Correct diagnosis of cholangiocarcinoma enables early treatment | am730

Although cholangiocarcinoma is not among the ten most common cancers in Hong Kong, the mortality rate is very high because it is usually found at an advanced stage and cannot be treated with surgery. In recent years, choledochoscopy technology has become more advanced, making it easier for doctors to obtain biopsies for testing, improving accuracy, and helping patients receive appropriate treatment as early as possible.

Zhu Jiayun, an expert in surgery, said that if we want to divide cholangiocarcinoma, it can be divided into intrahepatic cholangiocarcinoma, middle segment cholangiocarcinoma and lower segment cholangiocarcinoma. “Because the tumors are in different places, the nearby organs are also different, so their diagnosis and treatment methods will be different.”

Cause unknown

The cause of cholangiocarcinoma remains unclear, and many patients have no obvious risk factors. Zhu Jiayun continued, “However, the literature has also documented some factors that increase the risk of cholangiocarcinoma, such as patients with ulcerative colitis, fluke liver disease, bile duct stones, cirrhosis, recurrent suppurative cholangitis, intrabiliary papilloma , and abnormalities of the structure of the bile duct are congenital with a choledochal cyst, you will be more prone to cholangiocarcinoma.”

Symptoms caused by bile duct occlusion

Cholangiocarcinoma is like other cancers. Zhu Jiayun said, “When symptoms appear, bile duct occlusion is usually caused, followed by jaundice, skin itching, abdominal pain, cholangitis, and pancreatitis. However, we should pay attention to intrahepatic cholangiocarcinoma. Even if the tumor has grown to a large size, it may not be possible to detect bile duct obstruction only at a very late stage. mortality rate from cholangiocarcinoma.

Zhu Jiayun suggested that regular health examinations, especially ultrasound examinations for high-risk people every one to three years, can help with early detection, thereby improving curative effects and reducing mortality.

Choledochoscopy helps in correct diagnosis

Current methods for diagnosing cholangiocarcinoma include imaging tests and endoscopy. With the advancement of technology, the accuracy of imaging tests such as magnetic resonance imaging or computer scans has increased to 90%, but the gold standard for diagnosis is still biopsy. Zhu Jiayun said, “If the imaging examination reveals suspicious conditions, such as bile duct occlusion causing upstream bile enlargement, endoscopic retrograde cholangiopancreatography (ERCP) combined with choledochoscopy can be used to extract some cells for biopsy. the part is only as thick as udon and can be inserted directly into the bile duct for observation, making the diagnostic process more convenient than before. In addition, flow channels and accessory at the choledochoscope, which can remove biopsy tissue or conduct electrohydration. bile duct stones.

Security varies by location

If cholangiocarcinoma is diagnosed, the main treatments are surgery, chemotherapy and radiation therapy. Zhu Jiayun said, “Depending on the location of the tumor, if it is intrahepatic cholangiocarcinoma, it usually involves liver resection, which is similar to the treatment method for liver cancer, but the pathology different; there is a possibility of local resection. for mid-segment cholangiocarcinoma: resection of local bile ducts, gallbladder and nearby lymph nodes can be performed Solution; In the case of lower cholangiocarcinoma, since the tumor grows in the head of the pancreas, factors pancreaticoduodenectomy is needed or at a later stage, postoperative chemotherapy and chemotherapy are needed to reduce the risk of recurrence reduce

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