E mōhio ana koe ki te Cholangiocarcinoma? Me kōrero māmā noa iho.

Kua pāngia koe e tētahi mamae rerekē i te taha matau o tō puku, i raro i ō rara, he kōwhai o tō kiri me ō kanohi (pērā i te jaundice), he ngoikore noa iho rānei? Ahakoa he āhua noa ēnei, i ētahi wā he take nui kei muri i ēnei. I tēnei rā ka kōrero tātou mō tētahi momo mate pukupuku onge engari he tino morearea pea. Ko te mate pukupuku awa waikura tēnei, e mōhiotia whānuitia ana i te taha hauora ko te Cholangiocarcinoma .

He aha te cholangiocarcinoma?

Āe, me titiro tuatahi tātou he aha ēnei awa au. Whakaarohia, ka puta he wai i roto i tō tātou ate e kiia nei ko te "au". He tino āwhina tēnei ki te nakunaku i ngā kai momona. Nō reira, ko te pūnaha o ngā ngongo iti e kawe ana i tēnei au mai i te ate ki tō tātou whekau iti e kiia nei ko ngā awa au .

He mate pukupuku te cholangiocarcinoma e tīmata ana i roto i ngā pūtau o te pūnaha awa au.

He momo mate pukupuku tino kaha tēnei. Ko te mea pouri, i te nuinga o te wā, i te wā e kitea ai tēnei mate pukupuku, kua horapa kē ki tua atu i ngā awaawa o te ate. I roto i tēnei āhua, he tino uaua te rongoā, ā, he kino te matapae. Kaua e manukanuka, kei te kimi tonu ngā tākuta me ngā kaipūtaiao i ngā maimoatanga hou hei whakahaere i te horapa o tēnei mate pukupuku, hei whakapai ake hoki i te oranga o ngā tūroro.

He aha ngā momo matua o tēnei mate pukupuku?

E toru ngā momo matua o te mate pukupuku awaawa e ai ki tōna wāhi:

1. Kolangiocarcinoma intrahepatic: Ka puta tēnei i roto i ngā awaawa aukume iti i roto i te ate .

2. Te mate pukupuku kōrokoro o te kiriuhi/kiriuhi: Koinei te momo tino noa. Ka puta tata ki te hilum, te wāhi e puta ai ngā awa waikura i te ate. Ka kiia hoki ko te pukupuku Klatskin .

3. Kolangiocarcinoma tawhiti: Ka puta tēnei momo i roto i ngā awaawa aukume kei waho o te ate, e tata ana ki te whekau iti.

Ko ngā momo 2 me te momo 3 e kiia ana ko ngā mate pukupuku o te awaawa o waho o te ate . Arā, ko ngā mate pukupuku e whanake ana "i waho o te ate".

He aha pea ngā tohu o tēnei mate?

I te nuinga o te wā, kāore he tohu e puta mai ana kia tino nui rawa te mate pukupuku, ā, kia aukati i te awaawa au. Ina puta mai ngā tohu, tera pea ka kite koe i ēnei mea.

I ngā wāhanga tōmua, kāore tēnei mate pukupuku e mamae. Heoi, i te tipu haere o te pukupuku, ka pā pea te mamae ki te taha matau o te puku. Mō ētahi tāngata, ka horapa pea tēnei mamae ki ētahi atu wāhanga o te puku, ki te tuara rānei.

He aha ngā take me ngā āhuatanga mōrearea e pā ana ki te whanaketanga o tēnei mate pukupuku?

Kāore anō kia kitea te tino pūtake o tēnei mate pukupuku. Heoi, e whakaponohia ana ko te mumura mau tonu , arā, ko ngā āhuatanga mumura, i roto i ngā awaawa aukume, te tino take pea.

I te whakarapopototanga, ka taea e te kino tonu te whakakino i te DNA o ngā pūtau awaawa. He rite te DNA ki te "mahere matua" e tohutohu ana i ā tātou pūtau me pēhea te mahi. Ina pakaru tēnei DNA, ka tīmata ngā pūtau ki te wehewehe me te kore e taea te whakahaere, ka arahi ki te hanganga o ngā pukupuku matepukupuku.

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

• Ngā mate e pā ana ki ngā awaawa o te kōpū: Ngā āhuatanga pēnei i ngā kōhatu o te kōpū, ngā kōhatu o te awaawa o te kōpū, me te 'Primary sclerosing cholangitis' (he mate e whaiti ai, e ārai ai hoki ngā awaawa o te kōpū).
• Ngā mate ate: Te cirrhosis (te whara o te ate), ngā mate pukupuku Hepatitis B, Hepatitis C rānei.
• Ētahi atu āhuatanga hauora: Te mate puku mumura mau tonu, Te mate puku mumura (IBD), Te mate huka.
• Ngā āhuatanga o te noho: te nui o te inu waipiro, te momona, te momi hikareti.
• Ngā mate pirinoa: He mate pirinoa e kiia nei ko te 'Clonorchiasis' he mea tino noa i ngā whenua o Āhia ki te Tonga-mā-rāwhiti.
• Te pānga ki ngā matū paitini: Ko ētahi matū, inā koa ko ērā e whakamahia ana i roto i ngā wheketere rapa, i ngā wheketere motuka rānei.

Me pēhea te tautuhi a te tākuta i tēnei mate?

Ina kite koe i tētahi tākuta, ka whakarongo tuatahi ia ki ō tohumate, ka tango i tō hītori hauora, ā, ka whakahaere i tētahi whakamātautau tinana. Kātahi, ki te whakapaetia he mate pukupuku, ka tūtohu pea rātou i ētahi whakamātautau, pēnei i:

Ngā Whakamātautau Toto

• Ngā whakamātautau mahi ate: Ka taea e ēnei te whakaatu i te pai o te mahi a te ate. Mēnā ka āraia ngā awaawa o te ate, ka piki ake ngā taumata o ētahi whākōkī ('ngā whākōkī ate') i roto i te toto.
• Ngā whakamātautau tohu pukupuku: Ngā whakamātautau e ine ana i ētahi matū (ngā tohu pukupuku) e piki ake ana i roto i te toto ina kitea te mate pukupuku. Ko te 'CA 19-9' me te 'CEA' he tohu e rua ka piki ake i roto i tēnei momo mate pukupuku.

Ngā Whakamātautau Whakaahua

• Ko te tikanga ka mahia tuatahitia he matawai ultrasound o te puku.
• Hei tāpiritanga, ka taea te mahi i tētahi matawai CT , i tētahi matawai MRI rānei. Ko te magnetic resonance cholangiopancreatography (MRCP) he momo MRI motuhake e taea ai te kite mārama i te pūnaha awaawa aukume.

Ngā Whakamātautau Endoscopy

Ko te tikanga o tēnei ko te whakauru i tētahi ngongo angiangi, ngāwari (endoscope) me tētahi kāmera e piri ana mā roto i tō waha, ka tukuna mā roto i tō puku ki roto i tō whekau iti, te wāhi e tuwhera ai ngā awaawa au, ā, ka āta tirotirohia te wāhi. Ka whakamoea koe i tēnei mahi, kia kore ai koe e pāngia e te mamae. He whakamātautau noa te Endoscopic retrograde cholangiopancreatography (ERCP).

Te koiora

I konei, ka tangohia he wahi kiko iti rawa mai i te wāhi whakapae, ka tirohia i raro i te karu hiko. Ka taea te tiki i tēnei wahi kiko i te wā o te tikanga ERCP. Ka taea hoki te whakamātautau i tēnei tauira kiko mō ngā huringa ira (ngā tohu koiora) i roto i ngā pūtau matepukupuku. Ka taea hoki e tēnei te āwhina ki te whakatau mēnā ka taea te hoatu he "rongoā arotahi" motuhake ki ētahi tāngata.

He aha ngā wāhanga me ngā maimoatanga o te mate pukupuku?

Kia kitea te mate, ka whakatauhia e mātou te taumata o te mate pukupuku kia kitea ai te horapa o roto i te tinana. He mea tino nui tēnei mō te whakamahere maimoatanga. I te nuinga o te wā ka whakarōpūtia ki ngā taumata 0 ki te 4. Ko te taumata 4 te tikanga kua horapa te mate pukupuku ki tua atu i ngā awaawa o te ate ki ngā wāhanga tawhiti o te tinana (metastatic).

Ka whakatauhia te tikanga maimoatanga e te wāhi o te mate pukupuku, tōna wāhanga, me te hauora whānui o te tūroro.

• Pokanga: Ki te kore te mate pukupuku e horapa, ko te pokanga te maimoatanga pai rawa atu hei tango katoa i te mate pukupuku me ngā kiko e karapoti ana. I ētahi wā ka whakamahia hoki te pokanga hei whakanoho i tētahi stent hei pupuri i te awaawa aukume kia tuwhera tonu.
• Te whakawhitinga ate: He tūponotanga pai te whakawhitinga ate ki te rongoā mō ētahi mate pukupuku perihilar i te wā tōmua.
• Te rongoā irahiko: Ka whakamahia ngā hihi kaha-nui hei whakangaro i ngā pūtau matepukupuku, hei whakaiti rānei i ngā pukupuku.
• Te rongoā matū: Te hoatutanga o ngā rongoā ki te tinana hei patu i ngā pūtau matepukupuku.
• Te rongoā arotahi: Kei roto i tēnei ko te hoatu i ngā rongoā e arotahi ana ki ngā pūmua motuhake e āwhina ana i ngā pūtau matepukupuku ki te tipu me te aukati i ā rātou mahi.
• Ārai Mate: Te hoatu rongoā hei whakaoho i te pūnaha ārai mate o te tinana, hei āwhina hoki i a ia ki te whawhai ki ngā pūtau matepukupuku.

He huarahi hei tiaki i a koe i tēnei mate?

Kāore he huarahi hei ārai i te whanaketanga o tēnei mate pukupuku 100%. Heoi, ka taea e tātou te whakaiti i te mōrearea mā te pupuri i te hauora o ō tātou ate me ngā awaawa au.

• Tiakina koe mai i ngā huaketo pēnei i te Hepatitis B, te Hepatitis C, me te HIV (hei tauira, tikina te kano ārai mate Hepatitis B, whai i ngā mahi ārai haumaru)
• Āta karohia te inu nui rawa o te waipiro.
• Kia mau tonu te taumaha tinana hauora.
• Āta karohia te momi hikareti.

He pono he tino kino te mate cholangiocarcinoma. Heoi, mā te mōhio ki tēnei mate, mā te mōhio ki ngā āhuatanga mōrearea mēnā he mea kei reira, me te toro atu ki te tākuta i te wā tonu ka puta mai ngā tohu rerekē, ka nui te kaha hei whawhai i tēnei mate. Ko tō tākuta te tangata ka taea te hoatu i te tohutohu me te maimoatanga pai rawa atu ki a koe.