Ka hoʻokahe ʻana o ka biliary: no ke aha a pehea e hana ʻia ai?

Ke melemele nei kou mau maka a me kou ʻili a ke ʻānai nei kou kino holoʻokoʻa me ka hiki ʻole ke hoʻomanawanui? ʻO kēia nā hōʻailona o ka mea a mākou e ʻike ai he jaundice. ʻO ka hapa nui o ka manawa, ʻo ke kumu o kēia he paʻa ʻana i loko o ke kahawai bile, he wai ia e puka mai ana mai ko kākou akepaʻa a kōkua i ka ʻai ʻana. Ke paʻa kēia, hoʻi hou kēlā wai i loko o ke akepaʻa, e hana ana i ka melemele a me ka ʻānai. No laila, ʻo kahi ʻano lapaʻau kūikawā a nā kauka e hoʻohana ai i ia mau hihia ua kapa ʻia ʻo Biliary Drainage. I ka ʻōlelo maʻalahi, pili kēia i ka hoʻokomo ʻana i kahi ʻōmole liʻiliʻi i loko o ke kahawai bile i paʻa a ʻae i ka bile e kahe i waho. E kamaʻilio kākou e pili ana i kēia i kēia lā.

He aha ka Biliary Drainage? Aia kekahi mau ʻano?

ʻO ka hoʻokahe ʻana o ka biliary he hana ia e hoʻohana ana i kahi ʻōmole lahilahi a palupalu (catheter) e ʻae i ka bile e kahe ma o kahi mea i paʻa i loko o ke ala bile, e holo ana mai ke akepaʻa a i ka ʻōpū liʻiliʻi. Ua like ia me ka hana ʻana i kahi ala hou no kahi ala wai i paʻa. Hana ʻia kēia ma nā ʻano nui ʻelua. Na kāu kauka e hoʻoholo i ke ʻano hana maikaʻi loa iā ʻoe ma muli o kou kūlana.

He aha ke kau ʻana o ka stent?

I kekahi mau hihia, ʻoiai inā mau loa ka paʻa ʻana (no ka laʻana, ma muli o ke kanesa), hiki i kāu kauka ke kau mau i kahi ʻōmole liʻiliʻi e like me ka mesh, i kapa ʻia he stent, i loko o kou ʻauwai bile e mālama iā ia i ka wehe. Hana pinepine ʻia kēia i kekahi mau lā ma hope o ke kau ʻia ʻana o ka ʻōmole mua.

No ke aha e pono ai i kekahi ke ʻano o kēia ʻano lapaʻau?

ʻO ke kumu nui o ka pono o kēia lāʻau lapaʻau, ʻo ia ka paʻa ʻana a i ʻole ka haiki ʻana o ke ala bile (`stricture`). ʻO kēia ke kumu o ka hōʻiliʻili ʻana o ka wai bile i loko o ke akepaʻa (`cholestasis`). E noʻonoʻo, e like me ka wā e paʻa ai kahi paipu hoʻokahe i loko o ko mākou hale, hōʻiliʻili ka wai ma ʻaneʻi. Hiki ke loaʻa kekahi mau kumu no ka paʻa ʻana o ke ala bile:

• Nā pōhaku i loko o ka gallbladder a i ʻole nā ​​​​​​auwai bile (choledocholithiasis).
• ʻO ka pancreatitis a i ʻole ke kanesa pancreatic.
• ʻO ke kanesa o ka ʻauwai bile (Cholangiocarcinoma).
• Ka maʻi ʻaʻai ate a i ʻole ka maʻi ʻaʻai ʻōpū .
• Ka pehu ʻana o nā lymph nodes kokoke i ke akepaʻa a i ʻole ka pancreas ma muli o ke kanesa.
• ʻO kekahi mau maʻi parasitic .
• Ka hōʻino ʻana i nā ʻauwai bile i ka wā o ke ʻoki kino ʻē aʻe.
• Nā kūlana mumū lōʻihi o nā ʻauwai bile, e like me ke 'primary sclerosing cholangitis'.

Pehea ʻoe e hoʻomākaukau ai ma mua o ka mālama ʻana?

Aia kekahi mau mea e pono ai ʻoe e hana ma mua o kēia lāʻau lapaʻau. E hāʻawi kāu kauka iā ʻoe i nā ʻōlelo aʻoaʻo maopopo e pili ana i kēia. He mea nui loa ia e hahai pololei i kēlā mau ʻōlelo aʻoaʻo. 1. Meaʻai a me ka Mea Inu: Pono ʻoe e hoʻōki i ka ʻai ʻana, ka inu ʻana, a me ka puhipaka ma ka liʻiliʻi he 6 mau hola ma mua o ka lāʻau lapaʻau. Hiki i kāu kauka ke haʻi iā ʻoe i ka wā hiki iā ʻoe ke inu i nā wai, e like me ka wai. 2. Nā maʻi ʻaleka: E hōʻoia e haʻi i kāu kauka e pili ana i kekahi maʻi ʻaleka āu e loaʻa ai, ʻoi aku hoʻi i nā anesthetics, ka dye contrast i hoʻohana ʻia i nā X-ray, a i ʻole i nā plastics a i ʻole nā ​​​​metala. 3. Nā lāʻau lapaʻau:E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei (me nā huaora). ʻOi loa aku inā ʻoe e lawe ana i nā lāʻau hoʻokahe koko (anticoagulants) e like me ka aspirin a me ka warfarin, e nīnau inā pono ʻoe e hoʻōki i ka lawe ʻana iā lākou a me ka manawa hea. 4. Hāpai: E hōʻoia e haʻi i kāu kauka inā hāpai ʻoe a i ʻole e hāpai paha. 5. Hoʻokele: ʻAʻole hiki iā ʻoe ke hoʻokele ma hope o ka lāʻau lapaʻau no ka mea e ma lalo ʻoe o ka anesthesia. No laila e hoʻolālā e lawe mai i kekahi e lawe iā ʻoe i ka home.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?

E ʻokoʻa iki nā ʻanuʻu no kēia ma muli o ke kaʻina hana āu e hana nei (PTBD a i ʻole EBD). Akā, mai hopohopo, e wehewehe mua kāu kauka i nā mea āpau iā ʻoe.

Pehea e hana ʻia ai ke ʻano hana percutaneous (PTBD):

• ʻO ka mua, ua hoʻomaʻemaʻe ʻia ka ʻili ma kou ʻōpū a ua hoʻomānoʻanoʻa ʻia ka wahi.
• A laila hoʻokomo ke kauka i kahi nila liʻiliʻi ma o ka ʻili i loko o kahi ʻauwai bile i loko o ke akepaʻa.
• Hoʻokomo ʻia kahi wai kūikawā (ʻano hoʻohālikelike kala) e ʻike ʻia ai nā kukuna X.
• Ke loaʻa ka wahi kikoʻī o ka poloka, hoʻokomo ʻia ka paipu hoʻokahe i loko o kēlā wahi a ʻae ʻia ka wai bile e kahe.
• ʻO kekahi ʻaoʻao o kēia paipu e puka mai ana mai kou ʻili a ua pili i kahi ʻeke ma waho. Hōʻiliʻili ka wai bile i loko o kēia ʻeke. (Pono e hoʻokahe ʻia kēia ʻeke i nā manawa he nui i ka lā.)

Pehea e hana ʻia ai ke kaʻina hana endoscopic (EBD):

• I loko o kēia, e hāʻawi ʻia ʻoe i ka anesthesia laulā a i ʻole ka anesthesia māmā, no laila ʻaʻole ʻoe e manaʻo i kekahi mea.
• Ke ʻāʻī nei kou puʻu.
• Hoʻokomo ke kauka i kahi ʻōmole me kahi kāmela (endoscope) ma o ka waha, hoʻoili iā ia ma ka paipu meaʻai, a alakaʻi iā ia i kahi o ke kahawai bile.
• A laila, hoʻokomo ʻia kekahi paipu (catheter) ma o kēlā paipu a hoʻokomo ʻia ma o ke auwai i paʻa ʻia e ʻae i ka bile e kahe.
• Inā wehe ʻia ka phlegm ma waho, hoʻokomo ʻia kahi ʻōmole ma o ka ihu a hoʻopili ʻia i kahi ʻeke. Inā wehe ʻia i loko, hoʻokomo ʻia kahi stent i loko.

Nā pilikia a me ka mālama ʻana ma hope o ka mālama ʻana

E like me nā lāʻau lapaʻau āpau, aia nā pilikia a me nā pilikia e hiki ke loaʻa.

• Nā pilikia e hiki mai ana:
• Ka wehe ʻana, ka wili ʻana, a i ʻole ka paʻa ʻana o ka paipu i hoʻokomo ʻia.
• ʻEha a ʻoluʻolu ʻole paha.
• Maʻi (e kuhikuhi ke kauka i nā lāʻau antibiotic e pale aku i kēia).
• Ke kahe ʻana o ke koko.
• Nā loli i ka haku mele electrolyte o ke kino ('Nā ʻano ʻē o ke electrolyte').
• He mea kākaʻikahi loa, hiki ke loaʻa nā pilikia o ka māmā (`Pneumothorax`).

E wehewehe pono ke kauka i kēia mau pilikia iā ʻoe a e aʻo iā ʻoe i ka mea e hana ai inā kū mai kekahi mau pilikia.

Pehea e mālama ai iā ʻoe iho ma ka home?

Inā he ʻōmole a me ka ʻeke i hoʻokomo ʻia ma waho o kou kino, e aʻo aku ke kahu hānai iā ʻoe pehea e mālama ai.

• Mai hiamoe me kou kaumaha ma ka ʻaoʻao kahi o ka paipu. Hiki i kēia ke kumu o ka wili ʻana o ka paipu.
• Inā ʻōlelo aku kāu kauka iā ʻoe e holoi i ka ʻōmole me kahi wai saline liʻiliʻi i kēlā me kēia lā, e hana pēlā.
• E inu i nā mea inu electrolyte e uku no ka nui o ka wai e puka mai ana mai loko mai o ka ʻeke. E nīnau i kāu kauka i ka mea e inu ai a me ka nui e inu ai.
• Hiki iā ʻoe ke ʻauʻau i 48 mau hola ma hope o ka mālama ʻana. Eia naʻe, mai ʻauʻau i loko o nā loko wai a i ʻole ke kai/muliwai i ka wā e kau ana ka ʻōmole.
• Mai hāpai i nā mea kaumaha a hiki i ka wā e ʻōlelo aku ai kāu kauka.

Āhea ʻoe e ʻimi koke ai i ke kōkua lapaʻau?

Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, e kāhea koke aku i kāu kauka, a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.

• Kuni .
• Inā nui ka ʻeha, ka pehu ʻana, a i ʻole ka ʻulaʻula ma kahi i hoʻokomo ʻia ai ka paipu.
• Inā e kahe ana ka pus a i ʻole kekahi wai ʻē aʻe mai kahi o ka paipu.
• Inā piʻi aʻe ka ʻeha o ka ʻōpū a i ʻole e hana hou ʻia.
• Inā melemele hou ka ʻili a i ʻole nā ​​maka.
• Inā ʻoe e luaʻi ana.
• Inā me he mea lā e hemo ana ka paipu.
• Inā ʻaʻole e hele ka ʻōpala a i ʻole ʻaʻole e hele ka ea.

He lāʻau lapaʻau maikaʻi loa ka hoʻokahe ʻana o ka biliary no ke ālai ʻana o ka bile duct. E kōkua kāu hui lapaʻau iā ʻoe e koho i ke koho maikaʻi loa no kou kūlana. E ʻoluʻolu e nīnau iā lākou i nā nīnau a hopohopo paha āu e loaʻa ai. Ka Hoʻokahe ʻAi ʻAi Biliary, Ka Pale ʻAi ʻAi Bile, Jaundice, PTBD, EBD, Nā Maʻi ʻAke, Gallstones, ʻatikala lapaʻau Sinhala