Cholangiocarcinoma in patients without specific clinical manifestations, the majority of misdiagnosed as gallstones, cholecystitis embolism. Some patients in the right upper abdominal pain, right upper quadrant mass, or anemia and other symptoms, the disease is often advanced stage. Inspection methods help to understand the gallbladder in patients with early detection of bile duct disease.
Cholangiocarcinoma inspection methods include:
1, ultrasound: B-ultrasound can be repeated easily and without damage using its diagnostic accuracy rate of 75% ~ 82.1% for the preferred method of examination but it should be B-(US) susceptible to intestinal pneumatosis abdominal wall hypertrophy and difficult to judge the impact of stones covered with atrophic gallbladder wall type and the situation in recent years by EUS (endoscopic ultrasound) method solves the above-mentioned topics US high-frequency probe EUS are only separated by the stomach or duodenal wall on the tremendous progress of the gallbladder scan The detection rate of gallbladder cancer and to further determine the structure of the gallbladder wall layers and thus the extent of tumor invasion by the People will EUS examination as the US accurate method to judge whether further US or EUS images of early gallbladder ultrasound was eminence lesions mainly and limitations of some combination of the two wall hypertrophy in type 2, gallbladder cancer CT scan examination methods: CT scans of the gallbladder with a sensitivity of 50%, especially for early diagnosis of gallbladder cancer than US and EUSCT can be divided into three types of image changes : thickness type: localized or diffuse gallbladder wall thickening irregular nodules: papillary nodules broke into the cavity of the gallbladder from the gallbladder wall cavity real variations exist: because of extensive tumor infiltration of the gallbladder wall thickening was coupled cavity cancer block the formation of solid mass filling the liver if the invasion or portal lymph node metastasis of pancreatic CT imaging in the next multi-display 3, Color Doppler flow imaging: inside and literature lectures in the gallbladder wall measured to the abnormal mass and high-speed arterial blood flow signal is different from the gallbladder gallbladder metastasis of primary malignant or benign tumor of the important features of the gallbladder.
4, gallbladder inspection methods ERCP: ERCP speech was to show the gallbladder for diagnosis of gallbladder cancer rate of 70% to 90% but ER-CP check for more than half of the image does not show the performance of the gallbladder can be divided into three situations: (1 ) Gallbladder bile duct development is good: more than a typical case of early lesions can be seen as filling defect in the gallbladder wall or connected with the uplift of basement wide infiltration of gallbladder wall lesions are visible wall stiffness or deformation (2) do not develop gallbladder: mostly in advanced cases ( 3) do not develop gallbladder and a liver or extrahepatic bile duct stricture: filling defects and bile duct congestion at the top signs of expansion in an advanced stage 5, cytology: cytology biopsy or direct method of bile extraction Two Direct biopsies find cancer cells The methods are: B ultrasound-guided puncture of gallbladder disease PTCCS (percutaneous endoscopic examination of gallbladder) and other methods adopted by the laparoscopic method of bile extraction under the more bile, such as B-ERCP guided biliary gallbladder puncture PTCD literature lecture Picture microscope The positive rate of cytology is not high but the combination of imaging methods can still make a diagnosis more than half of patients with gallbladder cancer 6, inspection methods gallbladder tumor markers: CEA in the tumor specimens immunohistochemical study of the lecture gallbladder CEA-positive rate was 100% in patients with advanced gallbladder cancer CEA value of up to 9.6ng/ml, but worthless in the early diagnosis of CA19-9CA125CA15-3 and other tumor carbohydrate antigen only as gallbladder examinations.
Early extrahepatic metastasis occurs less, mainly along the bile duct wall, upward, downward infiltration of direct spread. As mentioned in paragraph directly invade the liver and hepatic duct carcinoma, than in the lower cancer more common. The most common is the hilar lymph node metastasis, but also to other parts of the abdominal lymph nodes. Way to survive the transfer, except those with advanced cancer, usually less. Various parts of the bile duct, the liver the most common, especially in high bile duct cancer tissue easy to violations of portal vein tumor thrombus formation can lead to liver metastasis. But also to the adjacent organs pancreas, gallbladder metastasis.