Η καρκινική νόσος γύρω από το κωνικό οστό της χολής

　　The etiology of this disease is not yet clear, and it may be related to many factors. If there is no metastatic focus and the overall condition allows, a primary pancreatectomy and duodenectomy can be performed. In a good pancreatic surgery center, the mortality rate of surgery is about1-2％. Most patients die of tumor recurrence after surgery, recurrence within three months after surgery often indicates poor prognosis.

　　In addition to general symptoms, it can also cause other diseases. This disease often appears toxic shock, secondary anemia, peritoneal metastasis or portal vein metastasis of pancreatic cancer can lead to ascites. Therefore, once found, it needs to be treated actively, and preventive measures should also be taken in daily life.

　　Progressive, painless jaundice, occasionally due to tumor necrosis, recanalization of the bile duct, presenting fluctuation, long-term bile stasis can lead to biliary cirrhosis, gallbladder enlargement, and infection of the bile duct can have high fever, chills, and even toxic shock. Abdominal pain is generally not severe, sometimes radiating to the back, digestive dysfunction, clay-colored stools, general pruritus, poor appetite, diarrhea, weight loss.

　　In a good pancreatic surgery center, the mortality rate of surgery is about1-2％. Most patients die of tumor recurrence after surgery, recurrence within three months after surgery often indicates poor prognosis. The size of the tumor, lymph node metastasis, involvement of major blood vessels, involvement of nerves, differentiation grade of tumor cells, tumor margin, blood transfusion during or after surgery are all related to prognosis.

　　1, laboratory examination:Early amylase levels can rise, serum bilirubin is generally higher13.68μmol/L (8mg) or more, occult blood test in stool approximately85～100% of patients are positive, microscopic examination can see undigested muscle fibers and fat, and there may be urinary sugar in the urine.

　　2, duodenal drainage:Occasionally, fresh blood or occult blood positivity can be seen in the drainage fluid, or it can be seen that cancer cells have been shed.

　　3, X-ray examination.

　　4, gastrointestinal barium meal and duodenal hypotonic contrast examination.

　　5PTC:It can show the blocked location at the lower end of the common bile duct, pay attention to complications such as bile leakage and cholecystitis.

　　6ERCP:It can view the inner wall of the duodenum and the papilla, and can also perform biopsies, confirm diagnoses, and is greatly helpful for the diagnosis of ampullary cancer and pancreatic cancer (which may have pancreatic duct stenosis or non-visualization).

　　7Selective celiac arteriography:It is beneficial for the diagnosis of pancreatic cancer, the change in vascular position can indirectly determine the location of the cancer in the pancreas.

　　8CT:对鉴别胰头癌有意义，有助于本病诊断，可显示肿瘤的位置与轮廓。

　　9It is meaningful for distinguishing pancreatic head cancer, helpful for the diagnosis of this disease, and can show the location and contour of the tumor.、Ultrasound：

　　10Can determine the dilation of the bile duct, and can also provide early clues for further examination for those without jaundice.、Radionuclide examination：

　　Dietary taboos for patients with periampullary cancer

　　Food therapyFuling steamed mandarin fish：15First prepare Fuling1grams, mandarin fish10After minutes, take the fish out of the pot, then add some soy sauce to the juice that the fish has steamed into a small pot, then add a little salt according to your taste, mix it evenly and pour it over the fish, so this Fuling steamed mandarin fish can be eaten.

　　First, surgical treatment

　　If the diagnosis is clear or highly suspicious, and no metastasis is found in clinical examination, an exploratory laparotomy should be performed.

　　1、Without metastatic foci, if the general condition allows, perform a pancreaticoduodenectomy in one stage. For those with poor constitution, consider PTCD or cholecystojejunostomy, and perform a second-stage pancreaticoduodenectomy after jaundice subsides.

　　2、When the tumor infiltrates adjacent organs or has distant metastasis, only perform cholecystojejunostomy or cholecystoduodenostomy to relieve jaundice.

　　Second, non-surgical treatment

　　1、Symptomatic treatment：Take oral multi-enzyme tablets, vitamins, protein. Blood transfusion, fluid replacement, pain relief.

　　2、Chemotherapy：used for comprehensive treatment before and after surgery or those who cannot be removed. 5-Fluorouracil250～500mg/.0g will be a course of treatment, rest7.5～1Weeks after the chemotherapy, give mitomycin2～4μετά από την επανάληψη της θεραπείας.4mg, Αλανίνη-αρβουροσάκχαρο100mg, 5-Fluorouracil500mg, προσθέστε10％ γλυκόζης2θα είναι μια εβδομάδα, η στατική ένεση10θα είναι μια θεραπευτική περίοδος. Κατά τη διάρκεια της λήψης του φαρμάκου κάθε5～7Επιθεώρηση της αίματος μια φορά την ημέρα, οι λευκοκύτταρα κάτω από3.5×109/L, τα αιμοπετάλια κάτω από8×109/L, πρέπει να σταματήσει τη λήψη.

　　3、Κινεζική παραδοσιακή ιατρική θεραπεία。

　　4、Ανοσοθεραπεία：Χρησιμοποιούνται θυμική πέψη, ανοσοθεραπεία, μεταφορικό παράγον