Vater periampullary carcinoma
Introduction
Brief introduction of cancer around the ampulla The ampulla of the spleen, also known as the ampulla of the liver and pancreas, refers to the inner wall of the common bile duct after the descending part of the duodenum, where it merges with the pancreatic duct to form a slightly enlarged hepatic and pancreatic ampulla. Refers to the large nipple. There are hepatic and pancreatic ampullas around the hepatic and pancreatic ampulla, and the end of the common bile duct and pancreatic duct are also surrounded by sphincters. The bile and pancreatic juice thus enter the duodenum through the opening. The cancer surrounding the ampulla of the ampulla refers to the general term for the growth of the ampulla, the duodenal papilla, the lower common bile duct, and the duodenal inner wall cancer. The common feature is that the common bile duct can be caused when the cancer is small. And obstruction of the main pancreatic duct. The course of the disease progressed slowly, the jaundice appeared early, the surgical resection rate was about 60%, and the five-year cure rate was 35% to 40%. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: toxic shock syndrome shock anemia ascites
Cause
The cause of cancer around the ampulla
The cause of the disease is still unknown and may be related to a variety of factors.
Prevention
Prevention of cancer around the ampulla
Early detection, early diagnosis, early treatment.
Complication
Lack of ampullary pericarcinoma Complications toxic shock syndrome shock anemia ascites
Toxic shock
2. Secondary anemia
3. Ascites can occur in peritoneal metastasis or portal vein metastasis of pancreatic cancer.
Symptom
Cancer symptoms around the ampulla of the ampullary common symptoms high fever abdominal pain weight loss cold diarrhea jaundice shock
Progressive aggravation of painless jaundice, occasional cancerous necrosis, bile duct recanalization and fluctuations, long-term cholestasis can lead to biliary cirrhosis, gallbladder enlargement, combined with biliary tract infection may have high fever, chills, and even toxic shock Abdominal pain is generally not heavy, sometimes released to the back, digestive tract dysfunction, terracotta color stool, general itching, poor appetite, diarrhea, weight loss.
Examine
Examination of cancer around the ampulla
1. Laboratory tests: early amylase can be elevated, serum bilirubin is generally above 13.68mol / L (8mg), fecal occult blood test is about 85 ~ 100% of patients positive, microscopic examination of undigested muscle fibers and fat, There may be urine sugar in the urine.
2. Duodenal drainage: Blood or occult blood is sometimes seen in the drainage fluid, or cancer cells can be seen.
3. X-ray inspection:
(1) Gastrointestinal barium meal and duodenal hypotonography:
(2) PTC: can display the obstruction of the lower end of the common bile duct, pay attention to complications such as bile leakage and biliary peritonitis.
(3) ERCP: It can peep into the inner wall of the duodenum and the nipple, and can be biopsied and diagnosed. It is helpful for the diagnosis of ampullary carcinoma and pancreatic head cancer (which may have pancreatic duct stenosis or no development).
(4) Selective celiac angiography: useful for the diagnosis of pancreatic head cancer, from the change of blood vessel position, can indirectly determine the location of pancreatic cancer.
(5) CT: It is meaningful for the differentiation of pancreatic head cancer, which is helpful for the diagnosis of this disease, and can show the location and contour of the tumor.
4. B-ultrasound: can determine the dilatation of the bile duct, can also provide early further examination clues for those without jaundice.
5. Nuclide examination: can understand the obstruction site.
Diagnosis
Diagnosis and diagnosis of cancer around the ampulla
Differential diagnosis
Liver cancer
2. Pancreatic cancer
