenzisa okufanayo noma okunye ukusikeka ukwenza izinqubo ezifana nokususa izitho noma ukuthatha amasampula wezicubu we-biopsy. I-laparoscopy iyasiza ukuthola ukuthi umdlavuza ungaphakathi kwe-gallbladder kuphela noma ususabalele ezicutshini eziseduze nokuthi ungasuswa yini ngokuhlinzwa.

• I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. I-biopsy ingenziwa ngemuva kokuhlinzwa ukuze kususwe isimila. Uma ngokusobala isimila singeke sisuswe ngokuhlinzwa, i-biopsy ingenziwa kusetshenziswa inaliti enhle ukususa amaseli ku-tumor.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Isigaba somdlavuza (noma ngabe umdlavuza ususabalale kusuka enyongweni uye kwezinye izindawo emzimbeni).

• Ukuthi umdlavuza ungasuswa ngokuphelele ngokuhlinzwa.

• Uhlobo lomdlavuza we-gallbladder (indlela iseli lomdlavuza elibukeka ngayo ngaphansi kwesibonakhulu).

• Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Ukwelashwa kungabuye kuncike eminyakeni yobudala nempilo ejwayelekile yesiguli nokuthi umdlavuza ubangela izimpawu noma izimpawu.

Umdlavuza we-gallbladder ungelapheka kuphela uma utholakala ungakasakazeki, lapho ungasuswa ngokuhlinzwa. Uma umdlavuza ususabalele, ukwelashwa okunciphisayo kungathuthukisa ikhwalithi yempilo yesiguli ngokulawula izimpawu nobunzima balesi sifo.

Ukubamba iqhaza kolunye lwezivivinyo zokwelashwa ezenziwa ukwenza ngcono ukwelashwa kufanele kubhekwe. Imininingwane mayelana nokuhlolwa kwemitholampilo okuqhubekayo iyatholakala kuwebhusayithi ye-NCI.

Izigaba Zomdlavuza We-Gallbladder

AMAPHUZU ASEMQOKA

• Ukuhlolwa nezinqubo zokwenziwa komdlavuza we-gallbladder kuvame ukwenziwa ngasikhathi sinye nokuxilongwa.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-gallbladder:

• Isigaba 0 (I-Carcinoma eSitu)

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

• Ngomdlavuza we-gallbladder, izigaba nazo zihlelwe ngokusho ukuthi umdlavuza ungalashwa kanjani. Kunamaqembu amabili okwelashwa:

• Kwenziwe kwaba okwasendaweni (Isigaba I)

• Okungaphindaphindeki, okuphindayo, noma kwe-metastatic (Isigaba II, iSigaba III, neSigaba IV)

Ukuhlolwa nezinqubo zokwenziwa komdlavuza we-gallbladder kuvame ukwenziwa ngasikhathi sinye nokuxilongwa.

Bona isigaba soLwazi Jikelele ukuze uthole incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuthola, ukuxilonga, kanye nomdlavuza wesiteji se-gallbladder.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

• Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.

• Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza udabula imithambo ye-lymph uye kwezinye izingxenye zomzimba.

• Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

• Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

• Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Isigaxa se-metastatic luhlobo olufanayo lomdlavuza njengesimila sokuqala. Isibonelo, uma umdlavuza we-gallbladder usakazekela esibindi, amangqamuzana omdlavuza wesibindi empeleni angamaseli omdlavuza we-gallbladder. Lesi sifo umdlavuza we-gallbladder we-metastatic, hhayi umdlavuza wesibindi.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-gallbladder:

Isigaba 0 (I-Carcinoma eSitu)

Esigabeni 0, kutholakala amaseli angajwayelekile ku-mucosa (ungqimba lwangaphakathi impela) lwodonga lwenyongo. Lawa maseli angajwayelekile angaba ngumdlavuza futhi asabalale abe izicubu ezijwayelekile eziseduze. Isigaba 0 sibizwa nangokuthi i-carcinoma in situ.

Isiteji I

Esigabeni I, umdlavuza wakheke ku-mucosa (ungqimba lwangaphakathi impela) lwodonga lwenyongo futhi kungenzeka ukuthi usabalalele kungqimba lwezicubu zodonga lwenyongo.

Isigaba II

Isigaba II sihlukaniswe ngezigaba IIA no-IIB, kuya ngokuthi umdlavuza usabalale kuphi enyongweni.

• Esigabeni IIA, umdlavuza usabalale ungqimba lwemisipha laya kungqimba lwezicubu ezihlangene lodonga lwenyongo ohlangothini lwenyongo olusondele eduze kwesibindi.

• Esigabeni IIB, umdlavuza usabalale ungqimba lwemisipha laya kungqimba lwezicubu ezihlangene lodonga lwenyongo ohlangothini olufanayo nesibindi. Umdlavuza awusakazelanga esibindini.

Isigaba III

Isigaba III sihlukaniswe ngezigaba IIIA kanye ne-IIIB, kuya ngokuthi umdlavuza usabalale kuphi.

• Esigabeni IIIA, umdlavuza usabalale ngezingqimba zezicubu ezixhunyiwe zodonga lwenyongo futhi okukodwa noma okuningi kokulandelayo kuyiqiniso:

• Umdlavuza usabalalele ku-serosa (ungqimba lwezicubu ezihlanganisa i-gallbladder).

• Umdlavuza ususabalele esibindini.

• Umdlavuza usabalalele esithweni esisodwa esiseduze noma esakhiweni (njengesisu, ithumbu elincane, ikholoni, amanyikwe, noma amapayipi enyongo ngaphandle kwesibindi).

• Esigabeni IIIB, umdlavuza wakheke ku-mucosa (ungqimba lwangaphakathi impela) lwodonga lwenyongo futhi kungenzeka ukuthi usabalalele emisipheni, ezicutshini ezihlangene, noma ku-serosa (ungqimba lwezicubu ezihlanganisa i-gallbladder) futhi kungenzeka ukuthi futhi usakaze esibindini noma isitho esisodwa esiseduze noma isakhiwo (njengesisu, ithumbu elincane, ikholoni, amanyikwe, noma imigudu yenyongo engaphandle kwesibindi). Umdlavuza usabalalele kwesinye kuya kwamathathu ama-lymph node.

Isigaba IV

Isigaba IV sihlukaniswe ngezigaba ze-IVA ne-IVB.

• Esigabeni se-IVA, umdlavuza usabalale waya emthanjeni we-portal noma umthambo we-hepatic noma ezithombeni noma ezakhiweni ezimbili noma ngaphezulu ngaphandle kwesibindi. Umdlavuza kungenzeka usabalalele kolunye kuya kwamathathu ama-lymph node aseduze.

• Esigabeni IVB, umdlavuza kungenzeka usabalalele ezithweni noma ezakhiweni eziseduze. Umdlavuza usabalale:

• kuma-lymph node amane noma ngaphezulu aseduze; noma

• kwezinye izingxenye zomzimba, njenge-peritoneum nesibindi.

Ngomdlavuza we-gallbladder, izigaba nazo zihlelwe ngokusho ukuthi umdlavuza ungalashwa kanjani. Kunamaqembu amabili okwelashwa:

Kwenziwe kwaba okwasendaweni (Isigaba I)

Umdlavuza utholakala odongeni lwenyongo futhi ungasuswa ngokuphelele ngokuhlinzwa.

Okungaphindaphindeki, okuphindayo, noma kwe-metastatic (Isigaba II, iSigaba III, neSigaba IV)

• Umdlavuza ongabuyiseki awukwazi ukususwa ngokuphelele ngokuhlinzwa. Iningi leziguli ezinomdlavuza we-gallbladder zinomdlavuza onganqandeki.

Umdlavuza ophindaphindiwe wumdlavuza obuye wabuya (ubuye) ngemuva kokuba welashwe. Umdlavuza we-gallbladder ungabuya ku-gallbladder noma kwezinye izingxenye zomzimba.

I-Metastasis ukusabalala komdlavuza kusuka endaweni eyinhloko (indawo lapho iqale khona) kuya kwezinye izindawo emzimbeni. Umdlavuza we-gallbladder we-metastatic ungasakazeka ezicutshini ezizungezile, izitho, kuwo wonke umgudu wesisu, noma ezingxenyeni ezikude zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza we-gallbladder.

• Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Izisusa imisebe

• Ukwelashwa komdlavuza we-gallbladder kungadala imiphumela emibi.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza we-gallbladder.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza we-gallbladder. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Umdlavuza we-gallbladder ungalashwa nge-cholecystectomy, ukuhlinzwa ukuze ususe i-gallbladder nezinye izicubu ezizungezile. Ama-lymph node aseduze angasuswa. I-laparoscope kwesinye isikhathi isetshenziselwa ukuqondisa ukuhlinzwa kwe-gallbladder. I-laparoscope inamathiselwe kwikhamera yevidiyo futhi ifakwe nge-incision (port) esiswini. Izinsimbi zokuhlinza zifakwa kwamanye amachweba ukwenza ukuhlinzwa. Ngoba kunengozi yokuthi amangqamuzana omdlavuza we-gallbladder angasakazeka kulawa machweba, izicubu ezizungeze izindawo zetheku nazo zingasuswa.

Uma umdlavuza usakazekile futhi ungeke ususwe, izinhlobo ezilandelayo zokuhlinzwa okunciphisayo zinganciphisa izimpawu:

• Ukudlula kwe-Biliary: Uma isimila sivimba i-bile duct futhi i-bile yakha ku-gallbladder, kungenzeka ukwenziwa kwe-biliary bypass. Ngalesi sikhathi sokuhlinzwa, udokotela uzosika i-gallbladder noma i-bile duct endaweni ngaphambi kokuvaleka bese eyithungela emathunjini amancane ukudala indlela entsha ezungeze indawo evinjiwe.

• Ukubekwa kwe-endoscopic stent: Uma isimila sivimba umgudu we-bile, ukuhlinzwa kungenziwa ukufaka i-stent (ithubhu elincanyana) ukukhipha ibile elakhiwe endaweni. Udokotela angafaka i-stent nge-catheter efaka i-bile esikhwameni ngaphandle komzimba noma i-stent ingazungeza indawo evinjiwe bese ichitha inyongo emathunjini amancane.

• I-Percutaneous transhepatic biliary drainage: Inqubo eyenziwe ukukhipha inyongo lapho kukhona ukuvinjelwa nokubekwa kwe-endoscopic stent akunakwenzeka. I-x-ray yesibindi kanye namapayipi enyongo yenziwa ukuthola ukuvinjelwa. Izithombe ezenziwe nge-ultrasound zisetshenziselwa ukuqondisa ukubekwa kwe-stent, esele kwesibindi ukukhipha inyongo emathunjini amancane noma esikhwameni sokuqoqa ngaphandle komzimba. Le nqubo ingenziwa ukukhulula i-jaundice ngaphambi kokuhlinzwa.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Kunezinhlobo ezimbili zokwelashwa ngemisebe:

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni.

• Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha umdlavuza we-gallbladder.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuvimba amaseli ukuthi angahlukani. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Lesi sigaba esifingqiwe sichaza izindlela zokwelashwa ezicwaningwa ekuhlolweni kwemitholampilo. Kungenzeka kungasho yonke imishanguzo emisha efundwayo. Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Izisusa imisebe

Ukuhlolwa komtholampilo kucwaninga izindlela zokwenza ngcono umphumela wokwelashwa ngemisebe kumaseli we-tumor, kufaka phakathi okulandelayo:

• Ukwelashwa kwe-Hyperthermia: Ukwelashwa lapho izicubu zomzimba zichayeka emazingeni okushisa aphezulu ukulimaza nokubulala amangqamuzana omdlavuza noma ukwenza amangqamuzana omdlavuza azwele kakhulu emiphumeleni yokwelashwa ngemisebe kanye nemithi ethile elwa nomdlavuza.

• Ama-Radiosensitizers: Izidakamizwa ezenza amangqamuzana ama-tumor azwele kakhulu ekwelashweni ngemisebe. Ukunikeza ukwelashwa ngemisebe kanye nama-radiosensitizers kungabulala amangqamuzana amaningi wesimila.

Ukwelashwa komdlavuza we-gallbladder kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho zokwelashwa zomdlavuza we-Gallbladder

Kulesi Sigaba

• Umdlavuza we-Gallbladder Wendawo

• Umdlavuza we-Gallbladder we-Grebladder ongenakulinganiswa

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Umdlavuza we-Gallbladder Wendawo

Ukwelashwa komdlavuza we-gallbladder owenziwe endaweni kungafaka okulandelayo:

• Ukuhlinzwa ukususa i-gallbladder nezinye izicubu ezizungezile. Ingxenye yesibindi nama-lymph node aseduze nayo ingasuswa. Ukwelashwa ngemisebe noma ngaphandle kwamakhemikhali kungalandela ukuhlinzwa.

• Ukwelashwa ngemisebe noma ngaphandle kwamakhemikhali.

• Isivivinyo somtholampilo sokwelapha ngemisebe ngama-radiosensitizers.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Umdlavuza we-Gallbladder we-Grebladder ongenakulinganiswa

Ukwelashwa komdlavuza we-gallbladder ongaphindaphindeki, ophindayo, noma we-metastatic imvamisa kungaphakathi kwesivivinyo somtholampilo. Ukwelashwa kungafaka okulandelayo:

• I-percutaneous transhepatic biliary drainage noma ukubekwa kwama-stents ukukhulula izimpawu ezibangelwa yimibhobho ye-bile evinjiwe. Lokhu kungalandelwa ukwelashwa ngemisebe njengokwelashwa okunciphisayo.

• Ukuhlinzwa njengokwelashwa okunciphisayo ukukhulula izimpawu ezibangelwa yimibhobho ye-bile evinjiwe.

• Ukwelashwa ngamakhemikhali.

• Isivivinyo somtholampilo sezindlela ezintsha zokunikeza ukwelashwa ngemisebe ye-palliative, njengokuyinika kanye nokwelashwa kwe-hyperthermia, ama-radiosensitizers, noma i-chemotherapy.

• Isivivinyo somtholampilo semithi emisha nokuhlanganiswa kwezidakamizwa.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukuze ufunde kabanzi Ngomdlavuza we-Gallbladder

Ukuthola eminye imininingwane ngeNational Cancer Institute mayelana nomdlavuza we-gallbladder, bheka iGallbladder Cancer Home Page.

Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:

• Mayelana Nomdlavuza

• Isiteji

• I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli