Cholangiocarcinoma

ʻO Cholangiocarcinoma (CCA) kahi ulu maʻi ʻaʻano maʻi nui (malignant) i kekahi o nā aʻa e hāpai i ka lāʻau mai ke ake a i ka ʻōpū liʻiliʻi.

ʻAʻole ʻike ʻia ke kumu kikoʻī o CCA. Eia nō naʻe, ua holomua mua ka nui o kēia mau tumors e ka manawa i loaʻa ai iā lākou.

Hoʻomaka paha ʻo CCA ma nā wahi a pau o ke aʻa aʻa. Kūleʻa kēia mau tumors i nā aʻa oʻa.

Hoʻopili ʻia nā kāne a me nā wahine. ʻOi aku ka nui o ka poʻe ma mua o 65.

Loaʻa i ka poʻe me nā pilikia olakino keu ka manawa kiʻekiʻe o ka hoʻomōhala ʻana iā CCA:

• Bile duct (choledochal) cista
• ʻO ka biliary āpau a me ka mumū o ke ake
• ʻO ka mōʻaukala o ka maʻi me nā ilo parasite, nā flukes o ke ake
• ʻO cholangitis sclerosing mua
• Ulcerative colitis

Pākuʻi ʻia paha nā ʻōuli o CCA i kekahi o kēia mau mea:

• Fiva a me nā anuanu
• Nā noho polū-pālolo a me ka mimi ʻeleʻele
• Kāwili
• Loaʻa ka ʻai ʻole
• ʻEha ma ka ʻōpū ʻākau i luna e hoʻomālamalama i ka hope
• Kaumaha emi
• Melemele o ka ʻili (jaundice)

E hana i kāu mea mālama ola i kahi hoʻokolohua kino. E hana ʻia nā hoʻokolohua e nānā no kahi tumo a i ʻole blockage i ke kahena o ka bile. Pākuʻi ʻia kēia mau mea:

• Scanner CT ʻōpū
• ʻO ke ultrasound ʻōpū
• Ke kaʻina hana e hoʻohana ai i kahi e ʻike ai e nānā i nā dule o ka bile (ERCP), kahi e lawe ʻia ai ke kino a nānā ʻia ma lalo o kahi microscope

Hiki ke hana ʻia nā hoʻokolohua koko e:

• Nā ho'āʻo hana ate (ʻoi aku ka nui o nā alkaline phosphatase a i ʻole bilirubin pae)
• Helu piha koko (CBC)

ʻO ka pahuhopu ka mālama ʻana i ka maʻi ʻaʻai a me ka blockage āna i hana ai. Ke hiki, ʻoki e wehe i ka tumo ka lapaʻau ʻana o ke koho a he hopena paha ka hopena. Ua laha pinepine ka maʻi ʻaʻai i kahi a i ʻole i kahi ʻē aʻe o ke kino e ka manawa i ʻike ʻia ai. ʻO ka hopena, ʻaʻole hiki ke ʻoki e hoʻōla i ka maʻi ʻaʻai.

Chemotherapy a radiation paha e hāʻawi ʻia ma hope o ke kahakaha ʻana e hoʻemi i ka makaʻu o ka maʻi ʻaʻai.

I nā hihia i koho ʻia, hiki ke hoʻāʻo i kahi transplant ake.

Hiki i ka endoscopic therapy me ke kau stent ke hoʻokuʻu i nā wahi i nā kaola biliary. Hiki i kēia ke hoʻokuʻu i ka jaundice ke hiki ʻole ke hemo ka tumo.

ʻO ka wehe loa ʻana i ka tumo e ʻae i kekahi poʻe e ola me ka hiki ke hoʻōla piha.

Inā hiki ʻole ke hemo loa i ka tumo, ʻaʻole hiki i kahi hoʻōla. Me ka mālama ʻana, ma kahi o ka hapalua o ka poʻe i hoʻopilikia ʻia e ola nei i hoʻokahi makahiki, a ma kahi o ka hapalua e ola nei ka lōʻihi, akā kakaikahi wale nō ma mua o 5 mau makahiki.

ʻO ka Hospice kahi kumuwaiwai maikaʻi maikaʻi loa no ka poʻe me CCA i hiki ʻole ke hoʻōla ʻia.

ʻO nā pilikia o CCA:

• Maʻi kīnā
• Hoka kōpaʻa
• Hoʻolahalaha (metastasis) o ka tumo i nā meaola ʻē aʻe

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe i ka jaundice a i ʻole nā ​​hōʻailona ʻē aʻe o cholangiocarcinoma.

Maʻi ʻaʻai ʻo Bile duct

• ʻŌnaehana Digestive
• Ala hele bile

Pūnaewele ʻo National Cancer Institute. Hoʻomaʻamaʻa ʻia ʻo Bile duct cancer (cholangiocarcinoma) (PDQ) - mana ʻoihana olakino. www.cancer.gov/types/liver/hp/bile-duct-treatment-pdq. Hoʻohou ʻia Kepakemapa 23, 2020. Loaʻa iā Nowemapa 9, 2020.

Rajkomar K, Koea JB. Intrahepatic cholangiocarcinoma. I: Jarnagin WR, hoʻoponopono. ʻO Blumgart's Surgery of the Liver, Biliary Tract a me Pancreas. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2017: chap 50.

Rizvi SH, Gores GJ. ʻO nā Tumors o nā aʻa o ka bile, gallbladder, a me ampulla. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 69.