E aʻo kākou e pili ana i kou mau ʻauwai bile. He mea nui loa kēia!

Aloha! Ua noʻonoʻo paha ʻoe i ke koʻikoʻi o nā ducts liʻiliʻi loa i loko o ko kākou kino? ʻO kekahi mea nui, akā malia paha he mea a kākou e kamaʻilio nui ʻole ai, ʻo ia ka bile duct. No laila i kēia lā e kamaʻilio mākou e pili ana i kēia bile duct ma nā ʻōlelo maʻalahi, he aha ia, he aha ka mea e hana ʻia iā ia, he aha nā maʻi e hoʻoulu ai, a pehea e hiki ai iā mākou ke mālama iā ia.

He aha ka Bile Duct? He aha kāna hana?

I ka ʻōlelo maʻalahi, ʻo ke kahawai bile kahi ʻōnaehana o nā paipu lahilahi e hoʻopili ana i kekahi mau ʻōkana i loko o kā mākou ʻōnaehana hoʻoheheʻe. Ua like ia me ka paipu e lawe ana i ka wai. ʻO kāna hana nui ka lawe ʻana i kahi mea i kapa ʻia ʻo 'bile' ma waena o kēia mau ʻōkana. ʻO ko mākou akepaʻa, ka gallbladder, a me ka ʻōpū liʻiliʻi, me kēia mau kahawai bile, e hana i ka ʻōnaehana biliary . No laila, no ke aha e pono ai kēia mau kahawai bile? Pono ko mākou kino i ka bile no nā hana like ʻole. Kōkua nā kahawai bile i ka lawe palekana ʻana i kēia bile mai kekahi wahi a i kekahi. He mea nui kēia ʻōnaehana o nā paipu no ka lawe ʻana i ka bile i ke kino i kēlā me kēia manawa, ma nā wahi āpau, me ka ʻole o ke komo ʻana i kekahi mea ʻē aʻe, a me ka ʻole o ka hōʻino ʻana i nā ʻōkana ʻē aʻe. I kēia manawa, ʻo kēia bile kahi wai i hana ʻia e ko mākou akepaʻa. Loaʻa iā ia kahi ʻano mea i kapa ʻia ʻo nā waikawa bile . ʻO kēia nā mea e kōkua iā mākou e hoʻoheheʻe i nā momona a me nā protein i loko o ka meaʻai a mākou e ʻai ai. Akā he ʻano ʻino kēia mau waikawa bile a hiki ke hoʻopōʻino i nā ʻōkana i hoʻohana ʻole ʻia iā lākou. Eia kekahi, hele pū kekahi mau enzymes digestive mai kā mākou pancreas ma o kēia mau kahawai bile. Pēlā nō, inā ʻaʻole lākou e hele i kahi kūpono, hiki ke kū mai nā pilikia.

Pehea e pili ai kēia ʻauwai bile i ko kākou mau kino?

E noʻonoʻo e like me ke kumulāʻau lālā. Hoʻomaka ia me ko kākou ake. Aia ke ake ma ka ʻaoʻao ʻākau o luna o ko kākou ʻōpū. I loko o ke ake he mau ʻāpana bile lahilahi a lālā. Kāhea mākou i kēia mau ʻāpana bile intrahepatic . Ke hana ke ake i ka bile, hōʻiliʻili ia ma o kēia mau ʻāpana. A laila, hui pū kēia mau ʻāpana liʻiliʻi i loko o ke ake e hana i nā ʻāpana hepatic ʻākau a hema nui iki. Puka mai kēia mau ʻāpana ʻelua mai ke ake a hui pū e hana i ke ʻāpana hepatic maʻamau . Kapa ʻia nā ʻāpana ma waho o ke ake he mau ʻāpana extrahepatic . I kēia manawa, hui pū kēia ʻāpana hepatic maʻamau me ke ʻāpana cystic e puka mai ana mai ko kākou gallbladder e hana i ke ʻāpana bile maʻamau.Hana. Ma kahi o ka hapalua o ka bile e puka mai ana mai ke akepaʻa e hele pololei i loko o kēia ʻauwai bile maʻamau. ʻO ka hapalua ʻē aʻe e hele i ka gallbladder. Aia ka gallbladder ma lalo pono o ke akepaʻa. Ua like ia me kahi ʻeke liʻiliʻi e mālama ana i ka bile. Mālama ia i ka bile i hoʻohana ʻole ʻia i kēlā manawa. Mālama ka gallbladder a hiki i ka wā e pono ai ko mākou ʻōpū liʻiliʻi. Ke ʻike ko mākou ʻōpū liʻiliʻi he mau momona a me nā protein e ʻeli ai, hoʻouna ia i kahi hōʻailona i ka gallbladder. A laila ʻaelike ka gallbladder a hoʻouna i ka bile ma ke ala cystic i ke ala bile maʻamau. Mai laila mai, hele ka bile i ka ʻōpū liʻiliʻi. ʻO kēia ala bile maʻamau ka ala bile nui loa a mākou. He 10 kenimika ka lōʻihi. Hoʻokaʻawale nā ​​ala bile ʻē aʻe a pau mai kēia. Hoʻopili pū ko mākou ala pancreatic i kahi like kahi e wehe ai kēia ala bile maʻamau i loko o ka ʻōpū liʻiliʻi, akā ma ke ʻano he ala kaʻawale. Ua maopopo iā ʻoe?

He aha nā kūlana e hoʻopilikia ai i nā ʻāpana bile?

ʻAe, e nānā kākou i nā ʻano maʻi e hiki ke hoʻopilikia i kēia ʻōnaehana ʻauwai bile koʻikoʻi.

1. Ka mumū

Hiki i kekahi mau maʻi a me nā kūlana mumū ʻē aʻe ke hoʻopilikia i nā ʻauwai bile. Hiki i kēia ke pōkole a i ʻole ka lōʻihi. I ka wā pōkole, hiki i ka mumū koʻikoʻi ke ālai i nā ʻauwai a hoʻōki i ke kahe ʻana o ka bile. Eia nō naʻe, i ka wā lōʻihi, hiki i ka mumū mau ke hana i ka ʻeha o ka ʻiʻo i loko o nā ʻauwai bile. ʻO kēia ʻiʻo ʻeha ke kumu o ka uʻi e hoʻohaiki i nā ʻauwai - ua kapa ʻia kēia he stricture . I ka hopena, ua ʻoki ʻia ke kahe koko a hiki ke hōʻino ʻia nā ʻauwai bile. Ua kapa ʻia kēia mumū o nā ʻauwai bile he cholangitis . Hiki i nā maʻi a me nā poloka ke hana i ka cholangitis koʻikoʻi . Eia kekahi, hiki i nā maʻi autoimmune ke hana i ka cholangitis mau . ʻO ka Primary Biliary Cholangitis (PBC) a me ka Primary Sclerosing Cholangitis (PSC) ʻelua mau ʻano maʻi mau.

2. Ke ālai ʻia

ʻO ke kumu maʻamau o nā pilikia o ke aʻa bile, ʻo ia ke ālai ʻana . ʻO kekahi o nā mea maʻamau, ʻo ia nā pōhaku gall . He mau kristal kēia mau pōhaku e hana ʻia ana i loko o ka gallbladder a i ʻole nā ​​aʻa bile. Ulu mālie lākou i nā makahiki he nui. I ka manawa pinepine, hemo nā pōhaku gall a hele i loko o ke aʻa bile maʻamau. Ua kapa ʻia kēia kūlana kikoʻī he choledocholithiasis.Inā nui kēia mau pōhaku i loko o nā ʻauwai bile, hiki iā lākou ke ālai i ke kahe ʻana o ka bile. Eia kekahi, ʻo ka bile duct stricture , ʻo ia hoʻi ka haiki ʻana o nā ʻauwai bile, hiki ke ālai i ke kahe ʻana o ka bile. Hiki i ka mumū lōʻihi ke hana i ka ʻiʻo ʻeha i loko o nā ʻauwai bile, e haiki ana iā lākou ma kēia ʻano. ʻO kekahi mau maʻi hānau - no ka laʻana , ka biliary atresia a me Alagille Syndrome - hiki ke hana i kēia ʻano.

3. Ka maʻi ʻaʻai

Ua kapa ʻia ʻo ka maʻi ʻaʻai bile duct ʻo cholangiocarcinoma . Hiki iā ia ke ulu i loko o nā ducts extrahepatic - ʻo ia ka mea maʻamau - a i ʻole i loko o nā ducts i loko o ke akepaʻa (intrahepatic ducts). He ʻokoʻa kēia mai ke kanesa o ke akepaʻa. Eia nō naʻe, inā ulu ka maʻi ʻaʻai ate, hiki iā ia ke hōʻino i nā ducts bile i loko o ke akepaʻa ma o ka hoʻoulu ʻana i ka mumū a i ʻole ke ālai ʻia.

He aha ka mea e hana ai inā e ālai ʻia kahi ʻauwai bile?

E like me ka ʻauwai i paʻa ʻia, inā ʻaʻole hiki i ka bile ke kahe ma o nā ʻauwai bile, e hoʻi hou ia a hoʻomaka e hōʻiliʻili i loko o nā ʻōpū. Hiki i kēia ke hana i ka mumū a me ka hōʻino ʻana i kēlā mau ʻōpū. No ka laʻana, ka mumū o ka gallbladder ( cholecystitis ), ka mumū o ka pancreas ( gallstone pancreatitis ), a me ka mumū o ke ake a me nā ʻauwai bile ponoʻī. Ke pau ke kahe ʻana o ka bile ( cholestasis ), ʻoi aku ka nui o ka hiki ʻana mai o nā maʻi. He ʻeha loa a he weliweli nā maʻi i loko o ka ʻōnaehana biliary. Inā pālahalaha lākou i ke ake, hiki iā lākou ke komo i ke kahe koko a hana i ka septicemia ma ke kino holoʻokoʻa, e alakaʻi ana i kahi kūlana weliweli i kapa ʻia ʻo sepsis .

He mea nui: He pilikia hoʻoweliweli ka Sepsis i ke ola.

Eia kekahi, ke hoʻomaka ka bile i kākoʻo ʻia e kahe i loko o ke koko, hiki iā ia ke hana i nā ʻano maʻi like ʻole. Hiki iā ʻoe ke loaʻa ka jaundice - ka melemele o ka ʻili a me nā maka - ka nausea, ka ʻāʻī, a i kekahi manawa ka hemahema o ka noʻonoʻo (hepatic encephalopathy) . ʻAʻole hiki i nā ala bile i paʻa ke hoʻokahe pono i ka bile i loko o ka ʻōpū liʻiliʻi. Hiki i kēia ke hana i nā pilikia digestive. He pilikia kou ʻōnaehana digestive i ka ʻeli ʻana i nā momona a me ka omo ʻana i nā huaora momona-soluble. Hiki i kēia malabsorption ke alakaʻi i ka malnutrition .

Pehea ʻoe e ʻike ai inā he pilikia kou me ka ʻōpū bile?

Hoʻomohala mālie pinepine nā maʻi maʻi i nā makahiki he nui. No laila, ʻaʻole paha ʻoe e loaʻa i kekahi mau hōʻailona a hiki i ka hōʻino nui ʻia ʻana o kāu mau ʻauwai bile. Eia nō naʻe, inā loaʻa iā ʻoe kahi maʻi koʻikoʻi , e like me ka poloka a i ʻole ka maʻi, e ʻike pinepine ʻoe i nā hōʻailona i kapa ʻia ʻo biliary colic . He aha ka biliary colic?

• ʻO kēia ka ʻeha o ka ʻōpū.
• Hele pinepine mai ia me ka nausea , a i kekahi manawa ka luaʻi .
• ʻO ka maʻamau, hana ʻia kēia ma hope o ka ʻai ʻana i kahi meaʻai momona .
• Hoʻomaka mālie ka ʻeha, piʻi mālie ka ikaika i loko o hoʻokahi hola, a laila emi hou i loko o hoʻokahi a ʻelua paha hola.

Hana ʻia kēia ʻano biliary colic ke hoʻāʻo kāu ʻōnaehana biliary e hoʻouna i ka bile i loko o kou ʻōpū liʻiliʻi e kōkua i ka ʻeli ʻana i ka meaʻai. A laila ʻaelike ka gallbladder, kahi e hoʻonui ai i ke kaomi i loko o nā ʻauwai bile. Inā loaʻa ka maʻi a i ʻole ka ālai ʻia o kāu mau ʻauwai bile, ʻo ia kaomi ke kumu o ka ʻeha.

E hoʻomanaʻo: Inā loaʻa iā ʻoe nā hōʻailona o ka biliary colic, ʻoiai inā ʻaʻole ia he koʻikoʻi loa, e hele koke i ka haukapila . Hiki i nā hoʻokolohua lapaʻau ke hoʻoholo koke i ka pilikia. Inā ʻaʻole ʻoe e loaʻa i ka ʻeha nui, akā he mau hōʻailona ʻē aʻe e pili ana i ka ʻōnaehana biliary, e like me ka jaundice , he hōʻailona paha ia o kahi maʻi mau.

Pehea e hoʻōla ai i kahi ʻauwai bile i ālai ʻia?

Aia kekahi mau ʻano hana a nā kauka e hoʻohana ai e ʻike a wehe i nā mea paʻa i loko o nā ʻauwai bile. ʻO ke ʻano hana i ʻōlelo ʻia no ʻoe e hilinaʻi ia i kou kūlana, inā he maʻi mau a ʻoi paha, a pehea ka wikiwiki.

• ʻO Endoscopic Retrograde Cholangiopancreatography (ERCP): He hana ʻoki kino ʻole kēia. Hoʻokomo ʻia kahi ʻōmole lōʻihi me kahi kāmela i hoʻopili ʻia (endoscope) ma o ka waha a hoʻoili ʻia i lalo i ke ala GI. Hiki i ke kauka ke hana i nā mea e pono ai ma o kēia endoscope.
• ʻO ka ʻimi ʻana i ke auwai bile: He hana ʻoki kino kēia. Hiki ke hana pinepine ʻia me ka hoʻohana ʻana i nā ʻano hana minimally invasive . ʻO ia hoʻi , ʻo ke ʻoki laparoscopic, ʻo ia hoʻi ka hana ʻana i hoʻokahi a ʻoi aku paha mau ʻoki liʻiliʻi ma ka ʻōpū. I kekahi manawa hana ʻia ia i ka wā o ke ʻoki kino e wehe i ka gallbladder no nā pōhaku gallstones.

Hiki i ke kauka ke ʻoki i ke ala bile e wehe i ka mea i paʻa ai a i ʻole e hoʻokomo i kahi stent e wehe mau ai. I kekahi manawa hana ʻia nā mea ʻelua. Inā ākea loa nā ala bile (dilated) ma muli o ka ʻōpala a me ka stenosis, hiki iā lākou ke wehe i nā ʻāpana o nā ala.

Pehea e mālama ai i kaʻu mau ʻāpana bile?

ʻO ka pilikia nui loa i kou mau ʻauwai bile, ʻo ia nā pōhaku gall . ʻO ke kumu nui o nā pōhaku gall, ʻo ia ka cholesterol kiʻekiʻe i loko o ke koko. Hiki i ka cholesterol keu i loko o ke koko ke hōʻiliʻili i loko o nā ʻauwai bile, e hoʻopaʻakikī ai a hana i nā pōhaku cholesterol. Hiki iā ʻoe ke hōʻemi i kēia pilikia ma ka hōʻemi ʻana i ka cholesterol i kāu meaʻai . ʻO ka lua o ka pilikia nui loa, ʻo ia ka maʻi akepaʻa . Inā loaʻa iā ʻoe ka maʻi akepaʻa mau, hiki iā ʻoe ke hōʻemi i ka hōʻino ʻana i kou akepaʻa a me ka ʻōnaehana biliary ma ka lawe ʻana i kahi nohona olakino.

• E hana i ka hoʻoikaika kino .
• E hōʻemi i ka momona mai kāu papaʻai.
• E hōʻalo i ka waiʻona a me nā lāʻau lapaʻau.

E kōkua nui kēia mau mea.

He liʻiliʻi loa nā ʻauwai bile, akā hana lākou i kahi hana maikaʻi loa no ko mākou kino. I kēlā me kēia lā, hilinaʻi kekahi o kā mākou mau ʻōkana a me nā kaʻina hana o ke kino i kēia mau ʻauwai bile. Inā ʻaʻole hiki i ka bile ke hiki i kahi e pono ai, hiki iā ia ke kahe i loko o ke koko a hoʻopilikia i ke kino holoʻokoʻa.

Hiki i nā maʻi o ke auwai bile ke hoʻopilikia i nā kino ʻē aʻe o ka ʻōnaehana biliary. Ma ka huli ʻana, hiki i nā pilikia i kēlā mau kino ke hoʻopilikia i nā auwai bile. No laila, inā loaʻa iā ʻoe nā hōʻailona e pili ana i ka ʻōnaehana biliary, e like me ka biliary colic a i ʻole ka jaundice, e ʻimi koke i ke kōkua lapaʻau . Hiki i kēia ke kōkua i ka pale ʻana i kāu ʻōnaehana biliary palupalu, me nā auwai bile.

No laila, he aha nā mea nui e hoʻomanaʻo ai mai nā mea a kākou i kamaʻilio ai i kēia lā?

• He ʻōnaehana liʻiliʻi akā koʻikoʻi loa ke aʻa bile o nā paipu e lawe ana i ka bile ma waena o ko kākou ake , ka ʻōpū gallbladder, a me ka ʻōpū liʻiliʻi.
• ʻO nā pōhaku gallstones a me ka mumū nā pilikia nui e hoʻopilikia ai i nā kahawai bile.
• E makaʻala inā ʻike ʻoe i nā hōʻailona e like me ka ʻeha o ka ʻōpū (biliary colic) a me ka jaundice ma hope o ka ʻai ʻana i nā meaʻai momona.
• He mea nui loa ka mālama ʻana i ka ʻai olakino a me ke ola kino no ke olakino o nā ʻauwai.
• Inā loaʻa iā ʻoe kekahi mau hōʻailona, ​​​​ʻo ka ʻike koke ʻana i ke kauka a me ka ʻimi ʻana i ka ʻōlelo aʻoaʻo e kōkua iā ʻoe e pale i nā pilikia nui.