Ngā mea e hiahia ana koe kia mōhio mō te Matepukupuku Ampullary

Kua kite koe i ēnei rā tata nei kua kōwhai haere ō kanohi me tō kiri? Kua ngaro whakarere rānei tō taumaha, kāore he take e kitea ana? Ahakoa he mea noa ēnei e whakaarohia ana e tātou kāore e aro nui ana ki tēnei, koinei pea ngā tohu tuatahi o tētahi mate onge engari he kino e kiia nei ko te Matepukupuku Ampullary. Kaua e mataku ina rongo koe i tēnei ingoa. Ko te mea nui ko te mōhio ki ngā āhuatanga katoa o tētahi mate. Nō reira, i tēnei rā ka kōrero tātou mō te Matepukupuku Ampullary, me pēhea te whanaketanga, ngā tohu, me ngā tikanga maimoatanga i roto i tētahi huarahi māmā e mārama ai koe.

He aha te Matepukupuku Ampulary?

Hei mārama ki tēnei, me mōhio tātou ki tētahi wāhanga iti o tō tātou tinana. E rua ngā okana o roto i tō tātou tinana, ko te repeure me te ate. Ka whakaputahia e ēnei okana e rua ngā wai motuhake hei āwhina i a tātou ki te nakunaku i ā tātou kai. Whakaarohia ka huihui ēnei wai e rua, ka tae ki te wāhi kotahi, pērā i te whakawhitinga o ngā rori e rua. Kātahi ka huihui mai i reira ēnei wai katoa ka haere ki roto i tō tātou whekau iti (duodenum).

I roto i te rongoā, ka kiia te pūaha iti nei te wāhi e kohia ai e taua wai ko te ampulla o Vater .

Nō reira, ina tīmata ngā pūtau matepukupuku ki te tipu i tēnei wāhi e kiia nei ko te ampulla o Vater , ka kiia e mātou ko te ampullary carcinoma . He momo matepukupuku tino kaha tēnei. Waihoki, nā te mea he tata rawa te wāhi e whanake ana ki ngā whekau tino nui pērā i te ate me te repeure, he nui te tūponotanga ka horapa te matepukupuku ki aua whekau. Nō reira, ko te huarahi pai ki te whiwhi hua pai ko te tango i tēnei matepukupuku mā te pokanga i mua i te horapa.

He pēhea te noa o tēnei mate?

He mate pukupuku tino onge tēnei. Neke atu i te 1% o ngā mate pukupuku katoa i roto i te pūnaha nakunaku (ara gastrointestinal) e kīia ana he mate pukupuku ampullary. Nō reira, ehara tēnei i te mate e pāngia ana e te katoa.

He aha ngā tohu? Me pēhea tātou e mōhio ai ki tēnei?

Ko te mea tino ahurei mō tēnei mate pukupuku ko te whakaatu i ngā tohu i ngā wāhanga tōmua. I roto i ēnei, ko te tohu matua me te mea tino kitea ko te jaundice . Ko te tikanga ka huri te mā o ngā kanohi me te kiri ki te kōwhai.

Haunga tēnei tohu matua, he maha atu anō ngā tohu ka kitea. Me titiro tātou ki ēnei i roto i tētahi huarahi e māmā ai te mārama.

He aha i puta ai tēnei momo mate pukupuku?

Ina hoki, kāore anō kia taea e ngā tohunga te kī tika he aha i puta ai tēnei mate pukupuku āmpulary. Engari e mōhio ana tātou ka puta ngā mate pukupuku katoa ina he huringa (whakarerekētanga) kei roto i te DNA e whakahaere ana i ngā mōhiohio ira i roto i ngā pūtau o tō tātou tinana. Mā tēnei ara, ka tīmata ngā pūtau rerekē me ngā huringa DNA ki te wehewehe tere me te kore e taea te whakahaere. Ka puta he pukupuku mate pukupuku ina tupu tahi ngā pūtau maha me te kore e taea te whakahaere.

Kei te rangahau tonu ngā tohunga i ngā huringa DNA e pā ana ki tēnei mate pukupuku. I runga i aua mōhiohio, tera pea ka kitea he maimoatanga whai hua ake a muri ake nei.

Ngā Take Mōrearea

He maha ngā āhuatanga e whakanui ake ana i te mōrearea o te whakawhanaketanga o tēnei mate pukupuku:

• Neke atu i te 70 tau te pakeke: Ka piki ake te mōrearea i te pakeketanga.
• Te tāne: He nui ake te kitea o tēnei mate pukupuku i roto i ngā tāne i ngā wāhine.
• Ētahi āhuatanga ira: Ka taea e ētahi āhuatanga ira te whakanui ake i te mōrearea o te mate pukupuku. Hei tauira, ko ngā āhuatanga pēnei i te Familial Adenomatous Polyposis (FAP) me te Lynch syndrome.

Me pēhea te tātaritanga tika a te tākuta i tēnei mate? (Tauātanga)

I te nuinga o te wā, ina haere te tangata ki te tākuta me ngā kanohi kōwhai me te kiri (jaundice), ka ara ake ngā whakapae, ā, ka tīmata ngā whakamātautau. He maha ngā whakamātautau ka mahia hei whakaū i te mate.

• Ngā whakamātautau toto me te mimi: Ka tirohia e ēnei ngā taumata o ngā matū i roto i te tinana e pā ana ki ngā pūtau matepukupuku, e kiia nei ko ngā tohu pukupuku.
• Ngā Whakamātautau Whakaahua: Ka whakamahia ēnei hei tango pikitia o ngā whekau o roto i te tinana hei tirotiro mō te mate pukupuku. Ka whakamahia ngā whakamātautau pēnei i te 'CT scan', te 'Ultrasound scan' me te 'MRCP' mō tēnei.
• Ngā Whakamātautau Endoscopy: Ko te whakauru i tētahi ngongo roa, angiangi (endoscope) me tētahi kāmera e piri ana ki roto i tō waha hei tirotiro i te mate pukupuku. Ko te endoscopy o runga me te ERCP (Endoscopic Retrograde Cholangiopancreatography) ētahi o aua whakamātautau. Ka hoatu he rongoā whakamoe ki a koe i roto i ēnei whakamātautau, kia kore ai koe e mamae.
• Te koiora:Koinei anake te whakamātautau ka taea te whakaū 100% mēnā he matepukupuku. I te wā o te endoscopy, ka tangohia he wahi kiko iti rawa mai i te wāhi whakapae, ka whakamatautauria i roto i te taiwhanga hei whakaū mēnā he pūtau matepukupuku kei roto.

He aha te whakatauranga o te mate pukupuku?

Kia kitea te mate, ka whakatauhia e te tākuta te horapa o te mate pukupuku. Ka kiia tēnei ko te whakatau i te taumata o te mate. Ka whakatauhia te maimoatanga i runga i tēnei taumata. Ko te mate pukupuku e kitea ana i ngā wāhanga tōmua ka nui ake te tūponotanga ka ora.

He mea tino nui mā te pātai atu ki tō tākuta kia mārama ai koe ki te wāhanga o tō matepukupuku me tōna pānga ki tō maimoatanga.

He aha ngā maimoatanga?

He maha ngā kōwhiringa maimoatanga mō te mate pukupuku ampullary.

• Te Tukanga Whipple:Koinei te pokanga tino noa, ā, ko te mea tino noa mō tēnei momo matepukupuku. He pokanga nui, tino uaua hoki. I roto i tēnei, ehara i te mea ko te matepukupuku tonu anake ka tangohia, engari ko ngā wāhi e karapoti ana i horapa ai pea ngā pūtau matepukupuku (te pūkahukahu, tetahi wāhanga o te awa au, tetahi wāhanga o te whekau iti, me te pane o te repeure).
• Pokanga Endoscopic: Mena kei te tīmatanga tonu te wahanga o te mate pukupuku, ka taea pea te tango i te mate pukupuku mā te whakamahi i te endoscope.
• Te rongoā matū: Ko te hoatutanga o ngā rongoā kaha ki te tinana hei patu i ngā pūtau matepukupuku. Ka hoatu tēnei maimoatanga hei patu i ngā pūtau matepukupuku e toe ana i muri i te pokanga, hei whakahaere rānei i te tipu o te matepukupuku ina kore e taea te pokanga.
• Whakaora Irahiko: Koinei te wāhi e whakamahia ai ngā hihi kaha o te pūngao hei whakangaro i ngā pūtau matepukupuku. I ētahi wā ka hoatuhia tēnei maimoatanga me te chemotherapy hei whakaiti i te pukupuku i mua i te pokanga, hei whakangaro rānei i ngā pūtau e toe ana i muri i te pokanga.
• Manaaki Whakaora: He maimoatanga tēnei e aro ana ki te whakaora i ngā tohumate, kaua ki te whakaora i te mate. Hei tauira, ka taea te whakanoho i tētahi stent ki roto i tētahi awaawa aukume kua āraia hei whakatuwhera. Ka āwhina tēnei ki te whakaiti i ngā tohumate pēnei i te jaundice me te kati, ka taea ai te whakarato i te whakaora nui.

Ka taea te whakaora katoa i tēnei mate pukupuku?

Ko te huarahi anake hei whakaora i tēnei mate pukupuku ko te tango katoa i te mate pukupuku mā te pokanga. Tērā pea ka angitu tēnei ina kitea te mate pukupuku i ōna wāhanga tōmua.

I ētahi wā ka ngaro katoa te mate pukupuku i muri i te pokanga. Heoi, ka taea te hoki mai anō i muri i tētahi wā (mate pukupuku hoki anō). Nō reira, ahakoa i muri i te pokanga, he mea nui tonu kia haere tonu ki te tākuta mō ngā whakamātautau me ngā wāhi rongoā e ai ki ngā taunakitanga. He tino teitei te mōrearea o te hoki anō o te mate pukupuku i roto i ngā tau tuatahi e rima.

He ara hei ārai i tēnei?

Engari, ko ngā āhuatanga mōrearea (te pakeketanga, ngā ira tuku iho) e puta ai tēnei mate pukupuku, ehara i te mea ka taea e tātou te whakahaere. Nō reira, kāore he huarahi motuhake hei ārai i tēnei. Heoi, ki te mea he mate ira tuku iho tōu pērā i te FAP, i te Lynch syndrome rānei, ka tūtohu pea tō tākuta kia tirotirohia koe i ia wā. Ka āwhina tēnei ki te kite i te mate pukupuku i te wā tōmua.

He mea noa te rongo i te taumaha me te ohorere ina rongo koe mō te mate pukupuku. Kōrerohia ki tō tākuta me tō whānau ō pātai, ō wehi, me ō ruarua. Ko te whiwhi i ngā mōhiohio tika, te maimoatanga tika, me te tautoko kare ā-roto he kaha nui i tēnei haerenga.