Cholangiocarcinoma Case Study

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1. Cholangiocarcinoma

담관암(Cholangiocarcinoma)은 담관 상피세포에서 발생하는 암으로, 주호소/입원사유는 ERBD(Endoscopic Retrograde Biliary Drainage) 교체를 위한 것이었다. 환자는 2024년 3월부터 담관암이 의심되었고, 복강경 담낭절제술 및 복막 종양 생검을 통해 전이성 암이 확인되었다. 최종 진단명은 Cholangiocarcinoma(C22.1)이었다.
2. Bladder Cancer

환자는 Bladder Cancer s/p 수술 및 항암치료 후 만성 표재성 위염 진단을 받았다. 이는 환자의 복합적인 의학적 상황을 보여준다.
3. ERBD (Endoscopic Retrograde Biliary Drainage)

ERBD는 담관 폐쇄를 해결하기 위해 내시경적으로 삽입하는 배액관이다. 환자는 2024년 3월 ERCP를 통해 EST 후 플라스틱 스텐트를 삽입받았고, 2024년 8월 EGD에서 기존 플라스틱 스텐트를 제거하고 ERBD(7Fr, 10cm)를 삽입받았다.
4. Nursing Diagnosis

간호진단으로는 감염 위험성, 영양 불균형, 피부 통합성 손상 위험성, 수술 후 통증과 관련된 불안 등이 있었다. 이에 대한 간호중재와 평가가 이루어졌다.

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1. Cholangiocarcinoma

Cholangiocarcinoma is a rare and aggressive type of cancer that originates in the bile ducts, which are the tubes that carry bile from the liver to the small intestine. This cancer is particularly challenging to treat due to its late presentation and the difficulty in detecting it early. Patients often experience non-specific symptoms such as abdominal pain, jaundice, and weight loss, making it challenging for healthcare providers to diagnose the condition in a timely manner. The prognosis for cholangiocarcinoma is generally poor, with a 5-year survival rate of only around 10-15% for advanced-stage disease. However, early detection and appropriate treatment, which may include surgery, chemotherapy, and radiation therapy, can improve outcomes for some patients. Ongoing research into new diagnostic and treatment approaches, as well as a better understanding of the underlying molecular mechanisms of this disease, are crucial to improving the outlook for individuals affected by cholangiocarcinoma.
2. Bladder Cancer

Bladder cancer is a type of cancer that originates in the bladder, the organ responsible for storing and eliminating urine from the body. It is a relatively common form of cancer, with an estimated 81,180 new cases and 17,100 deaths in the United States in 2022. Bladder cancer can be classified into two main types: non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). NMIBC is the more common form, accounting for approximately 75% of cases, and is generally less aggressive and more treatable than MIBC. Treatment options for bladder cancer depend on the stage and grade of the disease, and may include transurethral resection of the bladder tumor (TURBT), intravesical therapy, chemotherapy, radiation therapy, and in some cases, radical cystectomy (removal of the bladder). Early detection and appropriate treatment are crucial for improving outcomes, as bladder cancer can be a highly treatable disease if caught early. Ongoing research into new diagnostic and treatment approaches, as well as a better understanding of the underlying risk factors and molecular mechanisms of this disease, are essential for improving the prognosis and quality of life for individuals affected by bladder cancer.
3. ERBD (Endoscopic Retrograde Biliary Drainage)

ERBD, or Endoscopic Retrograde Biliary Drainage, is a minimally invasive procedure used to treat blockages or obstructions in the bile ducts, which are the tubes that carry bile from the liver to the small intestine. This procedure is often used to manage conditions such as bile duct stones, bile duct strictures, and malignant bile duct obstructions, which can lead to serious complications like jaundice, cholangitis, and liver dysfunction if left untreated. During an ERBD procedure, a healthcare provider uses a flexible endoscope to access the bile ducts through the mouth, and then inserts a small drainage tube (stent) to bypass the blockage and restore the flow of bile. ERBD is generally considered a safe and effective procedure, with a high success rate in relieving bile duct obstruction and improving patient outcomes. However, as with any medical procedure, there are potential risks, such as infection, bleeding, and pancreatitis. Careful patient selection, proper technique, and close monitoring are essential to ensure the best possible outcomes for individuals undergoing ERBD. Ongoing research and advancements in endoscopic techniques and stent technology continue to improve the safety and efficacy of this important procedure.
4. Nursing Diagnosis

Nursing diagnosis is a critical component of the nursing process, which is the systematic approach used by nurses to provide high-quality, patient-centered care. A nursing diagnosis is a clinical judgment about an individual's, family's, or community's response to actual or potential health problems or life processes. It serves as the foundation for the nursing care plan, guiding the selection of nursing interventions and the evaluation of patient outcomes. Accurate and comprehensive nursing diagnoses are essential for ensuring that nurses can effectively identify and address the unique needs of their patients. This process involves a thorough assessment of the patient's physical, emotional, and social well-being, as well as an understanding of the underlying pathophysiology and risk factors contributing to the patient's condition. Nurses must then use their clinical expertise and critical thinking skills to formulate appropriate nursing diagnoses, which can range from acute issues like pain or infection to chronic conditions like diabetes or heart disease. By developing a clear and accurate nursing diagnosis, nurses can then develop and implement targeted interventions to promote healing, prevent complications, and improve the overall quality of life for their patients. Ongoing education, research, and the adoption of evidence-based practices are essential for ensuring that nursing diagnoses remain a cornerstone of high-quality, patient-centered nursing care.

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