ʻO nā mea e pono ai ʻoe e ʻike e pili ana i ka Biliary Stricture

Ua ʻike anei ʻoe i ka ʻeha ʻē ma ka ʻaoʻao ʻākau o luna o kou ʻōpū, ka melemele o kou ʻili a me kou mau maka, a i ʻole ka nalowale o ka makemake? Ua ʻike paha ʻoe ua mae kou mau ʻōpala. ʻAʻole kēia he mau mea wale nō. ʻO kekahi kumu lapaʻau paha ma hope o kēia, ʻo ia ka haiki ʻana o nā ʻauwai bile. Kāhea mākou i kēia ma ke ʻano lapaʻau he `(Biliary Stricture)`. Mai hopohopo, e kamaʻilio mākou e pili ana i nā mea āpau ma nā ʻōlelo maʻalahi.

I ka ʻōlelo maʻalahi, he aha ka biliary stricture?

E noʻonoʻo inā paʻa kahi paipu wai i ka lepo a inā ʻomi ʻia ka paipu, e ālai ʻia ke kahe ʻana o ka wai, ʻeā? Pēlā nō hoʻi ka mea e hana ʻia ma ʻaneʻi. He wai koʻikoʻi ka Bile no ke kaʻina hana ʻai i loko o ko kākou kino. Hana ʻia kēia bile i loko o ko kākou akepaʻa a hele i ka ʻōpū liʻiliʻi ma o kahi ʻōnaehana o nā paipu liʻiliʻi. Ke lilo nā paipu e kahe ai ka bile i mea haiki, haiki, a ālai ʻia paha no kekahi kumu, ua kapa ʻia kēia he biliary stricture.

Ke ālai ʻia ke aʻa bile ma kēia ʻano, hoʻomaka ka bile e hōʻiliʻili i loko o ke ake. ʻO kēia ka mea e paʻakikī ai i ko mākou kino ke hoʻoheheʻe i ka meaʻai, ʻoiai nā meaʻai momona. A hoʻomaka nā hōʻailona ʻē aʻe e ʻike ʻia.

He aha nā kumu o ka hoʻohaiki ʻana o ke ala bile?

Nui nā kumu no kēia ʻano. Pili kekahi mau kumu i nā ʻano maʻi kanesa, aʻo kekahi e pili ana i nā ʻano ʻē aʻe ʻaʻole maʻi kanesa. Ma ke ʻano laulā, ma kahi o 70% o kēia mau ʻano ma muli o nā kumu maʻi kanesa, a ʻo ke koena 30% ma muli o nā kumu ʻaʻole maʻi kanesa.

I mea e maʻalahi ai ke hoʻomaopopo, e hoʻokaʻawale kākou i kēia mau kumu.

He aha nā hōʻailona o ka stenosis o ke kahawai bile?

Ke ālai ʻia ke aʻa bile, hoʻopilikia ia i ko mākou kino ma nā ʻano he nui. Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​pono ʻoe e hopohopo.

Pehea e ʻike ai i ka maʻi?

Ke ʻike ʻoe i ke kauka me kēia mau hōʻailona, ​​e nānā ʻo ia iā ʻoe a hana i kekahi mau hoʻokolohua e ʻike ai i ke kūlana. ʻO ka maʻamau, mālama kahi gastroenterologist (he kauka loea i ka ʻōnaehana hoʻoheheʻe) i kēia mau kūlana.

Nā hoʻāʻo koko

ʻO ka mea mua, hana ʻia kekahi mau hoʻokolohua koko.

• Hoʻāʻo Bilirubin: Ke ana kēia i ke kiʻekiʻe o ka pae bilirubin i loko o ke koko.
• Nā Hoʻāʻo Hana Ake: Ke nānā nei kēia mau hoʻokolohua i nā pae enzyme ate kiʻekiʻe e hoʻoholo ai inā he hōʻino ʻia ke ake.

Nā scan a me nā hoʻokolohua kiʻi ʻē aʻe

Ma hope o nā hoʻāʻo koko, hana ʻia kekahi mau scan e nānā i ke kūlana o nā ʻauwai bile mai loko mai.

• ʻO ke scan Ultrasound: ʻO kēia ka hoʻāʻo maʻalahi loa a ʻeha ʻole hiki ke hana mua. Lawe ia i nā kiʻi o nā ʻōpū o ka ʻōpū a hiki ke hāʻawi i kahi manaʻo maʻamau inā ua pehu nā ʻauwai bile, he mau pōhaku, a ua ālai ʻia paha.

• ERCP (Endoscopic Retrograde Cholangiopancreatography): He hoʻāʻo koʻikoʻi kēia i hoʻohana ʻia no ka ʻike ʻana a me ka mālama ʻana. Hāʻawi ʻia ʻoe i kahi mea hoʻomaha, a hoʻokomo ʻia kahi paipu liʻiliʻi me kahi kāmela i hoʻopili ʻia ma kou waha, ma kou ʻōpū, a i loko o ka puka o kāu ʻauwai bile. A laila hoʻokomo ʻia kahi kala kūikawā i loko o ke ʻauwai a lawe ʻia nā kukuna X. Hōʻike kēia i kahi e ʻike maopopo ʻia ai ka mea paʻa. Inā pono, hiki ke lawe ʻia kahi ʻāpana ʻiʻo i kēia manawa no ka hoʻokolokolo ʻana (biopsy) a me ka mālama ʻana i ka mea paʻa.

• MRCP (Magnetic Resonance Cholangiopancreatography): He scan MRI kēia. Me ka ʻole o ke kau ʻana i kekahi mau ʻōmole i loko o ke kino, hoʻohana ʻia kahi kahua magnetic e kiʻi i nā kiʻi ʻekolu-dimensional maopopo loa o nā ʻauwai bile, ke akepaʻa, ka gallbladder, a me ka pancreas.

• PTC (Percutaneous Transhepatic Cholangiography): I kekahi mau hihia, hoʻokomo ʻia kahi nila liʻiliʻi loa ma o ka ʻili i loko o ke akepaʻa, hoʻokomo ʻia kahi dye i loko o nā ʻāpana bile, a lawe ʻia kahi X-ray.

He aha nā lāʻau lapaʻau no kēia?

ʻO ke ʻano o ka mālama ʻana e pili ana i ke kumu o ka hoʻohaiki ʻana o nā ʻauwai bile.

ʻO nā lāʻau lapaʻau e hiki ke hana ʻia i ka wā o ka ERCP:

• Ka wehe ʻana i nā pōhaku: Inā paʻa nā pōhaku i loko o ka ʻōpū o ka ʻōpū, e wāwahi ʻia a wehe ʻia paha me nā mea hana kūikawā.
• Ke Kau ʻana o ka Stent: Hoʻonui ʻia ke aʻa i haiki ʻia ma ke komo ʻana a me ka hoʻopiha ʻana i kahi mea e like me ka pōpō. A laila, i mea e wehe ai ke aʻa a ʻaʻole e haiki hou, ua hoʻokomo ʻia kahi stent , kahi ʻōmole liʻiliʻi e like me ka ʻupena, i loko. Hiki ke hana ʻia kēia mau mea i ka palaki a i ʻole ka metala.
• Ka wehe ʻana i ka puʻupuʻu: Inā hana ʻia ka ālai ʻana e kahi puʻupuʻu liʻiliʻi, hiki paha ke wehe ʻia.

Nā Hana Lapaʻau

I kekahi mau hihia, ʻoiai inā he maʻi kanesa ia, pono paha ke ʻoki ʻana.

• ʻO ke ʻoki ʻana i ka ʻāpana ʻaoʻao: Pili kēia i ke kāpae ʻana i ke auwai i paʻa ʻia a me ka hana ʻana i ala hou no ke kahe ʻana o ka bile.
• Resection a me Anastomosis: ʻOki ʻia a wehe ʻia ka ʻāpana maʻi o ke aʻa bile , a hoʻopili hou ʻia nā ʻāpana olakino ʻelua i koe.

Aia kekahi mea hiki iā mākou ke hana e pale aku ai i kēia kūlana?

ʻAʻole hiki iā mākou ke pale aku i nā kumu āpau o ka stenosis o ke aʻa bile, e like me ke kanesa. Eia nō naʻe, aia kekahi mau mea pilikia e hiki iā mākou ke kaohi. Ma ka mālama ʻana iā lākou, hiki iā mākou ke hōʻemi i ka pilikia o ka loaʻa ʻana o kēia maʻi.

• E mālama i ka ʻai olakino: E hōʻemi i nā meaʻai kiʻekiʻe i ka ʻaila a me ka momona, a e hoʻohui i ka nui o nā huaʻai a me nā mea kanu i kāu papaʻai.
• E kāohi i kāu cholesterol: Hiki i ka cholesterol kiʻekiʻe ke alakaʻi i nā gallstones, no laila he mea nui e kāohi i kāu mau pae cholesterol.
• E mālama i ke kaumaha olakino: He mea maikaʻi nō hoʻi ka kaohi ʻana i ke kaumaha o ke kino no ke olakino o ka ʻōpū.
• E pale i ka inu nui ʻana i ka waiʻona: Hiki i ka inu nui ʻana i ka waiʻona ke hōʻino i ke akepaʻa a hoʻoulu i ka pancreatitis. Hiki i kēia mau kūlana ʻelua ke alakaʻi i ka haiki ʻana o nā ʻauwai bile.

Āhea ʻoe e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe nā hōʻailona ma lalo nei, mai hoʻowahāwahā iā lākou ma kekahi ʻano.E ʻike koke i kāu kauka a e ʻimi i ka ʻōlelo aʻo.