Izidumbu ze-Klatskin: Iimpawu kunye neZonyango

Isiqhumane seKlatskin ngumhlaza weengxube ze-bile. I-tumor yolu hlobo ifakwe kwi-duct ephezulu, apho ihlukaniswe phakathi kwe-lobes yesibindi. Izibilini ze-Klatskin zingazenza zombini okanye kumnye wabo, kunye nokuphuma kwibindi. Ngexesha le sifo, isisu singasasazeka kwimithambo yegazi.

Ulwazi olubanzi malunga nesifo

Nangona iyeza lonyango lifumene ezininzi izixhobo ezincedo apho kunokwenzeka ukuba zifumane kwaye zihlolisise ngokukhawuleza isifo, izifo ze-oncological zesibindi kunye ne-pancrea ziqondwa kakuhle. Ngokukodwa, le meko yezemicimbi ibandakanyeka kwinqanaba le-extracarticular ye-digestive system. Abasemngciphekweni besifo seKlatskin banamaqela athile obungozi . Owokuqala ngabantwana abangaphantsi kweminyaka emi-5 abangenayo i-pathologies yesigca esiswini. Okwesibini - abantu abaye bawela umgca oneminyaka engama-60 ubudala, abaneengxaki ezibalulekileyo zephepha lebhiliyari.

Izifo ze-ecological can rise for a variety of reasons, kodwa iyeza zanamhlanje ziqikelela oku kulandelayo: inkunkuma enobuthi ekhishwe emoyeni ngobuninzi; Ukuxinezeleka kunye nezinye iingxaki zesifo; Ukungcola kwendalo; Imikhwa emibi. Ukongezelela, imbangela yokubunjwa kwe-Klatskin inokusebenza kunye nokutya okungafanelekanga:

• Ukusetyenziswa kokutya okuguqulwa ngokwemizimba njengokutya;
• Ukusetyenziswa kakubi kotywala;
• Ukusetyenziswa kwenani elikhulu lamanyathelo okulondoloza nokutya.

Esi sifo sibonakala ngenxa yenkxwaleko yeengxaki ezibangela izifo ze-somatic. Ekugqibeleni bavelisa ukukhula okutsha kohlobo oluthile. Ukuba awuyikunyamekela iimpawu kwaye uqale isifo, ngokukhawuleza iqhubela phambili kwaye ibangela ukungakhululeki okukhulu.

Ukwahlula izidumbu ze-bile

1. Benign: i-papillomas, i-lipomas, i-adenomas.
2. I-Malignant: umdlavuza we- cholangiocellular, umdlavuza we- gallstream , umdlavuza we-bile .
3. I-Tumor yeKlatskin.

Ukwahlulelwa kwindawo yendawo

• Ukuxutywa kwamadaka e-bile nge-plug hepatic.
• Ukutshatyalaliswa kweminye yamadada.
• Ukutshatyalaliswa kwezi zombini.

Izikhalazo

Esi sifo sifumaneka ngabagqirha kakhulu. Impatho ephumelelayo ixhomekeke kwiimeko ezininzi, kodwa eyona nto ibalulekileyo yinkathalo yonyango kwigqirha. Ukuba umntu uphendukela kwingcali ngexesha, unyango kwiimeko ezininzi uphumelele, kodwa ukuba isifo sifunyiwe, iziphumo eziphumelelayo akunakwenzeka ukuba zilinde. Ngokuqhelekileyo isifo seKlatskin sifumaneka ngexesha loviwo ngenxa yezinye izifo ezinzima okanye ezingapheliyo zendlela yokugaya.

Kwezinye iimeko, izigulane ziza kugqirha kwi-gastroenterologist ngoncedo ngxaki enjalo. Izikhalazo eziqhelekileyo zezigulane kwimeko:

• Ixinzelelo kwicala;
• Ubuthathaka obunzima bomzimba kunye nokukhathala;
• Umlomo ongathandekiyo kwaye ungathandeki umlomo;
• Malaise.

I-oncology ngokwayo ifunyaniswa kungekhona nje. Inyaniso kukuba i-Klatskin isisu - i-jaundice engumatshini, njengokuba ibizwa ngokuba nayo-ineempawu ezifana nezifo ezahlukeneyo, ezifana ne-parenchyma yesibindi okanye i-bile ducts.

Iimpawu

Ngokwempawu, lesi sifo sinempawu elandelayo:

• Ukulahleka kwexabiso elithintekayo ngexesha elifutshane;
• I-Urine ithola umthunzi omnyama, iifesi zikhanya;
• Ngendlela esebenzayo yesi sifo kukhanda kwesikhumba, isikhumba seqhwa;
• I-tumor ekhulayo ibangela iintlungu kwiindawo ezahlukileyo zesisu, ezibonakala kwizigaba zesigulo.

Izizathu ze-etiological zokuphuhliswa kwezakhiwo ezinobungozi kwi-extrahepatic bile ducts azifihli. Kodwa ezi zilandelayo zingathathwa njengento ebalulekileyo ekuphuhlisweni kwesi sifo:

• Ngokuqhelekileyo kubantu abangaphezu kwama-60 i-tumor yeKlatskin iyenzeka ngokubambisana ne-cholelithiasis;
• Ukubaluleka okubaluleke kakhulu kunesimo semvelo, ngokukodwa kubantu abakhulileyo kodwa bengasemdala;
• Phakathi kwezifo zandulela, i- primary sclerosing cholangitis ingaqwalaselwa;
• Isifo esincinci sisifo sesifo sesifo se-hepatitis B ne-C.

Indlela yokufumanisa ukuba khona kwezifo

Ukufumana isisu seKlatskin, iindlela ezininzi zingasetyenziswa:

1. I-percutaneous cholangiography ye-Percutaneous - nge-nkqubo, oogqirha bafumana i-radiograph epheleleyo yeedy ducts. Ukuqhuba inkqubo, isigulane asivumelekanga ukuba sidle kwaye siphuze iiyure ezingama-6 ngaphambi kokuqala kwenkqubo, ngexesha elifanayo unikwa izidalwa zokuzikhethela. Inkqubo iqala ngokusungulwa kwe-anesthetic yangaphakathi kwisisu esifanelekileyo, kwaye inaliti encomekileyo ifakwe ngesikhumba ukuya kwi-bile ducts, apho idayi iyaziswa ngayo. Emva koko i-radiografi eyenziwa, ebonisa ukuba nayiphi na irregularities kwiphepha lebhiliyali yenzeka. Yonke inkqubo yokulawula ukuchaneka kwe-aldle hit isenziwa ngokusebenzisa umshini we-ultrasound. Ngaphambi nangemva kwe-cholangiography ye-transhepatic percutaneous, isigulane sichazwe ngamayeza anqanda ukukhuselwa.
2. Angiography. Olu hlobo lokuxilongwa lubekwe ukuba i-duct ifumaneka kwimida yegazi ephezulu yesibindi. Ngoncedo lwe-angiography, kunqunywe ukuba iinqanawa zichaphazelekayo. Yenziwe ngolu hlobo lulandelayo: ityhubhu encinci ifakwe kwi-artery inguinal, apho idayi ekhethekileyo iqhutyelwa kuyo, leyo idlulela kwi-artery.
3. I-Endoscopic retrograde ye-pancreatocholangiography isetyenziselwa ekuqaleni kwalo mhlaza, isebenza kwisithintelo senkunkuma. Yenzelwe ukuchonga ngokuchanekileyo ubude bekhosi yeenkqubo ze-pathological emva kokusebenzisa i-cholangiography ye-transhepatic percutaneous.
4. Unyango lwe-magnetic resonance ngenye yezindlela eziphambili zokuphanda i-tumor. Ivumela ukuchonga indawo eyiyo kwaye ibonise isakhiwo semithambo yegazi yesibindi.
5. I-Biopsy yindlela efanelekileyo kakhulu. Kuphela kukuvumela ukuba uchane ngokuchanekileyo ubukho be-tumor, isakhiwo sawo kunye nobume beetishu. Ngenxa yale njongo, kuthathwa i-puncture kwindawo ewonakalisiweyo, ehlolwe ngokuhlaziywa kwe-microbiological. Le nkqubo yenziwa ngokubambisana ne-percutaneous transhepatic cholangiography.

Unyango lwesifo

Njengoko sele kuthethwe ngaye, kunzima kakhulu ukuqonda isifo seKlatskin. Unyango lwe-cholangitis - kukuphunyezwa kweteti yemilinganiselo yokususa eso sifo. Ukuba unyango aluqalwanga ngexesha, isigulane ngokuqinisekileyo siya kufa kwiinyanga ezi-4-6. I-Cancer isifo esiphefumlelweyo kakhulu, isifo seKlatskin sinesimo esifanayo. Ukunyango kwesi sifo kudla ngokuba kususwa kweethambo ezichaphazelekayo. Kule meko, kufuneka ukuba igqibeleleyo, oko kukuthi, iifomthi ezichaphazelekayo zisuswa kunye nezicubu ezicocekileyo. Oku kwenziwa ukwenzela ukuba akukho zilwanyana ezinobungozi ezishiye kwindawo echaphazelekayo, ngamanye amaxesha enye ye-lobes yesibindi isuswe. Ukuba isifo se-Klatskin, esichazwe ngokubaluleka kwayo, asikwazi ukususwa ngenxa yomonakalo kwinkqubo yokujikeleza kwelo lonke iqumrhu, i-radiation kunye ne-chemotherapy esetyenzisiweyo, kodwa, njengommiselo, akusebenzi.

Kuphi ukukhangela uncedo

Nangona isifo esibuzwayo siyaziwa ngexesha elide kwaye kukho iindlela zokulwa nalo ngokususa iifom, asikho nanye indlela eya kumbuzo wokuphatha i-Klatskin ngesisu. Unyango lwe-cholangitis e-purulent iphumelele kakhulu kwaSirayeli kwiiklinikhi ezizodwa zokunyanga i-oncology. Kukho ixesha elide kukho konke okufunekayo ukunyanga umonakalo wesibindi salolu hlobo. Akuyiyo imfihlo yokuba ubani u-Israyeli yindawo yokugxininisa kweengcali ezinamandla kunazo zonke kwiinkcubeko zamachiza, ngoko kuyaqondakala ukuba kutheni i-tumor yeKlatskin iphinde iphathwe ngempumelelo apho. Impendulo evela kwizigulane ezaphathwa apho ibonisa ukuba inkonzo kwiiklinikhi zomhlaza zakwa-Israyeli ziphezulu.