Wopɛ sɛ wuhu pii fa ERCP (Endoscopic Retrograde Cholangiopancreatography) nhwehwɛmu no ho? Nsuro, momma yɛnkasa!

Sɛ wo duruyɛfo ka kyerɛ wo sɛ ɛsɛ sɛ woyɛ ERCP a, ebia wowɔ nsɛmmisa pii fa nea ɛyɛ, nea enti a wɔyɛ, ne so ɛbɛyɛ yaw ho. Ɛno yɛ ade a ɛfata. Nnipa pii ho popo kakra bere a wɔte din no. Nanso ERCP nyɛ biribi a ɛsɛ sɛ wosuro. Nokwarem no, ɛyɛ sɔhwɛ a ɛkɔ akyiri yiye a ebetumi ahu ɔhaw ahorow bi a ɛwɔ wo biliary system ne pancreatic ducts mu na ɛtɔ mmere bi a asa. Enti, momma yɛnka ERCP ho asɛm wɔ ɔkwan a ɛnyɛ den so nnɛ, ɛyɛ?

Dɛn ne ERCP (Endoscopic Retrograde Cholangiopancreatography) a wɔde hwehwɛ nipadua no mu?

Ebia edin tenten yi bɛma wo ho ayɛ wo yaw kakra, nanso momma yɛnbubu mu na yɛnte ase.

Sɛ yɛbɛka no tiawa a, ERCP yɛ ɔkwan titiriw bi a nnuruyɛfo de hwɛ wo bile ntini ne wo dwensɔtwaa mu ntini mu . Saa ntini yi kura bile ne dwensɔtwaa mu nsu, na ɛboa ma yɛyam aduan a yedi no.

Nea edin yi asekyerɛ ni:

• Endoscopic: Eyi de afiri bi a wɔfrɛ no endoscope na edi dwuma. Ɛyɛ afiri a ɛyɛ tratraa a ɛyɛ mmerɛw a mfoninitwa afiri ketewaa bi ne kanea wɔ ano biako. Wɔde fa w’anom na ɛkɔ fam kɔ ​​wo dwensɔtwaa no atifi (duodenum). Wɔbɛma wo aduru a ɛma wo ho dwo na aboa wo ma woada, enti worente nka sɛ wo ho nyɛ wo dɛ.
• Retrograde: Wɔ eyi mu no, wɔde afiri ketewaa foforo fa endoscope no mu na wɔde nsu titiriw bi (contrast dye) gu bile ntini ne dwensɔtwaa ntini no mu. "Retrograde" kyerɛ "akyi" efisɛ wɔde nsu no gu ɔkwan a ɛne no bɔ abira a ɛtaa sen no so.
• Cholangiopancreatography: Eyi kyerɛ mfonini ahorow a wɔatwa. "Cholangio" kyerɛ sɛ ɛfa bile ducts ho. "Pancreato" kyerɛ sɛ ɛfa dwensɔtwaa ho. "Graphy" kyerɛ sɛ wobɛtwa mfonini.

Enti, aduru a wɔde yɛ ade a ɛne ne ho bɔ abira no ma wo bile ntini ne wo dwensɔtwaa ntini no da adi pefee wɔ X-ray mfonini ahorow so. Eyi ma nnuruyɛfo hu sɛ ebia biribi siw saa ntini ahorow yi kwan - te sɛ akisikuru mu abo, akisikuru, anaasɛ ntini no a ɛyɛ teateaa esiane akuru ntini nti . Nea eye sen biara ne sɛ wobetumi adi ɔhaw ahorow yi bi ho dwuma wɔ hɔ ara, denam endoscope so.

Wɔ tebea horow bɛn mu na ERCP ho hia?

Ebia wo duruyɛfo bɛkra ERCP sɛ wosusuw sɛ ɔhaw bi wɔ wo biliary system no mu a. Nhwɛsoɔ:

• Sɛ wowɔ yafunu atifi yaw a wontumi nkyerɛkyerɛ mu , anaasɛ wowɔ biliary colic a.
• Sɛ tebea bi wɔ hɔ a ɛma mogya a ɛsen no siw anaasɛ sɛnkyerɛnne ahorow bi wɔ hɔ a ɛkyerɛ sɛ mogya no retu, sɛ nhwɛso no, jaundice .

ERCP nhwehwɛmu betumi aboa ma woahu ɔhaw ahorow a ɛtaa ka wo bile ntini ahorow te sɛ:

• Ntini a ɛma mogya tu no mu ɔfe (cholangitis) ne nyarewa a ɛbata ho.
• Ntini a ɛma mogya tu no a ɛyɛ teateaa esiane akuru ntini (biliary stricture) nti .
• Abo a asiw wɔ mogya ntini a ɛtaa ba no mu .
• Ɔyare a ɛwɔ dwensɔtwaa mu a abo na ɛde ba (gallstone pancreatitis) .
• Tumor anaa kokoram a ɛwɔ ntini a ɛma mogya tu no mu.
• Bile duct a ɛtwetwe anaa akwanhyia afoforo.

Ɔkwan bɛn so na ERCP yɛ adwuma?

ERCP ka akwan atitiriw abien bom: endoscopy ne fluoroscopy . Fluoroscopy te sɛ X-ray mfonini ahorow a ɛkɔ baabiara. Fa no sɛ ɛte sɛ video so X-ray.

Saa fluoroscopy yi ma oduruyɛfo no hu sɛnea nsu titiriw (contrast dye) no fa wo bile ntini ne wo dwensɔtwaa mu ntini mu. Ebetumi akyerɛ pefee sɛ nsu a ɛretu anaasɛ asiw biara.

Endoscope no ne nea ɛma oduruyɛfo (endoscopist) no tumi du beae no. Wɔnam eyi so de aduru a ɛne ne ho bɔ abira no gu nipadua no mu. Afei nso, sɛ wohu ɔhaw bi a, wobetumi de nnwinnade nketewa afa endoscope yi mu ahyɛ mu de asa.

Henanom na wɔyɛ ERCP?

Mpɛn pii no , yafunu mu ɔyaresafo na ɔyɛ ERCP . Saa nnuruyɛfo yi yɛ abenfo a wɔsa nyarewa a ɛwɔ wo aduan mu ne mogya mu nsu mu no mu. Wɔatete wɔn nso ma wɔayɛ endoscopy. Wɔatete wɔn nso wɔ endoscopic akwan a wobetumi de adi dwuma sen sɛ wɔbɛyɛ oprehyɛn nketenkete ho.

Wobɛyɛ dɛn asiesie wo ho ama ERCP?

Wo duruyɛfo bɛma wo akwankyerɛ pɔtee bi a ɛsɛ sɛ wudi akyi ansa na woayɛ ERCP. Mpɛn pii no, eyinom bi ne:

• Ɛsɛ sɛ wugyae sigaretnom, adidi, chewing gum, ne biribiara a ɛnyɛ nsu a wobɛnom nnɔnhwerew awotwe ansa na woayɛ sɔhwɛ no.
• Ɛsɛ sɛ woka ayaresa tebea foforo biara a wowɔ ne nnuru biara a wonom kyerɛ wo duruyɛfo . Ebia ɛho behia sɛ wogyae nnuru bi te sɛ nea ɛma mogya tu no nna kakraa bi ansa na wɔayɛ nhwehwɛmu no.
• Sɛ woadi kan ayɛ wo ho akisikuru wɔ aduru a wɔde yɛ ade a ɛne ne ho bɔ abira anaa aduru a wɔde kum nipadua no a wɔde di dwuma bere a wɔreyɛ nhwehwɛmu no ho a, ka kyerɛ wo duruyɛfo .
• Ɛho behia sɛ woyɛ kar ho nhyehyɛe na wode akɔ fie bere a wɔayɛ nhwehwɛmu no awie no, efisɛ egye bɛyɛ nnɔnhwerew 24 ansa na nnuru a wɔde kum nipadua no nkɛntɛnso no asɛe koraa. Enti, worentumi nka kar.

Dɛn na ɛba bere a wɔreyɛ ERCP sɔhwɛ no?

ERCP yɛ ayaresa a wɔde kɔ ayaresabea . Eyi kyerɛ sɛ wubetumi akɔ fie da koro no ara. Mpɛn pii no, adeyɛ no gye bɛyɛ dɔnhwerew biako anaa abien.

Wɔbɛma wo aduru bi a wɔde ma wo ntini mu (ɛnam ``IV`` so) na ama woada (sedated) . Ebia woada kɛse, anaasɛ ɛkame ayɛ sɛ woda. Nanso, worenkae sɔhwɛ no.

Wɔ sɔhwɛ no fã a wɔde hwehwɛ yare no mu no, oduruyɛfo no bɛyɛ nea edidi so yi:

• Sɛ wopɛ a, wobetumi de nsu a wɔde kum nipadua no ahyɛ mu na ama menewam a ɛyɛ yaw no so atew.
• Wɔde endoscope bi fa ano no mu na wɔde ahwɛyiye fa ɛwo kotoku ne yafunu no mu kɔ dwensɔtwaa ketewa no atifi (duodenum). Wɔde mfonini ahorow a wohu fi endoscope no mfoninitwa afiri no mu no kyerɛ wɔ screen so.
• Sɛ wohwɛ saa video ahorow no a, wubetumi ahu sɛnea bile duct ne pancreatic duct no abue wɔ dwensɔtwaa ketewa no mu.
• Wɔde afiri ketewaa foforo fa catheter a ɛwɔ endoscope no mu no mu na ɛkɔ baabi a wɔabue no mu.
• Wɔde aduru a ɛma nsonsonoe no fa saa afiri ketewa no mu no gu ntini no mu.
• Afei, wɔde fluoroscopy mfiridwuma di dwuma de twa X-ray video ahorow de hwɛ sɛnea nsu no fa nsukorabea ahorow no mu. Wɔ fluoroscopy mu no, wɔma X-ray ahorow no fi adi wɔ bere tiaa bi a ɛpae mu. Wobu eyi sɛ mframa a ano yɛ den a ahobammɔ wom.
• Saa mfonini yi na wɔde hwɛ sɛ ɔhaw biara wɔ nsuo afiri no ho - a ɛsiw, ɛho ahonhon, nsuo a ɛretu, ne nea ɛkeka ho.

Fa no sɛ eyi, ɛte sɛ nea wode mfoninitwa afiri bi ahyɛ nsu afiri mu, de nsu a ɛyɛ kɔla bi afa mu, na woahu baabi a asiw ne baabi a ɛretu.

Afei, sɛ oduruyɛfo no hu ɔhaw bi wɔ nhwehwɛmu yi mu a, ɔbɛbɔ mmɔden sɛ ɔbɛsa denam nnwinnade nketewa a ɔde bɛhyɛ endoscope no mu no so. Oduruyɛfo a ɔreyɛ endoscopy no betumi ayɛ nneɛma te sɛ:

• Abo a ɛwɔ akisikuru a wɔbubu na woyi fi hɔ.
• Akisikuru a wobeyi afi hɔ anaasɛ wɔbɛfa ntini mu nhwɛsode (biopsy). (Sɛ wɔyɛ biopsy a, wɔde kɔ lab kɔhwɛ sɛ ɛyɛ kokoram anaasɛ ɛnte saa.)
• Sɛ́ wɔbɛtrɛw mogya ntini a ayɛ teateaa anaa ayɛ mmerɛw no mu anaasɛ wɔbɛtrɛw mu.
• Ade ketewaa bi a ɛte sɛ tube (stent) a wɔde bɛhyɛ anwenne bi mu na ama abue.
• Sɛ wosiesie nsuo a ɛretu anaa apira wɔ paipu mu.
• Sphincterotomy yɛ ntini ketewaa bi a wɔtwa wɔ ntini a atwa ntini no bue ho no mu de ayɛ kɛse. (Eyi boa ma bile ne dwensɔtwaa mu nsu kɔ ntɛmntɛm.)

Dɛn na wubetumi ahwɛ kwan wɔ ERCP akyi?

Sɛ wɔyɛ nhwehwɛmu no wie a, wɔde wo bɛto ayaresabea anaa aduruyɛbea bɛyɛ dɔnhwerew biako anaa abien, kosi sɛ aduru a wɔde kum nipadua no mu nsunsuanso no bɛsɛe. Afei onipa a ɔbaa sɛ ɔrebɛfa wo no betumi de wo akɔ fie. Ebia wobɛte nka sɛ woada kakra, wo ho ayɛ wo hyew anaasɛ woayɛ spacey saa da no.

Nneɛma nketenkete a ɛnyɛ dɛ te sɛ eyinom betumi aba da koro anaa nnanu wɔ sɔhwɛ no akyi:

• Menewa mu yaw ne ɛyɛ den sɛ wobɛmene: Endoscope no betumi ama wo menewam ayɛ wo yaw kakra. Ɛyɛ papa sɛ wobɛnom nsu anaa nnuan a ɛyɛ mmerɛw kosi sɛ ɛbɛsa.
• Yafunu a ahuru anaa mframa a ɛyɛ yaw: Sɛ wɔde endoscope no hyɛ mu a, wɔbɔ mframa kakra kɔ GI kwan no mu na ama wɔatumi ahu ade yiye. Eyi na ɛde saa ɔhaw yi ba. Ɛbɛbrɛ ase bere tiaa bi akyi (bere a mframa no afi mu pɛn).
• Akisikuru: Eyi betumi ayɛ aduru a wɔde kum nipadua no mu nsunsuanso bɔne. Ɛbrɛ ase nso wɔ da a edi hɔ no.

Asiane bɛn na ɛwɔ ERCP mu?

Nsɛnnennen ba wɔ bɛyɛ 5% kosi 10% mu wɔ ERCP akwan horow no mu. Saa asiane yi gyina w’ayaresa tebea horow a woadi kan anya ne ayaresa ko a wo nsa ka wɔ ERCP no mu so. Wo duruyɛfo no ne wo bedi kan asusuw eyi ho. Nsɛnnennen a ebetumi aba no bi ne:

• Nneyɛe bɔne a ɛwɔ aduru a ɛma obi dwo no ho: Eyi betumi de koma ne ahurututu mu nsɛnnennen aba nnipa a na wɔwɔ ahurututu anaa komayare dedaw no mu.
• Allergic reaction to the contrast dye: Sɛ eyi ba a, oduruyɛfo no bɛma wo nnuru ntɛm ara na ama woagyae adeyɛ no.
• Wo GI kwan a wopira fi endoscope no mu: Eyi betumi ama mogya atɔ wo mu anaasɛ, wɔ tebea horow a emu yɛ den mu no, tokuru.
• Bile leak esiane opira a ɛba bile ducts a endoscopic nnwinnade de ba nti.
• Nyarewa a ɛwɔ wo biliary system mu: Nea ɛbɛyɛ na woasiw eyi ano no, wo duruyɛfo betumi adi kan ama wo nnuru a ekum ɔyare mmoawa.
• Adeyɛ no betumi ama dwensɔtwaa no ayɛ abufuw na ayɛ hyew (pancreatitis). Eyi ne ɔhaw a ɛtaa ba wɔ ERCP akyi.

Sɛ wonyinsɛn bere a wɔreyɛ nhwehwɛmu no a, asiane a ɛwɔ hɔ sɛ mframa a ɛba bere a wɔreyɛ fluoroscopy no bepira akokoaa no sua, nanso asiane ketewaa bi wɔ hɔ. Wo duruyɛfo bedi kan abisa wo sɛ ebia ebetumi aba sɛ wubetumi anyinsɛn anaa. Sɛ saa a, wo duruyɛfo no bɛbɔ mmɔden sɛ ɔbɛsan ayɛ nhwehwɛmu no ho nhyehyɛe anaasɛ sɛ ɛho hia a, ɔbɛtew mframa a ano yɛ den a wobɛma no so.

Bere tenten ahe na egye ansa na wɔahu nea efi sɔhwɛ no mu ba?

Sɛ wo nnya nnae esiane nnuru a wɔde kum wo a, .Ɛsɛ sɛ oduruyɛfo (endoscopist) a ɔyɛɛ ERCP no tumi ne wo kasa fa nhwehwɛmu no ho ntɛm ara. Ɔbɛka nea wohuu ne nea wobetumi ayɛ wɔ ho akyerɛ wo. Sɛ wɔfaa ntini bi (biopsy) a, ebia ebegye adapɛn pii ansa na nea efi mu ba no asan aba.

Sɛ wo ERCP no nhu hwee a, ebia ɛho behia sɛ woyɛ nhwehwɛmu foforo. Sɛ nhwehwɛmu no ansiesie wo haw no, anaasɛ nea efii biopsy mu bae no si so dua sɛ ɔhaw foforo bi wɔ hɔ a, ebia ebehia sɛ woyɛ ayaresa foforo. Wo duruyɛfo no ne wo bɛkasa afa nea ɛsɛ sɛ woyɛ akyi.

Bere bɛn na ɛsɛ sɛ wofrɛ oduruyɛfo no?

Sɛ wuhu saa sɛnkyerɛnne ahorow a emu yɛ den anaasɛ ɛyɛ soronko yi bi wɔ ERCP akyi a, frɛ wo duruyɛfo ntɛm ara:

• Yafunu mu yaw a emu yɛ den anaasɛ ne ho popo.
• Koko mu yaw anaasɛ ɛyɛ den sɛ wobɛhome.
• Atiridiinini, ɔfe, anaa sɛnkyerɛnne afoforo a ɛkyerɛ sɛ obi anya ɔyare mmoawa.
• Mogya a ɛba akyi berɛmo mu anaasɛ nsu a ɛyɛ tuntum a ɛyɛ tarry.

Nsonsonoe bɛn na ɛda ERCP ne endoscopy a wɔyɛ no daa ntam?

ERCP yɛ endoscopy a ɛkɔ akyiri. Esophagogastroduodenoscopy (EGD) a wɔtaa yɛ no hwɛ wo GI kwan a ɛwɔ soro no nkutoo. Eyi kyerɛ sɛ ɛhwɛ aduannoa mu, yafunu, ne dwensɔtwaa ketewa no fã a edi kan no nkutoo.

Nanso wɔ ERCP mu no, wɔde ntrɛwmu foforo di dwuma ka endoscope a wɔde di dwuma daa no ho - kyerɛ sɛ, tube a ɛto so abien (catheter) a ɛkɔ tube a edi kan no mu - eyi ne nea ɛkɔ wo biliary ducts no mu.

Saa mini endoscope ntrɛwmu yi ma oduruyɛfo no tumi sa wo ntini ahorow no yare tẽẽ. Endoscopic kwan baako pɛ a ɛbɛtumi ayɛ ducts no tẽẽ wɔ saa kwan yi so ne `ERCP`. Bere a endoscopic akwan afoforo te sɛ `MRCP` (magnetic resonance cholangiopancreatography) ne `EUS` (endoscopic ultrasound) tumi hu wo bile ducts ne pancreatic ducts no, ɛmma saa kwan yi a ɛyɛ mmerɛw sɛ wobɛsa wɔn yare.

So ERCP yɛ oprehyɛn kɛse?

ERCP nyɛ oprehyɛn sɛnea yɛtaa susuw ho no. Ɛnyɛ biribi a ɛtwa honam ani na ɛkɔ akwaa a ɛwɔ nipadua no mu no mu. ERCP yɛ adeyɛ a wɔde hwɛ nipadua no mu. Ɛkyerɛ sɛ ɛnam abɔdeɛ mu bue so kɔ nipadua no mu - wɔ saa asɛm yi mu no, menewa.

Nanso, sɛ oduruyɛfo no reyɛ ERCP a, obetumi afa endoscope no so ayɛ oprehyɛn ahorow bi. Ɛtɔ mmere bi a nnuruyɛfo frɛ saa akwan a wɔfa so hwɛ nipadua no mu yi sɛ endoscopic oprehyɛn . Eyinom yɛ oprehyɛn efisɛ nea ɛka ho ne sɛ wotwitwa ne nhama wɔ nipadua no mu. Nanso, eyinom taa yɛ oprehyɛn nketenkete, na asiane nnim na bere tiaa bi na ɛma obi ho tɔ no sen oprehyɛn a wɔde di dwuma wɔ amanne kwan so no.

So wɔyɛ ERCP ma dwensɔtwaa mu yare?

Yiw, sɛ wo duruyɛfo susuw sɛ biribi resiw wo bile ntini anaa wo dwensɔtwaa mu ntini a, ebia ɔbɛkra ERCP. Abo a ɛwɔ akisikuru a ɛbata ntini no mu no yɛ ade titiriw a ɛde dwensɔtwaa mu yare a emu yɛ den ba. Sɛ ɛba saa a, ebia ɛho behia sɛ wonya ERCP na ama woayi nea asiw kwan no afi hɔ.

Sɛ wowɔ dwensɔtwaa mu yare a enni sabea a, ɔfe no betumi ama wo dwensɔtwaa ntini no ayɛ akuru na ayɛ teateaa (strictures). Wɔ tebea horow a ɛtete saa mu no, ERCP betumi aboa ma ntini no atrɛw anaasɛ wɔde stent ahyɛ mu na ama wɔabue. Eyi boa ma dwensɔtwaa mu nsu kɔ so sen fa ntini no mu.

Kae ade a ɛho hia sen biara (Take-Home Message) .

ERCP (Endoscopic Retrograde Cholangiopancreatography) yɛ nhwehwɛmu a wɔde hu yare a sɛ ɛho hia a, wobetumi nso de asa yare no wɔ hɔ ara. Ɛwom sɛ ɛyɛ nea ɛyɛ hu kakra sen mfoninitwa nhwehwɛmu a wɔyɛ no daa de, nanso ɛnyɛ nea ɛyɛ hu kɛse te sɛ oprehyɛn akɛse. Wobetumi nso de ahu yare no na wɔasa bere koro mu.

Nnipa dodow no ara tumi yɛ sɔhwɛ yi a ɛnyɛ den pii, na ɛwɔ mfaso pii. Enti, sɛ oduruyɛfo bi hyɛ nyansa sɛ wɔnyɛ ERCP ma wo a, nsuro sɛ wo ne no bɛkasa afa ho, na bisa wo nsɛm nyinaa. Ɛbɛboa wo ma woasisi w’akwahosan ho gyinae a eye sen biara!

` ERCP, endoscopy, bile ntini, dwensɔtwaa, abo, jaundice, aduan mu nhyehyɛe