Ịghọta nyocha na Ngwọta nke nchịkwa Biliary
MRCP na ERCP maka Biliary Mgbasa
Iji ghọta nke ọma ihe Magnetic Resonance Cholangio-Pancreatography (MRCP) na Endoscopic Retrograde Cholangio-Pancreatography bụ, ị ga-ebu ụzọ ghọta ihe biliary obstruction bụ na ihe na-akpata ụdị nsogbu a.
Ọ bụ ezie na ụyọkọ agba na-emekarị ka a ghara igbochi ya, enwere ọtụtụ ihe kpatara ịmechi biliary nwere ike ime na ọtụtụ ụzọ isi mesoo nsogbu ndị ahụ ga-adabere na ọrịa onye ọrịa, usoro ahụ ike, ahụike, akụkọ ihe mere eme nke usoro nchịkwa na ihe ndị ọzọ nwere ike ịdị iche na onye mmadụ.
Akwụsịla Ngwurugwu Biliary
Ka anyị malite na usoro usoro digestive na-arụ ọrụ. Iji nweta ihe kachasị mma maka nri, nri ga-agbaji site na tract digestive ka a na-etinyekwa vitamin, mineral, protein, abụba, na carbohydrates n'ime obere eriri afọ. Usoro a na-amalite site n'inwe nri, na afọ na-eji mmiri ọgwụ eme ihe ma na-agbanye nri gburugburu iji nyere aka belata ya. Mgbe nke ahụ gasịrị, a na-etinye bile na nri iji kwatuo akụkụ abụba nke nri ahụ.
Bile bụ ihe ọṅụṅụ na-edozi ahụ nke a na-eme n'ime imeju na enwere ike iji ya ozugbo ma ọ bụ chekwaa maka ojiji. Ọ bụrụ na a ga-eji bile na-emesị, ọ ga-emegharị na imeju n'ime gallbladder site na otu n'ime mmiri bile ducts-tubes nke na-ebufe bile na-egbochi imeju na ebe ọ na-eji enyere aka mgbaze.
Ọ bụrụ na bile ga-eji ozugbo ọ hapụjujujujujujujuju, ọ ga-esi na imeju gaa kpọmkwem akụkụ mbụ nke eriri afọ ahụ (duodenum) site na ngwongwo bile.
A na-eji pasent 50 nke bile mee ihe ngwa ngwa n'ụzọ a mgbe ọkara ọzọ na-echere na gallbladder, ebe a na-ewepụ ọtụtụ mmiri na bile na-etinyekwu uche karị.
Mgbe bile na-enweghị ike ịkwaga n'ime otu bile ducts site na imeju ma ọ bụ gallbladder n'ihi nsogbu na ducts, a na-akpọ ya mkpọchi biliary.
Ụdị biliary kachasịsịsịsịsị bụ gallstone, nke bụ bọl nke bile nke na-esi ike n'oge usoro iwepụ mmiri si bile, nke bụ otu n'ime ọrụ nke gallbladder. Nkume ndị a na-ejide ọnyà na gallbladder ma ọ bụ na eriri nke na-ewe bile si gallbladder ruo duodenum.
Ihe Ndị Na-emekarị Maka Ọkụ Biliary
- Gallstones (nke a bụ ihe kachasị akpata biliary igbochi)
- Ọdịiche dị njọ nke otu n'ime mmiri bile, nke a na-akpọkarị biliary stenosis
- Bọl duct mbufụt
- Ịmepụta cyst na otu n'ime ụzọ
- Lymph node enlargement nke na-eme ka eriri ahụ dị n'èzí
- Pancreatitis, karịsịa ugboro ugboro ma ọ bụ na-adịghị ala ala
- Ọrịa / trauma nke gụnyere imeju, gallbladder, pancreas ma ọ bụ bile
- Tumors, nkwonkwo ma ọ bụ dị njọ
- Ọrịa nke gallbladder, bile ducts ma ọ bụ pancreas
- Ọrịa afọ ime
Ihe Ngbaghara maka Ọkụ Biliary
E nwere ọtụtụ ihe kpatara mmadụ ga - eji gbochie ya, ụfọdụ n'ime ihe ndị na - akpatakarị bụ:
- Akụkọ banyere gallstones
- Akụkọ banyere ịwa ahụ nke na-emetụta okporo mmiri bile
- Akụkọ banyere ọrịa kansa biliary
- Akụkọ banyere ọrịa cancer ma ọ bụ ọrịa
- Akụkọ banyere ọrịa cancer pancreatic ma ọ bụ ọrịa
- Akụkọ banyere nsogbu gallbladder
- Akụkọ banyere ịwa ahụ n'oge gara aga iji wepụ gallbladder
- Oge na-adịghị ala pancreatitis
- Ibu oke
- Ọnwụ dị arọ
Ihe ịrịba ama na mgbaàmà nke nkwụsịtụ biliary
Ihe ịrịba ama na ihe mgbaàmà nke mmechi biliary ga-adịgasị iche site n'aka onye ọ bụla n'otu n'otu, ma na-agụnye otu ma ọ bụ karịa n'ime ihe ndị a:
- Abdominal mgbu, nke dị n'oche aka nri
- Itching
- Jaundice (yellowing nke akpụkpọ ahụ)
- Nausea na Vomiting
- Akpụkpọ ụkwụ ma ọ bụ na-acha ọcha ọcha
- Ọchịchịrị urine
Ịchọpụta Biliary Mgbasa
Ọ bụrụ na a na-enyo enyo, ị nwere ule ọbara, nchọpụta ima, na usoro ndị a pụrụ ime iji kwado nyocha ahụ.
Nnwale ọbara na-emekarị nke ga - egosi nsogbu nsogbu bile nwere ike ịgụnye ọkwa dị elu nke alkaline phosphatase, ọkwa dị elu nke bilirubin, na imeju enzymes imeju.
Nsogbu nke na-eme ka bile na-azụ n'ime imeju ga-eme mgbanwe dị ịrịba ama na nyocha ọbara nke na-elekọta ọrụ imeju.
Nlekọta ndị ọzọ a pụrụ ime iji chọpụta ihe mgbochi biliary gụnyere:
- Ultrasound nke afọ
- CT nyocha nke afọ
- Nkọwa transhepatic cholangiogram (PTCA)
- Magnetic Resonance Cholangio-Pancreatography (MRCP)
- Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
Ngwọta ndị a ga-eme iji mesoo mgbochi biliary dabeere na ihe kpatara ya na ọnọdụ nke nsogbu ahụ. Ihe kachasị emetụta bụ ụyọkọ, na ọgwụgwọ gụnyere Endoscopic Retrograde Cholangio-Pancreatography (ERCP) na ịwa ahụ iji wepụ gallbladder (cholecystectomy).
Ọ bụrụ na ihe kpatara mgbochi ahụ bụ ihe ọzọ karịa ụda nkume, ọgwụgwọ ahụ nwere ike ịdịgasị iche site na mmadụ gaa na onye. Dịka ọmụmaatụ, a ga-emeso onye na-enwe mmechi biliary n'ihi ọrịa cancer dịka iche karịa onye na-enwe nsogbu otu ahụ n'ihi ọrịa. Onye agadi nwere ndidi gallstones nwere ike ịnweta ọgwụgwọ dị iche karịa nwanyị dị afọ 30 nke na-enwe ihe ịrịba ama na mgbaàmà ndị ahụ, ebe onye agadi nwere ike ọ gaghị enwe ike ịnagide otu ọgwụgwọ ahụ dị ka nwata.
Dịka, ụzọ kachasị emetụta ọnwụnwa na ịgwọ ọrịa bụ nke mbụ a ga-anwale-dị ka MRCP-mgbe usoro nchịkwa ọzọ dị ka nje ERCP ma ọ bụ ịwa ahụ gallbladder ọ bụ naanị ma ọ bụrụ na ọ dị mkpa. Nke ahụ kwuru na ịwa ahụ gallbladder, nke a makwaara dị ka cholecystectomy, bụ otu n'ime ịwa ahụ kachasị arụ ọrụ na United States.
Kedu ihe bụ Resonance Resonance Cholangio-Pancreatography (MRCP)
Magnetic Resonance Cholangio-Pancreatography, nke a maara dị ka MRCP, bụ ule na-abụghị ihe mgbochi dị ka Ụkpụrụ MRI . A na-anwale ule a iji nyochaa imeju, pancreas, gallbladder, na bile ducts iji chọpụta ma ọ bụ mmechi dị. Nnwale ahụ nwere ike inyere aka chọpụta ihe mgbochi, ma nwee ike inye aka chọpụta ihe kpatara mgbochi, nke nwere ike ikpebi otu esi emeso nsogbu ahụ.
Kedu mgbe a na-eme MRCP?
A na-eme MRCP mgbe enwere enyo na mmechi nke bile na-abịa ma na-akpata nsogbu. Ọ bụghị naanị na ule a nwere ike ịchọpụta ma ọ bụrụ na ịbechi bịịleị dị ugbu a, ule a nwere ike ịchọpụta ihe kpatara nsogbu a. N'ụzọ dị mwute, ebe MRCP bụ ụzọ dị mma iji chọpụta nsogbu ahụ, ule a nwere ike inyere aka chọpụta otu kacha mma si edozi nsogbu ahụ-MRCP n'onwe ya apụghị ịnagide mmechi ahụ.
Kedu ihe na-eme n'oge MRCP?
N'oge MRCP, a chọrọ onye ọrịa ka ọ ka nọ n'elu ihe ndina nke na-agagharị n'ime igwe ma ọ bụ dị ka MRI. Ule a abughi ihe ojoo, nke putara na o nweghi ihe di n'ime ya. Dịka x-ray, igwe ahụ agaghị emetụ gị aka nyochaa n'ime ahụ. Ule a bụ ihe na-agba ume ma na-ewe ọtụtụ awa.
Ihe ize ndụ nke MRCP
Ihe ize ndụ nke MRCP dị ntakịrị. Ndị ọrịa nwere ahụhụ na claustrophobia ma ọ bụ ndị dị oke arọ nwere ike ịchọ ka igwemịghe MRI nke na-adịghị ahụkebe maka ọmụmụ ihe ha karịa igwe na-eme ka ikuku, ma ọ dịghị ihe ize ndụ dị egwu na ụdị ọmụmụ a. Ọ bụrụ na eji usoro dị iche iche eme ihe, enwere obere ihe ize ndụ nke mmeghachi omume nrịanrịa, a ga-ejikwa nlezianya jiri nlezianya na ndị ọrịa nwere nsogbu akụrụ.
Ndị nwere ọrịa metal nwere ike ịnwe MRCP ma ọ bụrụ na ha emetụta bụ MRI nchekwa, dịka usoro ahụ na-eji magnet siri ike meepụta ihe oyiyi n'ime ahụ. Enweghi ikpochapu ikpochapu n'oge MRI.
ERCP kọwara
Endoscopic Retrograde Cholangio-Pancreatography, nke a na-akpọkarị ERCP, bụ usoro mmebi ahụ ebe a na-etinye nkwụnye akwara na -abanye n'ọnụ ma jiri nwayọọ na-akwagharị n'ime esophagus n'ime afo, wee banye na akụkụ mbụ nke eriri afọ ahụ a na-akpọ duodenum.
Njedebe nwere ma ìhè na igwefoto na njedebe, nke na-enye ohere ka dọkịta ahụ lelee anya n'ime traestive digestive. Nke a ga-ekwe omume n'ihi na ọtụtụ bile duct na-abanye n'ime duodenum, ma ọ bụrụ na a gallstone ma ọ bụ mmechi ọzọ dị na ngwongwo bile, onye ọkachamara gastroenterologist nwere ike iwepụ nkume mgbe ọ na-eji waya, nkata ma ọ bụ mkpọchi balloon na njedebe.
Kedu mgbe emere ERCP?
Emere ERCP maka otu n'ime ihe abụọ. Ihe mbụ kpatara ya bụ ịme nyocha-iji chọpụta ma ọ bụrụ na ịchọta mgbapụta dị nso site na nlele anya na-enyocha ụdọ. Ihe nke abụọ mere ERCP ji arụ ọrụ bụ mgbe nchọpụta ndị ọzọ, dịka nyocha ọbara ma ọ bụ MRCP, na-egosi na mmechi biliary abụghị naanị ugbu a, ma nsogbu ahụ nwere ike ịmebe site n'ịnọnye ihe na-esi ísì ma ọ bụ wepụ ihe ga-esi na ya.
N'adịghị ka MRCP, nke na-enye ihe oyiyi nke ihe na-eme n'ime ahụ, ERCP nwere ike ịgwọ nsogbu ahụ n'ezie.
Ihe ize ndụ nke ERCP
Ọ bụ ezie na a na-ele ERCP anya dịka ihe dị ize ndụ, dị ka usoro ọnyà ọ bụla nwere ike inwe nsogbu ndị a ga-atụle. Na mgbakwunye na ihe ize ndụ metụtara ọrịa ọgbụgba, ERCP nwere ike ịkpata pancreatitis, ọrịa, na ọbara ọgbụgba.
Ihe mgbagwoju kachasị njọ bụ ihe mgbochi-na mberede na-eme oghere-n'ime eriri afọ ma ọ bụ ebe ndị ọzọ ERCP na-emegharị. Ihe ize ndụ nke nkedo dị ala n'aka onye ọkachamara gastroenterologist, ma ọ bụ ezie na o kwere omume.
Anesthesia na ERCP
A na-eme usoro ERCP na onye ọrịa na-enweta nkwonkwo izugbe ka ha ghara ịma usoro a na-arụ. A ga-eme ka onye ahụ na-arịa ọrịa gwakọtara ya ma tinye ya na ventilator ma na-ehi ụra maka usoro dum.
Mgbe usoro ahụ zuru ezu, a ga-enye ọgwụ iji kwụsị nkwụsịtụ na onye ọrịa ga-eji nwayọọ nwayọọ na-eteta. Ozugbo onye ọrịa ahụ na-eku ume n'onwe ya, a na-ewepu ngwụcha ngwụcha ya na onye ọrịa na-ewere ya na Post Anesthesia Care Unit ( PACU ) ma ọ bụ ụlọ ụlọ ọgwụ ha iji weghachi.
Usoro a nwere ike ịrụ ọrụ dị ka onye na-agwọ ọrịa ma ọ bụ usoro ịpụ apụ. Ọ bụrụ na onye ahụ adịghị arịa ọrịa nke ukwuu, ha nwere ike ịlaghachi n'otu ụbọchị ahụ, ebe ndị ọrịa nwere ike ịdị mkpa ịlaghachi na ụlọ ọgwụ.
> Isi:
> Ngwunye okporo ahụhụ Bile. Ịbanye na February, 2017. http://www.nytimes.com/health/guides/disease/bile-duct-obstruction/overview.html