Umdlavuza we-gallbladder
Umdlavuza we-gallbladder
Ukukhula kweseli eliyingozi eliqala ku-gallbladder kwaziwa ngokuthi umdlavuza wenyongo. Ngakwesokudla sesisu sakho, ngaphansi kwesibindi sakho, kunesitho esincane esimise okwepheya okuthiwa i-gallbladder. I-bile, uketshezi lokugaya oludalwe isibindi sakho, lugcinwe ku-gallbladder.
Umdlavuza wenyongo awuvamile. Amathuba okwelapha aphakeme uma umdlavuza wenyongo utholakala ezigabeni zawo zokuqala. Kodwa-ke, iningi lomdlavuza we-gallbladder litholakala ezigabeni zakamuva, lapho ukubikezela ngokuvamile kubi kakhulu.
Ngenxa yokuthi umdlavuza wenyongo ngokuvamile awubonisi zimpawu noma izimpawu ezithile, ungase ungabonakali uze uthuthuke. Umdlavuza wenyongo nawo usemathubeni amaningi okuthi usabalale ungabonwa ngenxa yokuba yimfihlo okuhlobene kwenyongo.
Amaseli ayingozi (umdlavuza) atholakala ezicutshini ze i-gallbladder esimweni esingavamile esaziwa ngokuthi umdlavuza we-gallbladder. I-gallbladder iyisitho esimise okwepheya esitholakala phezulu kwesisu eduze kwesibindi. I-bile, into ekhiqizwa isibindi ukuze ihlukanise amafutha, igcinwa ku-gallbladder. Umgudu wenyongo ovamile, oxhumanisa inyongo, isibindi, kanye nengxenye yokuqala yamathumbu amancane, uvumela i-bile evela ku-gallbladder ukuthi ikhishwe lapho ukudla kugaywa esiswini nasemathunjini.
Izimpawu nezimpawu zomdlavuza wenyongo
Lezi nezinye izimpawu nezimpawu zingabangelwa umdlavuza wenyongo noma ezinye izimo. Hlola nodokotela wakho uma unokunye kwalokhu okulandelayo:
I-jaundice (isikhumba esiphuzi kanye nabamhlophe bamehlo).
Ubuhlungu ngaphezu kwesisu
Fever
I-nausea nokuhlanza
Ukuvimbela
Izigaxa esiswini
Izimbangela zomdlavuza we-gallbladder
Imbangela eqondile yomdlavuza wenyongo ayaziwa. Odokotela bayazi ukuthi ukuthuthukiswa kwe-DNA engavamile kumaseli e-gallbladder enempilo kuholela ekuthuthukisweni komdlavuza we-gallbladder. Iziqondiso ezazisa ingqamuzana lokho okumelwe likwenze zifakwe ikhodi ku-DNA yalo. Izinguquko ziyalela amangqamuzana ukuba ande angahloliwe futhi aphile isikhathi eside kunamanye amaseli uma kungenjalo. Amaseli aqoqayo adala isimila, esinamandla okuhamba ngaphandle kwenyongo nakwezinye izingxenye zomzimba.
Amangqamuzana endlala aklelisa ingaphakathi le-gallbladder yilapho iningi lomdlavuza wenyongo liqala khona. I-Adenocarcinoma yigama lomdlavuza wenyongo ovela kula maseli. Uma amangqamuzana omdlavuza ehlolwa ngesibonakhulu, athatha le ncazelo.
Izici eziyingozi zomdlavuza we-gallbladder
Izinto ezingandisa ingozi yomdlavuza we-gallbladder zihlanganisa:
- Ubulili bakho. Umdlavuza wenyongo uvame kakhulu kwabesifazane.
- Iminyaka yakho. Ingozi yakho yomdlavuza wenyongo iyanda njengoba ukhula.
- Umlando wamatshe enyongo. Umdlavuza wenyongo uvame kakhulu kubantu abanamatshe enyongo noma abake baba nenyongo esikhathini esidlule. Amatshe enyongo amakhulu angase athwale ingozi enkulu. Noma kunjalo, i-gallstones ivame kakhulu futhi nakubantu abanalesi simo, umdlavuza we-gallbladder uyivelakancane kakhulu.
- Ezinye izifo nezimo ze-gallbladder. Ezinye izimo ze-gallbladder ezingandisa ingozi yomdlavuza we-gallbladder zihlanganisa ama-polyps, ukuvuvukala okungapheli kanye nokutheleleka.
- Ukuvuvukala kwe-bile ducts. I-Primary sclerosing cholangitis, ebangela ukuvuvukala kwemigudu ekhipha i-bile ku-gallbladder nesibindi, yandisa ingozi yomdlavuza we-gallbladder.
Ukuxilongwa komdlavuza we-gallbladder
Umdlavuza we-Gallbladder kunzima ukuwuthola nokuwuxilonga ngenxa yalezi zizathu ezilandelayo:
- Azikho izimpawu noma izimpawu ezigabeni zokuqala zomdlavuza we-gallbladder.
- Izimpawu zomdlavuza wenyongo, uma zikhona, zifana nezimpawu zezinye izifo eziningi.
- I-gallbladder ifihliwe ngemuva kwesibindi.
Umdlavuza we-Gallbladder ngezinye izikhathi utholakala lapho i-gallbladder ikhishwa ngenxa yezinye izizathu. Iziguli ezine-gallstones azivamile ukuba nomdlavuza we-gallbladder.
Ukuxilongwa nokutholwa
Izinqubo ezenza izithombe zenyongo nendawo ezungezile zisiza ukuxilonga umdlavuza wenyongo futhi zibonise ukuthi umdlavuza ususabalele kangakanani. Inqubo esetshenziselwa ukuthola ukuthi amangqamuzana omdlavuza asabalale ngaphakathi naseduze kwe-gallbladder ibizwa ngokuthi i-staging.
Ukuze uhlele ukwelashwa, kubalulekile ukwazi ukuthi umdlavuza wenyongo ungasuswa yini ngokuhlinzwa. Ukuhlolwa kanye nezinqubo zokuthola, ukuhlonza, kanye nomdlavuza we-gallbladder esiteji ngokuvamile kwenziwa ngesikhathi esisodwa. Izivivinyo ezilandelayo nezinqubo zingasetshenziswa:
- Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukubheka izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.
- Ukuvivinya kokusebenza kwesibindi: Inqubo lapho isampula legazi lihlolwa ukuze kulinganiswe amanani ezinto ezithile ezikhishelwe egazini yisibindi. Inani eliphakeme kunelijwayelekile lento ingaba uphawu lwe isifo sesibindi esingase sibangwe umdlavuza wenyongo.
- Izifundo zamakhemikhali egazi: Inqubo lapho kuhlolwa khona isampula yegazi ukuze kulinganiswe amanani ezinto ezithile ezikhishelwe egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphezulu noma eliphansi kunokuvamile) lento lingaba uphawu lwesifo.
- Ukuskena kwe-CT (ukuskena kwe-CAT): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi emzimbeni, njengesifuba, isisu, ne-pelvis, ezithathwe kuma-engeli ahlukene. Izithombe zenziwa ikhompuyutha exhunywe kumshini we-x-ray. Udayi ungase ujovwe emthanjeni noma ugwinywe ukuze usize izitho noma izicubu zibonakale ngokucacile. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computerized axial tomography.
- Ukuhlolwa kwe-Ultrasound: Inqubo lapho amagagasi omsindo onamandla aphezulu (i-ultrasound) ebhampa ezicutshini zangaphakathi noma ezithweni futhi enze kunanela. Ama-echoes akha isithombe sezicubu zomzimba ezibizwa ngokuthi i-sonogram. I-ultrasound yesisu iyenziwa ukuxilonga umdlavuza wenyongo.
- I-PTC (i-percutaneous transhepatic cholangiography): Inqubo esetshenziswa ukwenza i-x-ray isibindi namapayipi enyongo. Inalithi ezacile ifakwa esikhumbeni ngaphansi kwezimbambo nasesibindini. Udayi ujovwa esibindini noma emiseleni yenyongo bese kuthathwa i-x-ray. Uma kutholakala ukuvaleka, ishubhu elincanyana, eligobekayo elibizwa ngokuthi i-stent ngezinye izikhathi liyashiywa esibindini ukuze likhiphe i-bile emathunjini amancane noma esikhwameni sokuqoqa ngaphandle komzimba.
- I-ERCP (i-endoscopic retrograde cholangiopancreatography): Inqubo esetshenziselwa ukwenza i-x-ray imigudu (amashubhu) athwala i-bile isuka esibindini iye enyongweni futhi isuke enyongweni iye emathunjini amancane. Kwesinye isikhathi umdlavuza wenyongo udala ukuthi le migudu ibe mincane futhi ivimbe noma ibambezele ukugeleza kwebile, okubangela i-jaundice. I-endoscope (ishubhu elincanyana, elikhanyayo) lidlula emlonyeni, emthonjeni, nasesiswini liye engxenyeni yokuqala yamathumbu amancane. I-catheter (ishubhu elincane) bese ifakwa nge-endoscope emiseleni ye-bile. Udayi ujovwa nge-catheter emiseleni bese kuthathwa i-x-ray. Uma imigudu ivinjwe a isisu, ishubhu elihle lingase lifakwe embotsheni ukuze liwuvule. Leli shubhu (noma i-stent) lingashiywa endaweni ukuze kugcinwe ipayipi livulekile. Amasampula ezicubu nawo angase athathwe.
- I-MRI (imaging resonance magnetic) nge-gadolinium: Inqubo esebenzisa uzibuthe, amaza omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi emzimbeni. Into ebizwa ngokuthi i-gadolinium ijovwa emthanjeni. I-gadolinium iqoqa ezungeze amaseli omdlavuza ukuze abonakale ngokugqamile esithombeni. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (NMRI).
- I-Endoscopic ultrasound (EUS): Inqubo lapho i-endoscope ifakwa khona emzimbeni, ngokuvamile ngomlomo noma nge-rectum. I-endoscope iyithuluzi elincanyana, elifana neshubhu elinokukhanya kanye nelensi yokubukwa. I-probe ekugcineni kwe-endoscope isetshenziselwa ukubhampa amaza omsindo onamandla aphezulu (i-ultrasound) ephuma ezicutshini zangaphakathi noma izitho futhi enze ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba ezibizwa ngokuthi i-sonogram. Le nqubo ibizwa nangokuthi i-endosonography.
- I-Laparoscopy: Inqubo yokuhlinzwa yokubheka izitho ezingaphakathi kwesisu ukuhlola izimpawu zesifo. Izimbobo ezincane (ukusikeka) zenziwa odongeni lwesisu kanye ne-laparoscope (ishubhu elincanyana, elikhanyayo) lifakwa kwesinye sezimbobo. Amanye amathuluzi angase afakwe ngendlela efanayo noma ngezinye izindlela ukuze enze izinqubo ezinjengokukhipha izitho noma ukuthatha amasampula ezicubu ukuze ahlolwe. I-laparoscopy isiza ukuthola ukuthi umdlavuza ungaphakathi kwenyongo kuphela noma ususabalele ezicutshini eziseduze nokuthi ungasuswa yini ngokuhlinzwa.
- Biopsy: Ukukhishwa kwamaseli noma izicubu ukuze zibukwe ngesibonakhulu udokotela wezifo ukuze ahlole izimpawu zomdlavuza. I-biopsy ingenziwa ngemuva kokuhlinzwa ukuze kukhishwe isimila. Uma isimila ngokusobala singakwazi ukususwa ngokuhlinzwa, i-biopsy ingase yenziwe kusetshenziswa inaliti enhle ukuze kukhishwe amaseli esimila.
Izigaba zomdlavuza we-gallbladder
Isigaba 0 (I-Carcinoma eSitu)
Esigabeni 0, amaseli angavamile atholakala ku-mucosa (ungqimba lwangaphakathi) lodonga lwenyongo. Lawa maseli angajwayelekile angase abe umdlavuza futhi asabalale esicutshini esivamile esiseduze. Isigaba 0 naso ebizwa ngokuthi i-carcinoma in situ.
Isigaba I
Esigabeni I, umdlavuza wakheka kulwelwesi lwamafinyila (ungqimba olungaphakathi impela) lodonga lwenyongo futhi kungenzeka ukuthi usakazeke ongqimbeni lwemisipha yodonga lwenyongo.
Isigaba II
Isigaba II sihlukaniswe ngezigaba IIA kanye ne-IIB, kuye ngokuthi umdlavuza usakazeke kuphi ku-gallbladder.
- Esigabeni se-IIA, umdlavuza ususabalele ngongqimba lwemisipha uye ongqimbeni lwezicubu ezixhumeneyo zodonga lwenyongo ohlangothini lwenyongo olungekho eduze kwesibindi.
- Esigabeni se-IIB, umdlavuza ususabalele ngongqimba lwemisipha uye ongqimbeni lwezicubu ezixhumeneyo zodonga lwenyongo ngasohlangothini olufanayo lwesibindi. Umdlavuza awusabalele esibindini.
Isigaba III
Isigaba III sihlukaniswe izigaba IIIA kanye ne-IIIB, kuye ngokuthi umdlavuza usakazeke kuphi.
- Esigabeni se-III, umdlavuza ususabalele ngongqimba lwezicubu ezixhumeneyo zodonga lwenyongo futhi okukodwa noma ngaphezulu kokulandelayo kuyiqiniso:
- Umdlavuza ususabalele ku-serosa (ungqimba lwezicubu ezivala inyongo).
- Umdlavuza ususabalele esibindini.
- Umdlavuza ususabalele esithweni esisodwa esiseduze noma isakhiwo (njengesisu, amathumbu amancane, ikholoni, amanyikwe, noma imigudu yenyongo ngaphandle kwesibindi).
- Esigabeni IIIB, umdlavuza wakheka kulwelwesi lwenyongo (ungqimba lwangaphakathi) lodonga lwenyongo futhi kungenzeka ukuthi ususakazekele esicutshini, izicubu ezixhumene, noma i-serosa (ungqimba lwesicubu esimboze inyongo) futhi kungenzeka ukuthi ususakazekele esibindini noma esibindini. isitho esisodwa esiseduze noma isakhiwo (njengesisu, ithumbu elincane, ikholoni, amanyikwe, noma imigudu yenyongo ngaphandle kwesibindi). Umdlavuza ususabalele kuma-lymph node owodwa kuya kwamathathu aseduze.
Isigaba IV
Isigaba IV sihlukaniswe izigaba IVA kanye IVB.
- Esigabeni se-IVA, umdlavuza ususabalele ku-portal vein noma i-hepatic artery noma ezithweni ezimbili noma ngaphezulu noma izakhi ngaphandle kwesibindi. Kungenzeka ukuthi umdlavuza ususabalele kuma-lymph node owodwa kuya kwamathathu aseduze.
- Esigabeni se-IVB, umdlavuza kungenzeka ususabalele ezithweni noma ezakhiweni eziseduze. Umdlavuza ususabalele:
- kuma-lymph nodes amane noma ngaphezulu aseduze; noma
- kwezinye izingxenye zomzimba, njenge-peritoneum nesibindi.
Ukwelashwa komdlavuza wenyongo
- Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza wenyongo.
- Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:
- Ukuhlinzwa
- Ukwelashwa kwamafutha
- Ukwelashwa ngamakhemikhali
- Izinhlobo ezintsha zokwelapha ziyahlolwa izivivinyo zokwelashwa.
- Izinzwa ze-radiation
- Ukwelapha okuhlosiwe
- immunotherapy
Thatha umbono wesibili ngokwelashwa komdlavuza wenyongo
- Amazwana Avaliwe
- Juni 23rd, i-2022
