2023-05-26 05:01:26
Exquisite, high-fat diet, plus eating late-night snacks, drinking less water and other living habits are particularly likely to cause the occurrence of gallstones. Although gallstones are not considered a serious disease if they are treated in time, they still cannot be ignored. Risk of disease! However, although cholangiocarcinoma is a rare cancer, it has a relatively high fatality rate because it is difficult to detect! Want to know whether there is a direct relationship between cholangiocarcinoma and gallstones? Dr. Qian Zhenghong from Department of Gastroenterology and Hepatobiliary will explain the symptoms and risk factors of cholangiocarcinoma to you.
What is Cholangiocarcinoma?
Cholangiocarcinoma is divided into two types according to the location of occurrence, namely “intrahepatic cholangiocarcinoma” and “extrahepatic cholangiocarcinoma”. The clinical manifestations of the two are different, so they must be discussed separately.
78% of intrahepatic cholangiocarcinoma grows into a lump (mass), which can be seen (or the only one) with abdominal ultrasound, but 16% grows along the bile duct, and 6% hides In the bile duct, these two types cannot be seen clearly with ultrasound.
A large section of hilar bile duct and common bile duct is located behind the duodenum and inside the pancreas, so “extrahepatic cholangiocarcinoma” is easily covered by the air in the duodenum under ultrasound.SoIt is not easy to diagnose early. Sometimes it is not discovered until the cancer cells have metastasized to the liver and tumors appear one by one. What’s more, 90% of cholangiocarcinomas are extrahepatic cholangiocarcinomas.
What are bile ducts?
The bile ducts are densely distributed in the liver like small blood vessels. Many small bile ducts will converge into thicker bile ducts. There is an “intrahepatic bile duct” in the right lobe and left lobe of the liver, and then these two bile ducts are under the liver. The border (at the hilum of the liver) merges into a large bile duct, called the common bile duct. At this time, the bile duct leaves the liver and belongs to the “extrahepatic bile duct”. The common bile duct is about 7 to 10 cm long. Merge together leading to the duodenum.
The bile produced by the liver goes through the small bile duct → intrahepatic bile duct → extrahepatic bile duct (common bile duct) → duodenum. As for the gallbladder, it is like a rest stop on the highway. Part of the bile will go to the gallbladder for a rest, and when the time is up, it will still be discharged to the duodenum through the common bile duct.
What are the symptoms of bile duct cancer?
1️.Jaundice, brown urine, gray stool
This is because the tumor blocks the bile duct and prevents the bile from draining, but usually the tumor will be blocked only when it has a certain size, and intrahepatic cholangiocarcinoma will not cause jaundice. If you suspect biliary obstruction or jaundice, you can take a blood test for “bile pigment” and “alkaline phosphatase”, which is quite accurate.
2️.Right upper quadrant pain
If the severe pain in the right upper abdomen is more like the pain caused by stones, the pain of bile duct cancer is usually described as “stuffy” and “swollen”.
3️.Itchy skin
It’s also caused by cholestasis, a deposit of bile salts on the skin that causes itching, most notably on the palms and soles of the feet.
4️. Poor appetite, weight loss
Failure to drain bile can lead to indigestion and poor nutrient absorption.
If you experience the above symptoms of cholangiocarcinoma, it is recommended to seek medical examination as soon as possible.
I hope you know: (upper abdominal pain, nausea and vomiting are symptoms of acute pancreatitis! Up to 90% become gallstones, caused by drinking)
What are the causes of cholangiocarcinoma?Pay attention to the 9 major risk factors
1️.Bile duct stones
Including intrahepatic bile duct stones and common bile duct stones will increase the risk of cholangiocarcinoma, especially intrahepatic bile duct stones are often combined with “liver abscess”, long-term inflammation of the bile duct is likely to cause cancer, statistics show that 50% to 70% of intrahepatic cholangiocarcinoma related to gallstones.
2️. Gallstones (gallbladder stones)
Gallstones do not directly cause bile duct cancer. After all, the risk of gallbladder cancer is relatively high. However, 10% of patients with gallstones will also have common bile duct stones, and the risk of cancer is still relatively high.
3️.Hepatitis B and C
Viral hepatitis not only causes liver cancer (hepatocellular carcinoma), but also increases the risk of cholangiocarcinoma. Therefore, in addition to testing for fetal protein (liver cancer), people with B and C liver carriers should also occasionally test for cholangiocarcinoma index (CA19 -9).
4️. Liver cirrhosis
Having cirrhosis increases the risk of intrahepatic cholangiocarcinoma 10-27 times.
5️.Alcoholic liver disease
Alcoholic liver disease increases intrahepatic bile ducts 7.4-foldcancerTherefore, drinking not only damages the liver but also damages the bile duct.
6️. Toxic substances
The liver is an organ for detoxification, and the toxins are excreted through the bile duct along with the bile. If you are often exposed to toxic substances at work, such as pesticides, chemical plastics, rubber, printing paint, etc., it is easy to cause cancer. 1,2-Dichloropropane (1,2-Dichloropropane) is known to be a carcinogen and its uses include household stain removers, waxes or sealants for stone surfaces, cleaning agents in printing, toner replacement, gold plating and silver use , degreaser and paint remover.suggestionCleaner, stain remover, or printer tonerwaitThere will be less volatile chemicals that smell subtle.
7️.Smoking
Smoking increases the risk of bile duct cancer and ampullary cancer, and smoking 2 packs a day doubles the risk.
8️. pylori infection
A cause-and-effect relationship is not yet certain, but pylori bacteria are thought to promote cancer cell growth.
9️.Diabetes and sugary drinks
Diabetes increased the risk 1.6-fold. A 2019 Swedish study pointed out that drinking more than 2 cups of sugary drinks per day increases the risk of cholangiocarcinoma by 1.8 times and the risk of gallbladder cancer by 2.2 times.
Guess you want to cure: (What to do with gallstones? 4 types of high-risk factors for women! If you have 2 major symptoms, you need to see a doctor!)
Cholangiocarcinoma is difficult to diagnose! 4 types of people should be alert
Cholangiocarcinoma that grows in the hilum of the liver or the common bile duct cannot be seen clearly under ultrasound and is easy to miss.ifduring inspectionIf you see dilated bile ducts, you must be vigilant. There should be a bile duct blocked somewhere.At this time shouldinstallComputed tomography or MRI and blood test for cholangiocarcinoma index can completely judge whether there is cholangiocarcinoma.
recommended inPeople over the age of 40 with liver disease, gallstones, or exposure to toxic substances at work should pay attention to whether the color of urine is normal, otherwise it will not be jaundice. When blood is drawn, you can pay attention to whether the bile pigment (Bilirubin) and alkaline phosphatase (ALK-P) are normal. In addition, the bile duct cancer index CA19-9 and CEA can be added as a reference. These tests are helpful for early detection of cholangiocarcinoma.
Please care about the day of treatment: (What can you eat for gallstones? It is taboo to eat late at night! The nutritionist explains the principles of gallstone diet)
Reminders for healing days
Finally, Dr. Qian also reminded,In terms of diet, in addition to drinking less sugary drinks, it is recommended that people with gallstones not eat raw food, and pay attention to cleanliness in diet, because bacteria or parasites will run up from the duodenum along the bile duct, causing damage to the gallbladder, bile duct and even the liver. Inflammation and purulence, long-term inflammation of the bile ducts will increase the risk of cancer.
Have a good chat and heal your healthy life
This article is reproduced from:Qian Zhenghong Gastrointestinal Hepatobiliary Physician
Image source: 123RF
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