Àdi be yeanya nu geɖe tso ERCP (Endoscopic Retrograde Cholangiopancreatography) dodokpɔa ŋua? Mègavɔ̃ o, na míaƒo nu!

Ne wò ɖɔkta gblɔ na wò be ele be nàwɔ ERCP la, ɖewohĩ nyabiase geɖe anɔ asiwò ku ɖe nusi wònye, nusitae wowɔe, kple ɖe wòavee ŋu. Ema sɔ. Ame geɖe tsia dzodzodzoe vie ne wose ŋkɔa. Gake ERCP menye naneke si ŋu wòle be woavɔ̃ ɖo o. Le nyateƒe me la, enye dodokpɔ deŋgɔ ŋutɔ si ate ŋu ade dzesi kuxi aɖewo le wò ʋumenugbagbeviɣidɔ kple dɔgbo ƒe ʋukawo me eye wòada wo ɣeaɖewoɣi. Eyata, mina míaƒo nu tso ERCP ŋu le mɔ bɔbɔe aɖe nu egbea, enyoa?

Nukae nye ERCP (Endoscopic Retrograde Cholangiopancreatography)?

Ŋkɔ didi sia ate ŋu ana nàse le ɖokuiwò me be yeƒe ta natsi vie, gake mina míagbãe ahase egɔme.

Kpuie ko la, ERCP nye dɔ tɔxɛ aɖe si ɖɔktawo zãna tsɔ léa ŋku ɖe wò ʋumenugbagbeviɣiwo kple dɔgbo ƒe ʋukawo me . Ʋuka siawo tsɔa ʋumenugbagbeviɣi kple dɔgbo me tsi, siwo kpena ɖe mía ŋu míeɖua nuɖuɖu si míeɖuna.

Gɔmesese si le ŋkɔ sia ŋue nye esi:

• Endoscopic: Esia zãa mɔ̃ aɖe si woyɔna be endoscope. Enye mɔ̃ tsɛ aɖe si te ŋu trɔna bɔbɔe eye fotoɖemɔ̃ sue aɖe kple kekeli le eƒe nugbɔ ɖeka. Wotsɔa wò nu me dea eme eye wòtoa wò dɔgbo ƒe akpa si le etame (duodenum). Woana atike si naa ame ƒe dzi dzea eme be wòakpe ɖe ŋuwò nàdɔ alɔ̃, ale be màse veve aɖeke o.
• Retrograde: Le esia me la, wotsɔa mɔ̃ sue bubu dea eme to endoscope la me eye wodoa tsi tɔxɛ aɖe (contrast dye) ɖe ʋumenugbagbeviɣiwo kple dɔgboa ƒe ʋukawo me. "Retrograde" gɔmee nye "megbe" elabena wodoa tsi la ɖe mɔ si to vovo na esi wòsina zi geɖe la nu.
• Cholangiopancreatography: Esia fia foto siwo woɖe. "Cholangio" fia be edo ƒome kple ʋumenugbagbeviɣiwo. "Pancreato" gɔmee nye esi do ƒome kple dɔgbo. "Graphy" gɔmee nye be woaɖe foto.

Eyata amadede si to vovo na wo nɔewo nana wò ʋumenugbagbeviɣimɔ̃wo kple dɔgbo ƒe ʋukawo dzena nyuie le X-ray-nɔnɔmetatawo dzi. Esia wɔnɛ be ɖɔktawo kpɔa ne nane xe mɔ na ʋuka siawo - abe aɖuɖɔtoe me kpewo, dɔdzẽ, alo ʋukawo ƒe tsitsi le abi ƒe lãkusi ta ene . Akpa nyuitɔ kekeakee nye be woate ŋu ada kuxi siawo dometɔ aɖewo le afima tututu, to dɔlékuiwutike dzi.

Nɔnɔme kawo mee ERCP hiã le?

Wò ɖɔkta ate ŋu adɔ ERCP ne wosusu be kuxi aɖe le wò ʋumenugbagbeviɣidɔ ŋu. Le kpɔɖeŋu me:

• Ne ƒodo ƒe akpa si le etame ƒe vevesese si womenya o le ŋuwò , alo ne biliary colic le ŋuwò.
• Ne nɔnɔme aɖe li si me ʋumenugbagbeviɣidɔ xea mɔ na ʋumenugbagbeviɣidɔ alo ʋumenugbagbeviɣidɔ ƒe dzesiwo li, le kpɔɖeŋu me, ʋumenugbagbeviɣidɔ .

ERCP dodokpɔ ate ŋu akpe ɖe ŋuwò nànya kuxi siwo bɔ siwo gblẽa nu le wò ʋukawo ŋu, abe:

• Ʋumenugbagbeviɣidɔ (cholangitis) kple dɔlékui siwo do ƒome kplii.
• Ʋukawo ƒe ʋuʋu le abi ƒe lãkusi (biliary stricture) ta .
• Kpe ƒe xexe le ʋumenugbagbeviɣidɔ si bɔ me .
• Dɔdzẽ si le dɔgboa me si kpewo hena vɛ (gallstone pancreatitis) .
• Dɔdzẽ alo kansa le ʋumenugbagbeviɣiwo me.
• Bile duct ƒe sisi alo afɔku bubuwo.

Aleke ERCP wɔa dɔe?

ERCP ƒoa mɔnu vevi eve nu ƒu: endoscopy kple fluoroscopy . Fluoroscopy le abe X-ray nɔnɔmetata siwo le ʋuʋum ene. Bu eŋu abe video dzi X-ray ene.

Fluoroscopy sia nana ɖɔktaa kpɔa alesi tsi tɔxɛa (contrast dye) zɔna toa wò ʋumenugbagbeviɣimɔ̃wo kple dɔgbo ƒe ʋukawo me. Ate ŋu aɖe tsi si le dodom alo xexe ɖesiaɖe afia kɔte.

Endoscope lae nana ɖɔkta (endoscopist) te ŋu ɖoa teƒea. Wotoa esia dzi doa amadede si to vovo na wo nɔewo. Azɔ hã, ne wokpɔ kuxi aɖe la, woate ŋu atsɔ dɔwɔnu suewo ade eme to dɔlékuiwutike sia me atsɔ adae.

Amekae wɔa ERCP?

Zi geɖe la , dɔgboŋutinunyalae wɔa ERCP . Ðɔkta siawo bi ɖe wò nuɖuɖumeŋusẽ kple ʋumenugbagbeviɣidɔ ƒe dɔlélewo dada me. Wona hehe wo hã be woawɔ endoscopy. Wona hehe wo le dɔdamɔnu siwo woate ŋu azã ɖe amekoko suewo teƒe hã ŋu.

Aleke nèdzrana ɖo ɖe ERCP ŋu?

Wò ɖɔkta ana mɔfiame aɖewo koŋ wò siwo dzi nàwɔ ɖo hafi awɔ wò ERCP. Le goawo katã me la, esiawo dometɔ aɖewoe nye:

• Ele be nàdzudzɔ atamanono, nuɖuɖu, aŋe ɖuɖu, kple nusianu si menye tsi o nono gaƒoƒo enyi hafi dodokpɔa nadze egɔme.
• Ele be nàgblɔ atikewɔwɔ me nɔnɔme bubu ɖesiaɖe si le ŋuwò kple atike ɖesiaɖe si nèzãna na wò ɖɔkta . Ðewohĩ ahiã be woadzudzɔ atike aɖewo, abe atike siwo nana ʋu mekɔna o ene, ŋkeke ʋɛ aɖewo hafi woado wo kpɔ.
• Gblɔe na wò ɖɔkta ne amadede si to vovo na wo nɔewo alo atike si naa alɔ̃dɔdɔ si wozãna le dodokpɔa wɔɣi la ƒe nulɔdɔ aɖe nɔ ŋuwò va yi .
• Ahiã be nàwɔ ɖoɖo ɖe ʋu aɖe ŋu be nàyi aƒeme le dodokpɔa megbe, elabena exɔa abe gaƒoƒo 24 ene hafi atike si naa alɔ̃dɔdɔ ƒe ŋusẽkpɔɖeamedziwo nu yina keŋkeŋ. Eyata màte ŋu aku ʋu o.

Nukae dzɔna le ERCP dodokpɔ me?

ERCP nye dɔdamɔnu si wozãna le kɔdzi . Esia fia be àte ŋu ayi aƒeme gbemagbe ke. Zi geɖe la, dɔa wɔwɔ xɔa abe gaƒoƒo ɖeka alo eve ene.

Woana atike aɖe wò si wotsɔ de ʋuka me (to ``IV`` dzi) be wòana nàdɔ alɔ̃ (sedated) . Ðewohĩ èdɔ alɔ̃ vevie, alo ɖewohĩ mèle ŋudzɔ kura o. Ke hã, màɖo ŋku dodokpɔa dzi o.

Le dodokpɔa ƒe akpa si woatsɔ akpɔ dɔlélea gbɔe la, ɖɔktaa awɔ nusiwo gbɔna:

• Ne èdi la, woate ŋu atsɔ tsi si naa alɔ̃dɔdɔ ame be wòaɖe ŋɔti ƒe vevesese dzi akpɔtɔ.
• Wodea dɔlékuiwutike to nu me eye wotsɔa ŋuɖɔɖɔɖo toa nuɖuɖutome kple dɔgbo me yia dɔgbo suea ƒe akpa si le etame (duodenum). Woɖea nɔnɔmetata siwo wokpɔna tso endoscope ƒe fotoɖemɔ̃a me la fiana le screen dzi.
• Ne èkpɔ video mawo la, àte ŋu akpɔ ʋuka si me ʋu sina tona kple ʋuka si me ʋu sina tona la ƒe ʋuʋu le dɔgbo suea me.
• Wotsɔa mɔ̃ sue bubu toa ka si le dɔlékuiwutikea me la me hedea ʋuƒoa me.
• Wodoa amadede si to vovo na wo nɔewo la ɖe nugoawo me to mɔ̃ sue ma dzi.
• Emegbe wozãa fluoroscopy mɔ̃ɖaŋununya tsɔ ɖea X-ray videowo tsɔ kpɔa alesi tsi la zɔna to mɔ̃awo me. Le fluoroscopy me la, woɖea X-ray-awo dona le ɣeyiɣi kpui aɖewo me. Wobua esia be enye keklẽŋusẽ ƒe agbɔsɔsɔ si le dedie.
• Wozãa nɔnɔmetata siawo tsɔ léa ŋku ɖe kuxi aɖeke ŋu le pɔmpiawo ŋu - xexe, vuvu, tsi si le dodom, kple bubuawo.

Bu esia ŋu kpɔ, ele abe fotoɖemɔ̃ dede pɔmpi me, ɖoa tsi si le amadede vovovowo me to eme, eye nèdi afisi wòxe kple afisi wòle dodom tsoe ene.

Fifia, ne ɖɔktaa kpɔ kuxi aɖewo le dodokpɔ sia me la, adze agbagba ada wo to dɔwɔnu suewo dede eme to dɔlékuiwutikea me. Ðɔkta si le dɔlékuiwutikea wɔm ate ŋu awɔ nuwo abe:

• Gallstones tutu kple wo ɖeɖe ɖa.
• Dɔdzẽwo ɖeɖeɖa alo lãmekawo ƒe kpɔɖeŋu ɖeɖe (biopsy). (Ne woɖe biopsy la, woɖonɛ ɖe dodokpɔxɔ aɖe be woakpɔe ɖa be kansa le eŋu loo alo menyee o hã).
• Be woakeke ʋuka siwo xa alo xaxa alo akeke.
• Nu sue aɖe si le abe mɔ̃ ene (stent) dede nugo aɖe me be wòanɔ ʋuʋu ɖi.
• Dzadzraɖo ɖe tsi si le dodom alo abi si le pɔmpi me ŋu.
• Sphincterotomy nye lã sue aɖe si woɖena le lãmeka si ƒo xlã ʋukaa ƒe ʋuʋu me be wòalolo. (Esia kpena ɖe ʋumenugbagbeviɣi kple dɔgbo me tsi ŋu be tsi nado bɔbɔe.)

Nukae nàte ŋu akpɔ mɔ na le ERCP megbe?

Le dodokpɔa megbe la, woatsɔ wò anɔ kɔdzi alo atikewɔƒe abe gaƒoƒo ɖeka alo eve ene, vaseɖe esime atike si wua alɔ̃dɔdɔa ƒe ŋusẽkpɔɖeamedziwo nu nayi. Ekema ame si va xɔ wò la ate ŋu akplɔ wò ayi aƒemee. Àte ŋu ase le ɖokuiwò me be yele alɔ̃ dɔm vie, yeƒe lãme le ʋuʋum alo yeƒe lãme le ʋuʋum gbemagbe.

Maseɖeamedzi suesuesuewo abe esiawo ene ate ŋu adzɔ ŋkeke ɖeka alo eve le dodokpɔa megbe:

• Kɔmeve kple nu mimi sesẽ: Endoscope ate ŋu ana wò ŋɔti nave vie. Anyo wu be nàno tsi alo nuɖuɖu falɛfalɛwo vaseɖe esime wòahaya.
• Dɔgbo alo gas ƒe vevesese: Ne wotsɔ endoscope la de eme la, woƒoa ya vi aɖe ɖe GI-mɔ̃a me be woate ŋu akpɔ nu nyuie wu. Esiae hea vevesese sia vɛ. Aɖiɖi le ɣeyiɣi aɖe megbe (ne wonya ɖe ya la ɖa ko).
• Aɖuɖɔtoe: Esia ate ŋu anye atike si naa alɔ̃dɔdɔ ame ƒe nugbegblẽ le ame ŋu. Efa hã le ŋufɔke.

Afɔku kawoe le ERCP me?

Kuxiwo dzɔna le ERCP ƒe dɔwɔwɔ siwo ade 5% va ɖo 10% me . Afɔku sia nɔ te ɖe wò atikewɔwɔ ƒe nɔnɔme siwo nɔ asiwò do ŋgɔ kple atike si ƒomevi nèxɔna le ERCP wɔɣi dzi. Wò ɖɔkta adzro nya sia me kpli wò do ŋgɔ. Kuxi siwo ate ŋu ado tso eme ate ŋu anye:

• Nu gbegblẽ le atike si naa ame ƒe dzi dzea eme ŋu: Esia ate ŋu ahe dzitodzito me kuxiwo vɛ na amesiwo ŋu lãkusi alo dzidɔ nɔ do ŋgɔ.
• Nulɔdɔ le amadede si to vovo na wo nɔewo ŋu: Ne edzɔ alea la, ɖɔktaa ana atike wò kaba be wòadzudzɔ dɔlélea.
• Nuveviwɔame le wò GI-mɔ̃ ŋu tso endoscope gbɔ: Esia ate ŋu ana ʋu nado le ememe alo le nɔnɔme sesẽwo me la, do nado.
• Aɖuɖɔtoewo ƒe sisi le abi si woxɔna le ʋumenugbagbeviɣimɔ̃wo ŋu si dɔwɔnu siwo wotsɔ léa ŋku ɖe dɔlékuiwo nu hena vɛ ta.
• Dɔlékuiwo ƒe gege ɖe wò ʋuka me: Be nàxe mɔ ɖe esia nu la, wò ɖɔkta ate ŋu ana dɔlékuiwutikewo wò do ŋgɔ.
• Dɔwɔwɔa ate ŋu ana dɔgboa nado dziku eye wòaxɔ abi (dɔdzẽ). Esiae nye kuxi si bɔ wu le ERCP megbe.

Ne èfɔ fu le dodokpɔa wɔɣi la, afɔku si li be keklẽŋusẽ si dona le fluoroscopy me ate ŋu agblẽ nu le fugboea ŋu la le sue, gake afɔku sue aɖe hã le eme. Wò ɖɔkta abia wò do ŋgɔ nenye be ate ŋu adzɔ be nàfɔ fu hã. Ne nenemae la, wò ɖɔkta adze agbagba be yeatrɔ asi le dodokpɔa ŋu alo aɖe keklẽŋusẽ si nàzã dzi akpɔtɔ ne ehiã.

Ɣeyiɣi didi kae wòxɔna hafi woate ŋu anya dodokpɔa me tsonu?

Ne alɔ̃dɔdɔ meku wò haɖe o le atike si naa alɔ̃dɔdɔ ame ta la, .Ele be ɖɔkta (endoscopist) si wɔ ERCP la nate ŋu aƒo nu tso dodokpɔa ŋu na wò enumake. Agblɔ nusi ŋu woke ɖo kple nusi woate ŋu awɔ tso eŋu na wò. Ne woɖe lãkusi (biopsy) la, ate ŋu axɔ kwasiɖa geɖe hafi emetsonuwo nagatrɔ ava.

Ne wò ERCP mekpɔ naneke o la, ahiã be nàwɔ dodokpɔ bubu ƒomevi aɖe na wò. Ne dodokpɔa mekpɔ wò kuxia gbɔ o, alo ne biopsy me tsonuawo ɖo kpe kuxi yeye aɖe dzi la, ahiã be woawɔ atike bubu na wò. Wò ɖɔkta aƒo nu na wò tso nusi nàwɔ emegbe ŋu.

Ɣekaɣie wòhiã be nàƒo ka na ɖɔktaa?

Ne èkpɔ dzesi sesẽ alo esi mebɔ o siawo dometɔ aɖe le ERCP megbe la, yɔ wò ɖɔkta enumake:

• Dɔgbo ƒe vevesese sesẽ alo ʋuʋudedi.
• Akɔtave alo gbɔgbɔ sesẽ.
• Asrã, ʋuʋudedi, alo dɔléle ƒe dzesi bubuwo.
• Ʋu si dona le dɔgboa me alo aɖuɖɔ si le yibɔ, si me aŋɔ le.

Vovototo kae le ERCP kple endoscopy edziedzi dome?

ERCP nye dɔlékuiwo me toto ƒe mɔnu deŋgɔ aɖe. Esophagogastroduodenoscopy (EGD) si wozãna ɖaa la léa ŋku ɖe wò GI ƒe akpa si le etame ŋu ko. Esia fia be nuɖuɖutome, dɔgbo, kple dɔgbo suea ƒe akpa gbãtɔ koe wòléa ŋku ɖe.

Gake le ERCP me la, wozãa kekeɖenudɔ bubu kpe ɖe endoscope si wozãna edziedzi ŋu - si nye mɔ̃ evelia (catheter) si yia mɔ̃ gbãtɔ me - esiae nye nusi ɖoa wò ʋukawo me.

Mini endoscope extension sia na ɖɔktaa te ŋu daa dɔ na wò ducts tẽ. Endoscopic mɔnu ɖeka kolia si ateŋu ada dɔ na ducts tẽ le mɔ sia nu enye `ERCP`. Togbɔ be endoscopic dɔwɔwɔ bubuwo abe `MRCP` (magnetic resonance cholangiopancreatography) kple `EUS` (endoscopic ultrasound) ateŋu akpɔ wò ʋumenugbagbeviɣimɔ̃wo kple dɔgbo ƒe ʋukawo hã la, womenaa alesi wòle bɔbɔe alea na wo dada o.

Ðe ERCP nye amekoko gã aɖea?

ERCP menye amekoko abe alesi míesusunɛ zi geɖe ene o. Menye nane si tsoa ŋutigbalẽa me yia ŋutinu siwo le ŋutilãa me la me o. ERCP nye dɔdamɔnu si wozãna tsɔ léa ŋku ɖe dɔlékuiwo ŋu. Efia be eyia ŋutilãa me to dzɔdzɔmeʋuʋu aɖe me - le go sia me la, ŋɔti.

Gake ne ɖɔkta le ERCP wɔm la, ate ŋu awɔ amekoko aɖewo to endoscope dzi. Ðɔktawo yɔa dɔ siawo siwo wowɔna to dɔlékuiwutike dzi ɣeaɖewoɣi be dɔlékuiwutikewo ƒe dɔwɔwɔ . Esiawo nye amekoko elabena wobiaa lãɖeɖe kple nutete ɖe ŋutilãa me. Gake zi geɖe la, esiawo nyea dɔdamɔnu suesuesuewo, eye afɔku mele wo me boo o eye woƒe hayahaya ƒe ɣeyiɣi nɔa kpuie wu amekoko si wowɔna tsã.

Ðe wowɔa ERCP na dɔgbo ƒe dɔlélea?

Ẽ, ne wò ɖɔkta susu be nane le wò ʋukawo alo dɔgbo ƒe ʋukawo xem la, ate ŋu adɔ ERCP. Aɖuɖɔtoemekpe siwo tsi ʋukawo me nye nu vevi aɖe si hea dɔdzẽ sesẽ vɛ. Ne edzɔ alea la, ahiã be nàwɔ ERCP be nàɖe mɔxenua ɖa.

Ne dɔdzẽ si nɔa anyi didi le ŋuwò la, dɔdzẽa ate ŋu ana wò dɔgboa ƒe ʋukawo naxɔ abi eye woaxe (strictures). Le nɔnɔme mawo me la, ERCP ate ŋu akpe ɖe ame ŋu wòakeke ʋukaawo alo ade ʋuka si me wotsɔa ʋuka ɖonae me be woanɔ ʋuʋu ɖi. Esia kpena ɖe dɔgboa me detsiƒonuwo ŋu wòyia edzi nɔa sisim to mɔ̃awo me.

Ðo ŋku nu vevitɔ kekeake dzi (Take-Home Message) .

ERCP (Endoscopic Retrograde Cholangiopancreatography) nye dodokpɔ si wozãna tsɔ dia dɔlélea si woate ŋu azã hã atsɔ ada dɔlélea le teƒea ne ehiã. Togbɔ be ewɔa dɔ vie wu nɔnɔmetatawo dodokpɔ edziedzi hã la, mewɔa nuvevi ame boo o wu amekoko gãwo. Woate ŋu azãe hã atsɔ anya dɔlélea ahadae le ɣeyiɣi ɖeka me.

Ame akpa gãtɔ ate ŋu awɔ dodokpɔ sia sesẽ boo aɖeke manɔmee, eye viɖe geɖe le eŋu. Eyata, ne ɖɔkta aɖe do susua ɖa be woawɔ ERCP na wò la, mègavɔ̃ be yeaƒo nu kplii tso eŋu o, eye nàbia wò nyawo katã. Akpe ɖe ŋuwò nàwɔ nyametsotso nyuitɔwo kekeake le wò lãmesẽ ŋu!

` ERCP, endoscopy, ʋumenugbagbeviɣiwo, dɔgbo, kpewo, jaundice, nuɖuɖumeŋusẽ