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Holangiokarcinoma
- 1. Dana Miule
- 2. Epitelils, primrs 勅aundab朝gs aknu audzjs, kas att朝sts no 転ults vadiem. Lni augo邸s, metastzes veidojas ilg laika period. Metastzes: regionlie limfmezgli, smadzenes, plau邸as. 90 % holangiokarcinomu ir duktlas adenokarcinomas.
- 3. http://www.nature.com/nrgastro/journal/v3/n1/fig_tab/ncpgasthep0389_F1.html Anatomisk lokalizcija intrahepatic extrahepatic Nonhilar lesions Hilar lesions (Bismuth classification) Dzeltens - audzjs
- 4. Patel, T. (2011) Cholangiocarcinomacontroversies and challenges Nat. Rev. Gastroenterol. Hepatol. doi:10.1038/nrgastro.2011.20
- 7. Incidence: 1/ 100 000 Z-Amerik lielk incidence 6.5/ 100 000 V朝r. : siev. 1 : 2.5 ( 60 70 gadus veci) 1 : 15 ( >40 gadiem ) Dz朝vildze ir zema http://emedicine.medscape.com/article/277393-overview#showall
- 8. 50 % R- Eirop krona slim朝ba, 笛lainais kol朝ts 貼ultsvadu stze Hronisks 転ultsvadu un aknu iekaisums Paraz朝ti Ascaris lumbricoides Hepat朝ti B, C HIV Diabts Alkahola lieto邸ana Carolis slim朝ba http://patient.info/doctor/cholangiocarcinoma
- 9. Spes labaj aug邸j vdera kvadrant, kas izstaro uz muguru Dzelte Apet朝tes zudums Svara zudums Holang朝ts Drudzis Hepatomeglija Tum邸s ur朝ns https://www.nlm.nih.gov/medlineplus/ency/article/000291.htm
- 10. Agr朝na - sare転庁朝ta Asinsaina: hematokr朝ts, tromboc朝ti, CEA (Carcinoembriogenic antigen), hiperkalcmija. CT http://www.hopkinsmedicine.org/liver_tumor_center/conditions/bile_duct_cancer.html
- 11. MRI izmrs lokalizcija Endoskopija
- 15. Zint cloni un to novrst 超irur庁iska iejauk邸ans likvidjot Aknu transplantcija netiek veikta augst recid朝va riska d勅 saslim邸ana atkrtojas labki rezultti, ja pirms tam veikta 跳朝mijterapija 超朝mijterapija Endoskopisk terapija
- 16. http://emedicine.medscape.com/article/277393-overview#showall http://patient.info/doctor/cholangiocarcinoma https://www.nlm.nih.gov/medlineplus/ency/article/000291.htm http://www.hopkinsmedicine.org/liver_tumor_center/conditions/bile_duct_cancer.h tml http://www.hopkinsmedicine.org/liver_tumor_center/conditions/bile_duct_cance r.html http://www.pathologyoutlines.com/topic/livertumorcholangiocarcinoma.html http://www.med.upenn.edu/gastro/documents/ClinLiverDischolangiocarcinoma. pdf https://gi.jhsps.org/GDL_Disease.aspx?CurrentUDV=31&GDL_Disease_ID=A6D 10E80-887D-49A7-B3BB-0517D38CE757&GDL_DC_ID=320F4EDD-0021- 4952-83D7-8B0C67B47BFF
Editor's Notes
- #4: Lesion - bojjums The Bismuth classification of hilar cholangiocarcinoma into type I to IV stages is illustrated. Yellow areas represent tumor and brown areas normal bile duct.
- #5: Cholangiocarcinomas are classified according to their anatomic location as intrahepatic and extrahepatic Hilar cancers that arise from extrahepatic large duct epithelium at the hilum can extend into the liver, and have been misclassified as intrahepatic in some schema and in epidemiological and clinical reports. Further subclassification on the basis of macroscopic or microscopic characteristics can provide additional distinction that might correlate with clinical outcomes. Cancers that arise from the gall bladder or the ampulla of Vater are biliary tract cancers with unique clinical presentations, natural history, etiology and patterns of growth or spread and are considered separately from cholangiocarcinoma.
- #7: A, Cholangiocarcinoma within a cirrhotic liver; B, cross-section of tumor; C, histological imaging showing tumor cells surrounding normal hepatocytes.
- #9: Carolis slim朝ba ( A-R, policistiska nieru saslim邸ana, 転ultsvadi tiek dilatti)
- #10: Holang朝ts 転ultsvadu iekaisums
- #11: Asinsaina hematokr朝ts, tromboc朝tu, CT (kompjutertomogrfija abdominla) , Comparison of radiographic images showing cholangiocarcinoma; A, computed tomography (CT) image; B, cholangiogram (ERCP) image.油 Arrows designate the tumor.
- #12: MRI magntisk rezonanse Endoskopija - esophagus, stomach and beginning of the lower intestine without surgery.
- #13: You will be lightly sedated and your doctor will insert an endoscope through the mouth, down the esophagus, and into the stomach and small bowel. 油A smaller tube or catheter is passed through the endoscope and into the bile ducts. 油Dye is injected into the ducts, and the doctor takes X-rays that can show whether a tumor is present in the bile ducts. Aizliegta 邸ana un perorlu medikamentu lieto邸ana vismaz 6 stundas, dzer邸ana - 2 stundas pirms endoskopijas. Dien pirms izmekl邸anas: vieglas vakarias ne vlk k 20.00, pc tam dzert tikai 笛deni bez gzes. P.S. Aug邸js endoskopijas laik bez specilas iepriek邸jas pacienta sagatavo邸anas vajadz朝bas gad朝jum ir iespjams veikt da転das diagnostiskas un油 terapeitiskas manipulcijas k biopsijas, asio邸anas aptur邸anu, polipa izgrie邸anu, sve邸跳ermeu izem邸anu un tml.
- #15: In this procedure, a thin needle is inserted through the skin and into the bile ducts. A dye is injected through the needle so that a contrast image will show up on X-rays. By looking at the X-rays, the doctor may be able to see whether there is a tumor in the bile ducts.
- #16: 超朝mijterapija pc audzja izgrie邸anas Endoskopisk terapija stenta ievieto邸ana mazina blokdes 転ultsvad, mazina dzelti, tajs situcijs, kad audzju nevar likvidt