He aha ka Kanesa Ampullary? Nā Hōʻailona, Nā Kumu, a me ka Lapaʻau

He aha ka kanesa ampullary?

ʻO ka kanesa ampullary kahi ʻano kanesa maʻamau ʻole e ulu ana ma ka ampulla of Vater, kahi wahi liʻiliʻi kahi e hui ai kou paila duct a me ka pancreatic duct ma mua o ka hoʻokuʻu ʻana i loko o kou ʻōpū liʻiliʻi. E noʻonoʻo iā ia he huihui kahi e kahe ai nā wai hoʻoheheʻe koʻikoʻi.

ʻO kēia wahi liʻiliʻi akā koʻikoʻi, ma ka nui o kahi mea kākau penikala, he kuleana nui ia i kāu hoʻoheheʻe ʻana ma ka ʻae ʻana i ka paila a me nā enzyme pancreatic e komo i loko o kou ʻōpū. Ke ulu ka kanesa ma ʻaneʻi, hiki iā ia ke pale i kēia mau ala koʻikoʻi a hoʻopilikia i ke ʻano o ka hoʻoponopono ʻana o kou kino i ka meaʻai a me nā meaʻai.

ʻO ka lono maikaʻi, ʻo ka kanesa ampullary pinepine e hōʻike i nā hōʻailona ma mua, ʻo ia hoʻi hiki ke hopu ʻia a mālama ʻia ma mua o ka pālahalaha ʻana i nā ʻāpana ʻē aʻe o kou kino. ʻOiai ʻaʻole ia he 1% o nā kanesa ʻōnaehana hoʻoheheʻe a pau, ʻo ka hoʻomaopopo ʻana i kāna mau hōʻailona hiki ke hana i kahi ʻokoʻa maoli i nā hopena.

He aha nā hōʻailona o ka kanesa ampullary?

ʻO ka hōʻailona mua loa o ka kanesa ampullary ʻo ia ka jaundice, kahi e hana ai ke hiki ʻole i ka paila ke kahe maʻamau i loko o kou ʻōpū. Hiki iā ʻoe ke ʻike i kou ʻili a me nā keʻokeʻo o kou mau maka e huli melemele, me ka mimi ʻeleʻele a me nā ʻōpala māmā.

Nui nā kānaka me ka kanesa ampullary e ʻike i kēia mau hōʻailona hou aku:

• ʻEha ʻōpū, ʻoi aku hoʻi ma ka ʻākau luna
• Pau ke kaumaha wehe ʻole ma nā hebedoma a i ʻole mau mahina he nui
• Nalowale ka makemake ai a i ʻole ka manaʻo piha koke ma hope o ka ʻai ʻana
• Nausea a me ka luaʻi
• ʻIli ʻili ma muli o ka hōʻiliʻili ʻana o ka paila
• Loli i nā neʻe ʻōpū, me ka luaʻi a i ʻole nā ​​ʻōpala momona
• Luhi a nāwaliwali

Hiki i kekahi poʻe ke ʻike i nā hōʻailona maʻamau ʻole e like me ka maʻi wela, ʻeha kua, a i ʻole ke koko i loko o kā lākou mau ʻōpala. Hiki i kēia mau hōʻailona ke ulu mālie, a hiki iā ʻoe ke hoʻohoka mua iā lākou ma ke ʻano he mau pilikia hoʻoheheʻe a i ʻole nā ​​pilikia pilikia.

E hoʻomanaʻo he nui nā kumu o kēia mau hōʻailona ma waho aʻe o ka kanesa, no laila ʻo ka ʻike ʻana iā lākou ʻaʻole ia e hōʻike ana he kanesa ampullary kāu. Eia naʻe, ʻo nā hōʻailona mau, ʻoi aku hoʻi ka jaundice, pono e nānā koke i ke kauka.

He aha nā kumu o ka kanesa ampullary?

ʻAʻole maopopo loa ke kumu pololei o ka kanesa ampullary, akā e ulu ana ia i ka wā e hoʻomaka ai nā cell maʻamau i ka ampulla e ulu a hoʻokaʻawale ʻia me ka manaʻo ʻole. Hana kēia ma muli o nā loli i ka DNA o kēia mau cell, ʻoiai ʻo ka mea e hoʻonāukiuki ai i kēia mau loli e ʻokoʻa mai kahi kanaka i kahi kanaka.

Nui nā mea e hiki ke hoʻopili i ka ulu ʻana o ka kanesa ampullary:

• Nā kūlana genetic e like me ka familial adenomatous polyposis (FAP) a i ʻole ka Lynch syndrome
• Hoʻoheheʻe mau i nā paila duct a i ʻole ka pancreas
• Mōʻaukala mua o kekahi mau ʻano polyps i loko o ka ʻōpū
• Hōʻike ʻia i kekahi mau kemika a i ʻole nā ​​mea ʻino ma mua o ka manawa
• Pāpā ʻana i nā huahana paka
• Hoʻohana nui ʻana i ka waiʻona

I nā hihia maʻamau ʻole, hiki i ka kanesa ampullary ke ulu ma ke ʻano he ʻāpana o nā syndromes kanesa hoʻoilina e holo ana i nā ʻohana. Hoʻonui nui kēia mau kūlana genetic i ka pilikia akā he hapa liʻiliʻi wale nō o nā hihia.

ʻAʻole nui nā kānaka e loaʻa ka kanesa ampullary i nā mea pilikia maopopo, ʻo ia hoʻi e like me ka ulu ʻana o ka kanesa me ka manaʻo ʻole. Hiki i kēia ke manaʻo huhū, akā ʻo ia hoʻi ʻaʻole pono ʻoe e hewa iā ʻoe iho inā loaʻa iā ʻoe kēia ʻike.

He aha nā mea pilikia no ka kanesa ampullary?

ʻO ka makahiki ka mea pilikia nui loa, me ka nui o nā hihia e hana ana i nā kānaka ma luna o 60 mau makahiki. Eia naʻe, hiki i ka kanesa ampullary ke ulu i kēlā me kēia makahiki, me nā ʻōpio, ʻoi aku hoʻi nā mea me nā predisposition genetic.

Nui nā kūlana a me nā mea hana ola e hiki ke hoʻonui i kou pilikia:

• Familial adenomatous polyposis (FAP), ka mea e hoʻokumu ai i nā polyps he nui i loko o ka colon
• Lynch syndrome, kahi kūlana hoʻoilina e hoʻopilikia ana i ka hoʻoponopono ʻana o ka DNA
• Peutz-Jeghers syndrome, ka mea e hoʻokumu ai i nā polyps ma o ka ʻōnaehana hoʻoheheʻe
• Hoʻoheheʻe mau pancreatitis a i ʻole ka hoʻoheheʻe ʻana o ka paila duct
• Pāpā ʻana i nā sigareta a i ʻole ka hoʻohana ʻana i nā huahana paka ʻē aʻe
• Hoʻohana nui ʻana i ka waiʻona ma nā makahiki he nui
• Ke kāne, ʻoiai ʻoi aku ka nui o nā kāne i kēia kanesa ma mua o nā wāhine

ʻOi aku ka nui o ka pilikia o nā kānaka me kekahi mau kūlana genetic maʻamau ʻole ma mua o ka lehulehu. Inā loaʻa iā ʻoe kahi mōʻaukala ʻohana o kēia mau syndromes a i ʻole nā ​​lālā ʻohana he nui me nā kanesa hoʻoheheʻe, hiki ke kōkua ka ʻōlelo aʻo genetic e loiloi i kou pilikia.

ʻO ka loaʻa ʻana o hoʻokahi a ʻoi aku paha nā mea pilikia ʻaʻole ia e hōʻike ana e loaʻa nō ʻoe i ka kanesa ampullary. Nui nā kānaka me nā mea pilikia ʻaʻole loa e loaʻa i ka maʻi, ʻoiai kekahi poʻe me nā mea pilikia ʻike ʻole ʻia.

I ka wā hea e ʻike ai ʻoe i ke kauka no ka kanesa ampullary hiki?

Pono ʻoe e hoʻokaʻaʻike koke i kāu kauka inā loaʻa iā ʻoe ka jaundice, ʻoi aku hoʻi inā ʻike ʻia me ka ʻeha ʻōpū a i ʻole ka nalowale o ke kaumaha wehe ʻole. Pono ka jaundice e ulu koke a i ʻole ka hoʻoikaika koke ʻana i ka nānā koke ʻana i ke kauka.

E hoʻonohonoho i kahi hālāwai i loko o kekahi mau lā inā ʻike ʻoe i nā hōʻailona mau e like me ka ʻeha ʻōpū mau, ka nalowale nui o ke kaumaha me ka ho'āʻo ʻole, a i ʻole nā ​​loli i kāu mau neʻe ʻōpū e mau ana ma mua o hoʻokahi a ʻelua pule paha.

E ʻimi i ka mālama ola kino koke inā loaʻa iā ʻoe ka ʻeha ʻōpū nui, ka maʻi wela kiʻekiʻe me ka jaundice, a i ʻole ka luaʻi e pale aku iā ʻoe mai ka mālama ʻana i nā wai. Hiki i kēia mau hōʻailona ke hōʻike i nā pilikia e pono ai ka mālama koke.

Mai kali e ʻike inā e hoʻomaikaʻi nā hōʻailona ma luna o lākou iho, ʻoi aku hoʻi inā loaʻa iā ʻoe nā hōʻailona he nui e hana pū ana. ʻO ka ʻike mua a me ka mālama ʻana i ka kanesa ampullary e hoʻomaikaʻi nui i nā hopena, no laila ʻo ka loiloi koke ʻana i ke kauka ka koho kūpono mau.

He aha nā pilikia hiki o ka kanesa ampullary?

Inā waiho ʻole ʻia, hiki i ka kanesa ampullary ke hoʻokumu i nā pilikia koʻikoʻi ma ka pale ʻana i ke kahe ʻana o ka paila a me nā wai pancreatic. ʻO ka hopohopo koke loa pinepine ʻo ia ka jaundice nui, ka mea e alakaʻi ai i nā pilikia ate a me ka maʻi.

ʻO nā pilikia maʻamau e komo pū ana:

• Pale ʻana o ka paila duct e alakaʻi ana i ka hōʻino ʻana o ka ate
• Nā maʻi i loko o nā paila duct (cholangitis)
• Pale ʻana o ka pancreatic duct e hoʻokumu ana i ka ʻeha nui
• Ka nele o ka meaʻai ma muli o ka hoʻoheheʻe maikaʻi ʻole o ka momona
• Nā pilikia clotting koko
• Pālahalaha ʻana o ka kanesa i nā ʻōnaehana kokoke e like me ka ate a i ʻole nā ​​lymph nodes

I nā hihia holomua, hiki i ka kanesa ke pālahalaha i nā ʻāpana mamao o ke kino, me ka ate, nā māmā, a i ʻole nā ​​iwi. Hana kēia i ka mālama ʻana i ka pilikia akā ʻaʻole ia e hana iā ia he mea hiki ʻole.

ʻO ka lono maikaʻi, hiki ke pale ʻia a i ʻole ke hoʻokele maikaʻi ʻia nā pilikia he nui me ka mālama ola kino kūpono. E nānā pono kāu hui olakino iā ʻoe a e lawe i nā hana e pale ai i nā pilikia i kēlā me kēia manawa.

Pehea ka hōʻoia ʻana o ka kanesa ampullary?

ʻO ka hōʻoia ʻana i ka kanesa ampullary e hoʻomaka pinepine me nā hoʻokolohua koko e nānā i ka hana ate a e ʻimi i nā mea hōʻailona e hōʻike ana i ka pale ʻana o ka paila duct. E hana pū kāu kauka i kahi hoʻokolohua kino a e nīnau i nā nīnau kikoʻī e pili ana i kāu mau hōʻailona.

He kuleana nui nā hoʻokolohua kiʻi i ka hōʻoia ʻana a hiki ke komo pū me:

• CT scan e kiʻi i nā kiʻi kikoʻī o kou ʻōpū
• MRI e nānā i nā paila duct a me nā pūnaewele a puni
• ERCP (ka hana endoscopic) e nānā pololei i ka ampulla
• Ultrasound e nānā i nā pale a i ʻole nā ​​mea nui
• PET scan e hoʻoholo inā ua pālahalaha ka kanesa

ʻO ka hōʻoia hope loa e pono ai kahi biopsy, kahi e lawe ʻia ai kahi laʻana liʻiliʻi o ka pūnaewele i ka wā o ka hana endoscopic a nānā ʻia ma lalo o ka microscope. Hana pinepine ʻia kēia hana i kou wā e moe ai no ka hōʻoluʻolu.

Hiki i kāu kauka ke kauoha i nā hoʻokolohua hou aku e hoʻoholo i ke ʻano pololei o ka kanesa ampullary a e hoʻolālā i ke ala mālama maikaʻi loa. Kēia kaʻina hana, i kapa ʻia ʻo ka staging, e kōkua i ka wānana ʻana i ke ʻano o ka kanesa a me ka pane ʻana i ka mālama ʻana.

He aha ka mālama ʻana no ka kanesa ampullary?

ʻO ka ʻoki pinepine ka mālama nui no ka kanesa ampullary, ʻoi aku hoʻi ke hopu ʻia ka kanesa ma mua a ʻaʻole i pālahalaha i nā ʻōnaehana ʻē aʻe. ʻO ka hana maʻamau loa i kapa ʻia ʻo ka Whipple operation, ka mea e wehe ai i ka ampulla me nā ʻāpana o ka pancreas, ka ʻōpū liʻiliʻi, a me ka paila duct.

ʻO nā koho mālama e hilinaʻi ana i ke kahua a me kahi o kāu kanesa:

• Wehe ʻana i ka ʻoki (Whipple procedure a i ʻole local excision)
• Chemotherapy e hoʻemi i nā mea nui a i ʻole ke pale ʻana i ka hoʻi hou ʻana
• Radiation therapy e hoʻopili i nā cell kanesa
• Nā hana palliative e hoʻomaha i nā hōʻailona a hoʻomaikaʻi i ka maikaʻi o ke ola
• Nā lāʻau lapaʻau kikoʻī no nā ʻano kanesa kikoʻī
• Immunotherapy i kekahi mau hihia

Inā ʻaʻole hiki ke hana ʻoki ma muli o kahi o ka kanesa a i ʻole kou olakino holoʻokoʻa, e kaukaʻi kāu hui lapaʻau i nā mālama e hiki ke kaohi i ka kanesa a hoʻokele maikaʻi i nā hōʻailona. Hiki paha kēia ke komo pū me ka waiho ʻana o ka stent e mālama i nā paila duct i wehe.

E hoʻopilikino ʻia kāu hoʻolālā mālama i kāu kūlana, e noʻonoʻo ana i kou olakino holoʻokoʻa, nā ʻano o ka kanesa, a me kāu mau makemake pilikino. Nui nā kānaka e hana pū me kahi hui e komo pū ana i nā kauka ʻoki, nā oncologists, a me nā loea ʻē aʻe.

Pehea ʻoe e hoʻokele ai i ka kanesa ampullary ma ka home?

ʻO ka mālama ʻana iā ʻoe iho ma ka home he ʻāpana koʻikoʻi ia o kāu huakaʻi mālama. E kau i ka manaʻo i ka ʻai ʻana i nā meaʻai liʻiliʻi, pinepine e maʻalahi ke hoʻoheheʻe, a e noʻonoʻo e hana pū me kahi meaʻai e hoʻomaopopo ana i nā pilikia o ka kanesa ampullary.

ʻO nā hoʻolālā mālama home maikaʻi e komo pū ana:

• Lawe ʻana i nā mea hoʻohui enzyme i kuhikuhi ʻia me nā meaʻai e kōkua i ka hoʻoheheʻe ʻana
• ʻAi ʻana i nā meaʻai liʻiliʻi, pinepine ma mua o nā ʻāpana nui
• Pale ʻana i nā meaʻai momona a momona paha e paʻakikī ke hoʻoheheʻe
• Mālama i ka wai me ka wai a me nā wai maopopo
• Loaʻa ka hoʻomaha kūpono a me ka hoʻokele ʻana i ka luhi
• Lawe ʻana i nā lāʻau lapaʻau e like me ka kuhikuhi ʻana
• Nānā ʻana i kāu mau hōʻailona a hōʻike ʻana i nā loli i kāu hui olakino

ʻO ka hoʻokele ʻana i nā hopena mai ka mālama ʻana he mea nui like. Inā ʻike ʻoe i ka nausea, e ho'āʻo e ʻai i nā meaʻai palupalu a lawe i nā lāʻau anti-nausea e like me ka kuhikuhi ʻana. No ka luhi, e kaulike i ka hana me ka hoʻomaha a noi i ke kōkua ke pono ʻoe.

E noho pili me kāu hui olakino a mai kānalua e kāhea inā loaʻa iā ʻoe nā hopohopo e pili ana i nā hōʻailona, ​​nā hopena, a i ʻole nā ​​nīnūnē lāʻau. Aia lākou e kākoʻo iā ʻoe ma kēlā me kēia ʻanuʻu o kāu mālama.

Pehea ʻoe e hoʻomākaukau ai no kāu hālāwai kauka?

Ma mua o kāu hālāwai, e kākau i kāu mau hōʻailona a pau, me ka wā i hoʻomaka ai lākou a pehea lākou i loli ai i ka manawa. E kikoʻī e pili ana i nā pae ʻeha, nā loli kaumaha, a me nā pilikia hoʻoheheʻe āu i ʻike ai.

E lawe mai i kahi papa inoa piha o nā lāʻau lapaʻau, nā mea hoʻohui, a me nā huaora āu e lawe ai, me nā dosages. E hoʻomākaukau pū i ka ʻike e pili ana i ka mōʻaukala olakino ʻohana, ʻoi aku hoʻi nā kanesa a i ʻole nā ​​kūlana genetic.

E noʻonoʻo e lawe mai i kahi hoaaloha a i ʻole lālā ʻohana hilinaʻi i kāu hālāwai e kōkua iā ʻoe e hoʻomanaʻo i ka ʻike a hāʻawi i ke kākoʻo manaʻo. Hiki iā lākou ke kōkua iā ʻoe e noʻonoʻo i nā nīnau āu e poina ai e nīnau.

E kākau i nā nīnau ma mua i ʻole ʻoe e poina iā lākou i ka wā o ka hālāwai. Hiki i nā nīnau koʻikoʻi ke komo pū me ka nīnau ʻana e pili ana i nā koho mālama, nā hopena, ka prognosis, a me ka mea e manaʻo ai i ka wā hoʻōla.

He aha ka lawe nui e pili ana i ka kanesa ampullary?

ʻO ka kanesa ampullary kahi kūlana maʻamau ʻole akā hiki ke mālama ʻia, ʻoi aku hoʻi ke hopu ʻia ma mua ma o ka nānā koke ʻana i nā hōʻailona e like me ka jaundice. ʻOiai hiki i ka loaʻa ʻana o kēia ʻike ke manaʻo nui, nui nā kānaka me ka kanesa ampullary e ola i nā ola piha, olakino ma hope o ka mālama ʻana.

ʻO ka mea nui loa āu e hiki ai ke hana ʻo ia ka hana pili me kāu hui olakino a hahai i kāu hoʻolālā mālama. Mai kānalua e nīnau i nā nīnau, e hōʻike i nā hopohopo, a i ʻole e ʻimi i nā manaʻo ʻelua inā manaʻo ʻoe he maopopo ʻole kekahi ʻāpana o kāu mālama.

E hoʻomanaʻo ua hoʻomaikaʻi nui ʻia ka mālama ʻana i ka kanesa ampullary i nā makahiki i hala iho nei, a ke hoʻomau nei ka noiʻi e hoʻomohala i nā ala hou a maikaʻi hoʻi. E kau i ka manaʻo i ka lawe ʻana i nā mea hoʻokahi a hoʻolauleʻa i nā lanakila liʻiliʻi ma ke ala.

Nā nīnau pinepine e pili ana i ka kanesa ampullary

He hereditary anei ka kanesa ampullary?

ʻAʻole hereditary ka hapa nui o nā hihia o ka kanesa ampullary a ulu me ka manaʻo ʻole. Eia naʻe, ʻoi aku ka nui o ka pilikia o nā kānaka me kekahi mau kūlana genetic e like me ka familial adenomatous polyposis (FAP) a i ʻole ka Lynch syndrome. Inā loaʻa iā ʻoe kahi mōʻaukala ʻohana o kēia mau kūlana a i ʻole nā ​​kanesa hoʻoheheʻe he nui i kou ʻohana, hiki ke kōkua ka ʻōlelo aʻo genetic e loiloi i kou pilikia.

He aha ka nui o ka ola no ka kanesa ampullary?

ʻOi aku ka maikaʻi o nā nui o ke ola no ka kanesa ampullary ma mua o nā kanesa hoʻoheheʻe ʻē aʻe, ʻoi aku hoʻi ke hopu ʻia ma mua. Hiki i nā nui o ke ola ʻelima makahiki ke piʻi mai 20% a 80% ma muli o ke kahua i ka hōʻoia ʻana a inā hiki ke wehe piha ʻia ka kanesa ma ke ʻoki ʻana. Hiki i kāu kauka ke hāʻawi i ka ʻike kikoʻī hou aku ma muli o kāu kūlana pilikino.

Hiki ke pale ʻia ka kanesa ampullary?

ʻAʻohe ala hōʻoia e pale ai i ka kanesa ampullary ʻoiai ka nui o nā hihia e ulu ana me nā kumu maopopo ʻole. Eia naʻe, hiki iā ʻoe ke hoʻemi i kou pilikia ma ka ʻole o ka puhi ʻana, ka palena ʻana i ka hoʻohana ʻana i ka waiʻona, a me ka mālama ʻana i kahi ola olakino. Pono nā kānaka me nā kūlana genetic e hoʻonui i ka pilikia e hana pū me kā lākou mau kauka ma nā hoʻolālā nānā a me ka nānā kūpono.

Pehea ka lōʻihi o ka hoʻōla ma hope o ka ʻoki kanesa ampullary?

ʻOkoʻa ka manawa hoʻōla ma muli o ke ʻano o ka ʻoki a me kou olakino holoʻokoʻa ma mua o ke kaʻina hana. Nui nā kānaka e noho ma ka haukapila no 7 a 14 mau lā ma hope o kahi hana Whipple, a hiki i ka hoʻōla piha ke lawe i nā mahina he nui. E hāʻawi kāu hui ʻoki i nā kuhikuhi kikoʻī e pili ana i nā palena hana, nā loli meaʻai, a me ka mālama hoʻomau i ka wā hoʻōla.

E pono anei iaʻu ka mālama mau ma hope o ka ʻoki kanesa ampullary?

Nui nā kānaka e loaʻa i ka mālama hou ma hope o ka ʻoki ʻana, e like me ka chemotherapy a i ʻole ka radiation therapy, e hoʻemi i ka pilikia o ka hoʻi ʻana o ka kanesa. ʻOiai ma hope o ka pau ʻana o ka mālama ʻana, pono ʻoe i nā hālāwai hoʻomau a me nā hoʻokolohua kiʻi e nānā i nā hōʻailona o ka hoʻi hou ʻana. E hana kāu hui oncology i kahi hoʻolālā nānā pilikino ma muli o kāu kūlana kikoʻī a me ka pane mālama.