As human civilization entered the early 21st century, the improvement of human medical level has made most of the diseases that could not be cured before can now be controlled, and the material level has improved It has also greatly increased the average life expectancy of human beings, and tumors have subsequently become the most dangerous factor that endangers human health.
The current level of medical treatment cannot cure most malignant tumors, the best way for ordinary people to face malignant tumors The method is to reduce the morbidity rate through a healthy lifestyle so as to prevent it, and the most important thing for patients is nothing more than the “three early principles” of early detection, early diagnosis, and early treatment.
There may be malignant tumors in various parts of the body caused by various factorsmalignant proliferation of its own cells. We call the disease caused by it cancer,< /span>The incidence and malignancy of various cancers are not the same, but they all cause harm to human health, and we need to pay attention to them.
There are also differences in the prevalence of various cancers in different groups, some groups may be due to their own The specificity of work characteristics or living habits is a risk factor for some cancers, and the incidence rate is higher than others.
Secondly, the improvement of diagnosis level will also enable the detection of some cancers that were not commonly heard before The cholangiocarcinoma that I will introduce today is this kind of cancer. Patients with bile duct stones are more likely to suffer from it than ordinary people. With the improvement of diagnosis level, cholangiocarcinoma has also become a “frequent visitor” in hepatobiliary surgery.
Compared to our We often hear that lung cancer, stomach cancer, liver cancer and other cancers have a high incidence rate, and cholangiocarcinoma is not particularly “outstanding”. However, in an environment where “cancer” is becoming discolored, as long as it is cancer, it will make people afraid. For cholangiocarcinoma, it can be treated correctly with a scientific understanding of it, so it is necessary to have a certain understanding of cholangiocarcinoma.
1. What is cholangiocarcinoma?
In a broad sense, cholangiocarcinoma refers to bile duct Malignant tumors of the epithelium, bile ducts are divided into intrahepatic bile ducts and extrahepatic bile ducts according to the relationship between their anatomical location and the liver, Therefore, cholangiocarcinoma is also divided into intrahepatic cholangiocarcinoma and extrahepatic bile duct Intrahepatic cholangiocarcinoma, and since both intrahepatic cholangiocarcinoma and liver cancer lesions occur in the liver, the diagnosis and treatment are often confused with hepatocellular carcinoma. Before the research on cholangiocarcinoma continues to deepen, there is little understanding of intrahepatic cholangiocarcinoma, soCholedochocarcinoma in the narrow sense usually refers to extrahepatic cholangiocarcinoma, that is, malignant tumors from the left and right hepatic ducts to the lower end of the common bile duct.
The etiology of cholangiocarcinoma is still unclear, but studies have shown that it may be related to the pathological factors of the liver and gallbladder,Take common gallstones as an example, when When gallstones persist, the pressure of the bile duct increases, and it is easy to be infected repeatedly.Under such pathological conditions, the possibility of malignant transformation of cells is greatly increased, which eventually leads to the occurrence of cholangiocarcinoma.
The general classification of cholangiocarcinomais Papillary, nodular, and diffuse carcinoma.
The spread of cholangiocarcinoma is local invasion , lymphatic metastasis, and intraperitoneal planting, etc. Most tumors tend to spread. When cholangiocarcinoma spreads, it will greatly reduce the prognosis of the patient, and even endanger the life of the patient.
For cholangiocarcinoma, chemotherapy And radiation therapy is less effective and there is no way to completely eliminate cancer tissue, there is a risk of recurrence and metastasis, in principle, we should strive for radical resection, in other words, Surgical treatment is The mainstay of treatment for cholangiocarcinoma.
When the tumor cells are confined to the bile duct, it can be cured However, when tumor cells spread to other tissues, resection of the primary disease cannot cure cholangiocarcinoma, which will not only increase the difficulty of cholangiocarcinoma surgery, but also increase the scope of surgical resection and reduce the quality of life of patients< /span> Therefore, for patients with cholangiocarcinoma, it is the top priority to strive for early detection of cholangiocarcinoma and timely radical treatment.
Although early cholangiocarcinoma is hidden, it is not without trace, The doctor reminded: 3 symptoms keep appearing, maybe it is cholangiocarcinoma.
Second, these 3 This symptom keeps appearing, maybe it is cholangiocarcinoma, don’t ignore it!
The physical manifestations of cholangiocarcinoma are not completely undetectable. Therefore, when the body has the following symptoms, it needs to be alert to whether there is cholangiocarcinoma.
1) Progressive jaundice
Jaundice is cholangiocarcinoma The more obvious symptoms are yellow staining of mucous membranes in various parts of the body, and yellow staining of eyeball sclera may also appear.
This is due to,Tumor The existence of cells may block the common bile duct, and bile is synthesized and secreted by liver cells, and it is collected into the intrahepatic bile duct and merged with the extrahepatic bile duct, which is called the common bile duct, and enters the duodenum through the common bile duct to complete the function of digestion. When the tumor blockage leads to the blockage of the bile metabolic pathway, it stays in the liver and merges into the blood.The main component of bile is bilirubin, so eventually The result will be an increase in serum total bilirubin.
Our definition of jaundiceis total serum bilirubin concentration More than 34.2 μmol/L, In the early stage of cholangiocarcinoma, the symptoms of jaundice may not be obvious, but in the case of persistent tumor cells, the disease will continue to develop, HumanIf the blockage of bile excretion in the human body is not resolved, the total bilirubin in the serum will continue to rise, and the human body will appear progressively aggravated jaundice. Becausebilirubin is orange-red, its affinity with tissueThe combination of strong proteins will cause yellow stains in various parts of the human body, which is why cholangiocarcinoma can have yellow stains.
Although cholangiocarcinoma It is not the only cause of pathological jaundice. There are many causes of pathological jaundice, such as liver and gallbladder disease, butWhen the body has progressively aggravated jaundice, it is still necessary to Be alert to the possible risk of cholangiocarcinoma. On the other hand, it is urgent to go to the hospital for diagnosis and treatment when jaundice occurs.
2) Large liver
A large liver is a lot of middle-aged A common symptom in men, some middle-aged men, due to alcoholism,The liver metabolizes alcohol for a long time, alcohol will damage liver cells and affect the discharge of fat droplets in liver cells, resulting in fatty degeneration of liver cells , Induce alcoholic fatty liver.
The most obvious manifestation of hepatic steatosis in the body is hepatomegaly. The prevalence of drinking culture in the society has led to an endless stream of patients with alcoholic fatty liver, and the treatment of such diseases is relatively simple, mainly based on abstinence from alcohol, and its impact on the body is small, most patients with alcoholic fatty liver do not pay attention to the disease, This has also led towhen patients with cholangiocarcinoma have symptoms of hepatomegaly, it is easy for patients to contact alcoholic fatty liver at the first time, thereby reducing the importance of symptoms.
Although cholangiocarcinoma can also cause symptoms of hepatomegaly, its pathogenic mechanism and harm are quite different from alcoholic fatty liver.Bile excretion disorder not only causes bile to flow into the blood Causes the increase of total serum bilirubin to cause jaundice, and also leads to bile stasis in the liver, causes damage to liver cells, liver cell damage can also induce hepatitis, a large amount of inflammation The substance exists in the liver tissue, which further leads to congestion and edema of the liver tissue, and the signs are manifested as liver enlargement.
Tumor cells continue to exist, and the cause of liver damage has not been eliminated, which will lead to continuous damage to liver cells. When the liver is in the compensatory capacity, the liver can still maintain the normal metabolic function of the human body.When the liver’s compensation is exceeded hepatitis will further develop into liver cirrhosis, liver fibrosis, and even liver cancer,so don’t underestimate the liver If hepatomegaly manifests, don’t judge it by yourself as alcoholic fatty liver. The safest thing to do after hepatomegaly is to see a doctor to clarify the symptoms and carry out targeted treatment.
3) Ascites< /span>
There is some fluid in our abdominal cavity, which is used for the lubrication of the abdominal organs during movement, ButWhen intraperitoneal fluidWhen it exceeds 200ml, that is too much fluid, we call it ascites,When the ascites exceeds 1000ml, there will be movement during physical examination Sexual dullness is positive, and you can even feel it yourself.
Ascites caused by cholangiocarcinoma is also caused by bile stasis,When bile stasis causes damage to liver cells, and the degree of damage exceeds the compensatory capacity of the liver, the liver disease enters the decompensation stage and will Cause liver insufficiency, hepatobiliary circulation is blocked, portal vein pressure is increasing, venous return is blocked, tissue fluid will flow into the peritoneal cavity, resulting in peritoneal effusion< span>, and the liver is the place for protein metabolism,In the case of hepatic insufficiency, protein metabolism will be abnormal, resulting in hypoalbuminemia and watery Sodium retention, is also one of the causes of ascites.
Although the above symptoms It is not serious, and usually does not have a great impact on life, but it cannot be a reason for inaction on the disease. Many patients with cholangiocarcinoma miss the best period of radical surgery because they do not pay attention to early symptoms. Once the optimal operation time for cholangiocarcinoma is missed, the risk of recurrence and metastasis is relatively higher.
Therefore, we must pay enough attention to the abnormal symptoms of the body, Seeing a doctor is the best solution to deal with the disease.
In general, the incidence of cholangiocarcinoma is not high, but because people don’t know enough about it, patients with cholangiocarcinoma often only know that they have cholangiocarcinoma when the malignancy of advanced tumors is relatively high. the best time for treatment.
for good health For us, we have no regret medicine to take. We often say that the body is the first capital, but we don’t pay enough attention to the health of the body. There are many other diseases like cholangiocarcinoma, but the principle of dealing with the disease is the same.The appearance of abnormal symptoms means that our body is warning us, all we have to do is to see a doctor Hospital, Although the lesions of cholangiocarcinoma are relatively hidden and the symptoms are not obvious compared with other malignant tumors, can be detected under systematic examination Identify the condition and provide the most effective treatment plan for the patient. A positive attitude towards the disease is also an integral part of overcoming the disease.
< p> Dou Kefeng. Comprehensive treatment of hilar cholangiocarcinoma. “CNKI”, 1998
 Peng Shumai, Wang Jianwei, Liu Yingbin, etc. Surgical treatment of primary liver cancer with tumor thrombi in the bile duct. “Chinese Journal of Surgery”, 2003
 Mei Huanming, Meng Jing, Yang Rong. Serum ascites albumin in patients with decompensated liver cirrhosis Study on the relationship between gradient and esophageal varices. “CNKI;WanFang”, 2013
 Duan Jianguo. Ultrafiltration of peritoneal effusion concentrated intraperitoneal reinfusion in the treatment of 42 cases of cirrhosis with persistent ascites. “CNKI;WanFang”, 2004