Ua loaʻa anei iā ʻoe kahi ʻauwai bile i haiki? E aʻo kākou e pili ana i ka Biliary Stricture.

Ua lohe paha ʻoe i kahi maʻi i kapa ʻia ʻo biliary stricture? Ua ʻike paha ʻoe i ka ʻeha ma ka ʻaoʻao ʻākau o luna o kou ʻōpū a me ka melemele o kou ʻili (e like me ka jaundice )? A laila he mea kēia e hoihoi paha iā ʻoe. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi i kapa ʻia ʻo biliary stricture . Mai hopohopo, ʻo ka hoʻomaopopo pono ʻana i kēia hiki ke kōkua iā ʻoe e hoʻoponopono i nā pilikia he nui.

He aha ka Biliary Stricture? E hoʻomaopopo maʻalahi kākou!

I ka ʻōlelo maʻalahi, ʻo Biliary Stricture ka wā e haiki ai nā ʻauwai bile i loko o kou kino ma muli o kekahi maʻi, ʻeha , a i ʻole ke ālai ʻia. E noʻonoʻo e like me ka paipu wai i ālai ʻia, a e emi iho ke kahe ʻana o ka wai. Ke haiki kēia mau ʻauwai bile, ua kaupalena ʻia ke kahe ʻana o ka bile mai ke akepaʻa a i ka ʻōpū liʻiliʻi. He aha ka mea e hana ʻia a laila? Hoʻomaka ka ʻohi ʻana o ka bile i loko o ke kino, e paʻakikī ai ka ʻeli ʻana i ka meaʻai. Ua kapa ʻia hoʻi kēia ʻo "bile duct stricture."

No laila he aha kēia mau ʻauwai bile?

ʻAe, i kēia manawa e nānā kākou i ke ʻano o nā ʻauwai bile. Ua like kēia me nā ʻōmole liʻiliʻi e hoʻopili ana i nā ʻōpū i loko o kāu ʻōnaehana hoʻoheheʻe . Hana kou akepaʻa i kahi wai i kapa ʻia ʻo bile. Kōkua kēia bile iā ʻoe e hoʻoheheʻe i ka meaʻai. No laila, lawe kēia mau ʻauwai bile i ka bile a hāʻawi iā ia i kou ʻōpū liʻiliʻi. Ma laila, hoʻopau nā waikawa i loko o ka bile i nā momona a me nā protein i loko o kāu meaʻai a kōkua iā ʻoe e hoʻoheheʻe iā ia. Hoʻopili pū kāu ʻauwai bile i kāu ʻauwai pancreatic. Hoʻokuʻu kēia ʻauwai pancreatic i nā enzymes, kahi ʻano protein, e kōkua iā ʻoe e hoʻoheheʻe i ka meaʻai.

Pehea ka maʻamau o kēia haiki ʻana o nā ʻauwai bile?

ʻAʻole ʻike maopopo nā loea i ka nui o ka poʻe e loaʻa ana i kēia ʻūlū ʻana o nā ʻauwai bile i kēlā me kēia makahiki. Eia nō naʻe, me he mea lā e lilo ana kēia ʻano i mea maʻamau. ʻO kekahi kumu paha ka hoʻonui ʻia ʻana o ke ʻoki ʻana i ka gallbladder , ʻoiai ka laparoscopic cholecystectomy. I ka wā o kēia mau ʻoki ʻana, hiki ke hōʻino ʻia a ʻeha ʻia nā ʻauwai bile i kekahi manawa, hiki ke hoʻohaiki iā lākou. Eia naʻe, he mea kakaikahi loa kēia ʻano i nā keiki ʻōpio.

He aha nā kumu nui o ka hoʻohaiki ʻana o ke aʻa bile?

He mea kākaʻikahi loa, hiki i kahi pēpē ke loaʻa kahi ʻauwai bile haiki i ka wā hānau. He maʻi hānau ia . Eia nō naʻe, i ka hapanui o nā hihia, ma kahi o ʻehiku o nā pēpē he ʻumi, ʻo kēia haiki o ke auwai bile ke kumu o ka maʻi kanesa. He ʻoiaʻiʻo loa kēia no ka maʻi kanesa pancreatic a me ka cholangiocarcinoma.ʻO kēia ke kumu nui. Hiki i kēia mau ʻano maʻi ʻaʻai ke hana i ka hoʻohaiki ʻana o ka ʻaʻa bile:

• Ka maʻi ʻaʻai ʻōpū
• ʻO ka maʻi kanesa hepatocellular
• Ka maʻi ʻaʻai ate
• ʻO ka maʻi ʻōpū
• Ka laha ʻana o ke kanesa i nā ʻāpana ʻē aʻe o ke kino ( Metastasis )
• Ka maʻi ʻōpū liʻiliʻi

He aha nā kūlana ʻē aʻe ma waho aʻe o ke kanesa e hiki ai ke hana i kēia?

Hiki ke kū ka ʻūlū ʻana o ke auwai bile ma muli o nā kūlana ʻaʻole maʻi kanesa (benign), ʻo ia hoʻi ma kahi o 30 pakeneka o nā hihia. Hiki nō hoʻi ke hana ʻia e kekahi mau lāʻau lapaʻau. E nānā kākou i ko lākou ʻano:

• Nā ʻeha a i ʻole ka trauma o ka ʻōpū
• ʻO ka pancreatitis Autoimmune a me ka pancreatitis (ka mumū o ka pancreas)
• ʻO ka ʻeha o ke kahawai bile mai nā pōhaku gallstones
• ʻO ka maʻi Mirizzi (hiki kēia ke paʻa nā pōhaku gall i loko o ka gallbladder a ālai i nā ʻauwai bile)
• ʻO ka cholangitis biliary mua
• ʻO ka cholangitis sclerosing mua
• Hoʻōla radiation

He aha kēia `(Anastomotic biliary stricture)`?

ʻO kekahi mau ʻoki kino, e like me ke kaʻina hana Whipple (kahi ʻoki kino nui no ka maʻi ʻaʻai pancreatic) a i ʻole ka hoʻoili ʻana o ke ake, hiki ke hana i kahi anastomotic biliary stricture. I loko o kēia mau ʻoki kino, hoʻopili hou ke kauka lapaʻau i nā ʻōmole i loko o kāu ʻōnaehana hoʻoheheʻe. Ua kapa ʻia kēia hoʻopili hou ʻana he anastomosis. I kekahi manawa, hiki i nā ʻauwai bile ke hōʻino ʻia a ʻeha paha a haiki ma kahi i pili ai lākou. Ua kapa ʻia kēia he anastomotic biliary stricture.

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

Inā loaʻa iā ʻoe kēia maʻi, hiki iā ʻoe ke ʻike i nā hōʻailona e like me kēia. E hoʻomanaʻo ʻo ka loaʻa ʻana o hoʻokahi a ʻelua paha o kēia mau hōʻailona wale nō ʻaʻole ia he manaʻo ua loaʻa iā ʻoe ka maʻi, akā he mea nui e makaʻala iā lākou.

• ʻEha ma ka ʻaoʻao ʻākau o luna o ka ʻōpū .
• Manaʻo e like me ʻoe e loaʻa ana i ke kuni a ke anu nei kou kino .
• Hiki ke loli ke kala o kou mau noho . Hiki ke hina a māmā paha, e like me ka lepo.
• Ka maneʻo mau o ka ʻili (Pruritus).
• Jaundice : He melemele kēia o nā keʻokeʻo o nā maka a me ka ʻili.
• Ka nalowale o ka makemake .
• Manaʻo luaʻi a me ka luaʻi .

He aha nā pilikia e hiki ke kū mai inā hoʻomau kēia?

Inā e haiki a ālai ʻia paha kahi ʻauwai bile no ka manawa lōʻihi, hiki i ka bile ke hōʻiliʻili i loko o ke ake. Inā hana ʻia kēia, hiki iā ʻoe ke loaʻa i nā maʻi , nā maʻi ake , a me nā ʻōpala o ke ake, hiki ke alakaʻi i nā kūlana e like me ka cirrhosis o ke ake . No laila he mea nui e makaʻala i kēia mau hōʻailona.

He aha ke ʻano kauka e pono ai no ka ʻike a me ka mālama ʻana i kēia maʻi?

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​pono ʻoe e ʻike mua i kahi gastroenterologist, he kauka loea i nā maʻi e pili ana i ka ʻōnaehana hoʻoheheʻe . ʻO ia ka mea hiki ke ʻike pololei a mālama i kēia mau kūlana.

Pehea e ʻike ai nā kauka i kēia ʻūlū ʻana o nā ala bile?

Hiki i kāu kauka ke hana i kekahi mau hoʻokolohua e hōʻoia i kēia kūlana.

• Nā hoʻāʻo koko:
• Hoʻāʻo Bilirubin: Ke haiki a paʻa paha nā ʻauwai bile, hōʻiliʻili kahi huahana ʻōpala i kapa ʻia ʻo bilirubin i loko o ka bile i loko o ke kino. Ana kēia hoʻāʻo i kēlā pae.
• Nā hoʻāʻo hana ate: Nānā kēia i nā pae enzyme ate kiʻekiʻe.

• Nā hoʻokolohua kiʻi: Hiki i kēia mau hoʻokolohua ke nānā i ke kūlana o nā ʻāpana bile i loko o ke kino.
• Ultrasound: Hoʻohana kēia i nā nalu kani e kiʻi i nā kiʻi o nā ʻauwai bile e hōʻike i nā ālai ʻana a i ʻole ka haiki ʻana. Loaʻa paha iā ʻoe kahi ultrasound endoscopic ( kahi ultrasound i hana ʻia ma o kahi ʻōmole me kahi kāmela), kahi ultrasound ʻōpū, a i ʻole kahi ultrasound akepaʻa.
• ʻO ka Endoscopic retrograde cholangiopancreatography (ERCP): He hui pū ʻana kēia o kahi endoscopy luna a me kahi X-ray. Hoʻopaʻa ʻia kou puʻu a hoʻokomo ʻia kahi endoscope (kahi paipu palupalu me kahi kāmela) e nānā i nā ʻōpū i loko o kou ʻōpū a me nā ʻauwai bile. I kēia manawa, hiki ke lawe ʻia kahi hāpana ʻiʻo me ka hoʻohana ʻana i nā lako kūikawā a hoʻouna ʻia no kahi biopsy . Hiki ke hoʻohana ʻia kēia biopsy e nānā i nā hunaola kanesa.
• ʻO ka cholangiopancreatography resonance magnetic (MRCP): He hoʻāʻo MRI holomua kēia e hiki ke kiʻi i nā kiʻi maopopo loa o kāu mau ʻāpana bile, ate, pancreas, a me ka gallbladder.
• ʻO ka cholangiography transhepatic Percutaneous (PTC): He hoʻāʻo X-ray kūikawā kēia. Ma kēia hoʻāʻo, hoʻokomo ke kauka i kahi dye kūikawā (contrast dye) ma o kou akepaʻa i loko o kou mau ʻauwai bile. A laila hoʻohana ʻia nā kukuna X e ʻike i ke ʻano o ka hele ʻana o ka dye ma o nā ʻauwai bile i loko o ka ʻōpū liʻiliʻi. Hiki i ka dye ke hōʻike i nā mea i ālai ʻia.

Pehea e mālama ʻia ai kēia ʻūmiʻi o ke aʻa bile?

I kekahi manawa, hiki i nā kauka ke mālama i ke kumu o ke ālai ʻana o ka ʻauwai bile i ka manawa like me kā lākou hana ʻana i kahi ERCP a i ʻole PTC. Ma muli o ke kumu, hiki i ke kauka ke hana i nā mea e like me:

• Inā he mau pōhaku i loko o ka gallbladder, e wāwahi iā lākou a lawe aku.
• Me ka hoʻohana ʻana i kahi mea like me ka pōpō e hoʻonui ai i kahi ala bile i haiki ʻia, ua hoʻokomo ʻia kahi stent (kahi paipu liʻiliʻi i hana ʻia me ka metala a i ʻole ka plastic) e pale aku ai i ka haiki hou ʻana.
• Ke wehe ʻana i nā tumors, inā he.

He aha nā ʻano hana lapaʻau?

He kakaikahi wale nō ka poʻe e pono ai ke ʻoki kino e hoʻoponopono i kahi ʻauwai bile i haiki. Inā ʻo ke kanesa ka mea i hoʻopilikia ʻia ai, hiki ke hana ʻoki kino. ʻO nā koho ʻoki kino e komo pū me:

• Hana ʻia ke ʻoki bypass e kāpae i ke ala bile i ālai ʻia a hoʻokomo pololei i ka bile i loko o ka ʻōpū liʻiliʻi.
• ʻO ka resection e pili ana i ka ʻoki ʻana i ka ʻāpana maʻi o ke kahawai bile a me ka hoʻopili hou ʻana i ka ʻāpana olakino (anastomosis).

Hiki ke hoʻi hou mai kēia maʻi ma hope o ka mālama ʻana?

ʻAe, hiki ke lilo hou ke ala bile i haiki ma hope o ka mālama ʻana a me ka wehe ʻana. Inā hana ʻia kēia, hiki i kāu kauka ke hana i ke ʻoki ʻana i ke ala bile e wehe ai i ke ala bile i haiki. Ma hope o ka wehe ʻana, ua hoʻopili hou ʻia ke ala bile olakino a me ka ʻōpū liʻiliʻi.

Aia kekahi mau pilikia ma hope o ka mālama ʻana?

ʻOkoʻa nā pilikia ma hope o ka mālama ʻana ma muli o ka mālama ʻana. Hiki i kekahi poʻe ke loaʻa i ka pancreatitis acute (ka pehu ʻana o ka pancreas) ma hope o ka ERCP. No laila, he mea nui e hahai pono i nā ʻōlelo a kāu kauka.

Aia kekahi mea e hiki ai iā mākou ke hana e pale aku i kēia ʻūmiʻi ʻana o ka ʻauwai bile?

Aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia o ka loaʻa ʻana o kekahi mau kūlana e hiki ai ke hoʻohaiki i ka ʻauwai bile. Eia kekahi laʻana:

• E ʻai i ka meaʻai olakino me nā huaʻai a me nā mea kanu hou.
• E hoʻohaʻahaʻa i kou pae cholesterol . E kōkua kēia i ka mālama ʻana i ke olakino o ka gallbladder a pale i ke kūkulu ʻia ʻana o nā gallstones.
• E mālama i kahi kaumaha olakino e kūpono iā ʻoe.
• Inā loaʻa iā ʻoe nā pilikia me ka hoʻohana ʻana i ka waiʻona, e kiʻi i ke kōkua. Hiki i kēia ke kōkua i ka pale ʻana i ka pancreatitis a me nā hōʻino ʻē aʻe o ke ake.

ʻO ka mea nui loa, ʻo ia ka hoʻāʻo ʻana e mālama i kahi nohona olakino. ʻO nā mea e like me ka ʻai kaulike a me ka hoʻoikaika kino e pale aku iā ʻoe mai nā maʻi he nui.

He aha ka manaʻolana no ka ho'ōla hou ʻana no kekahi me kēia maʻi?

Aia kou mau manaʻolana e hoʻōla ʻia ma ke kumu o ke ālai ʻana o kou ʻaʻa bile. ʻO ka maʻamau, ʻo nā lāʻau lapaʻau e wehe ai i ke ʻaʻa bile i ālai ʻia he holomua. Eia nō naʻe, ʻo ke kūlana kumu i hoʻokumu i ke ālai ʻana (e like me ke kanesa) e koi paha i ka lāʻau lapaʻau paʻakikī.

Pehea ka manawa ho'ōla ma hope o ka lā'au lapa'au?

ʻO kou manawa hoʻōla, ʻo ia hoʻi ka wikiwiki o kou hoʻi ʻana i ka hana, ke kula, a me nā hana maʻamau, e loli ma muli o ke ʻano o ka lāʻau i loaʻa iā ʻoe. ʻO nā lāʻau lapaʻau minimally invasive e like me ERCP e ʻoi aku ka wikiwiki a me ka ʻeha ʻole ma mua o nā ʻoki hāmama e pono ai nā ʻoki nui. He mea nui e hahai pono i nā ʻōlelo a kāu kauka e hōʻoia i ka hoʻōla palekana. Hiki ke ʻōlelo ʻia iā ʻoe e ʻai i kahi wai, ʻai palaka no kekahi manawa, a i ʻole e hoʻololi i kāu meaʻai e hoʻokomo i nā meaʻai maʻalahi ke ʻeli .

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e ʻike koke i ke kauka:

• Ke kuni mau.
• ʻEha hou o ka ʻōpū luna.
• Nā hōʻailona o ka maʻi ma hope o ka mālama ʻana (e.g., ka pus e kahe ana mai ka ʻeha, ka ʻulaʻula).
• Ka emi ʻana o ke kaumaha me ke kumu ʻole, ka manaʻo nawaliwali, a i ʻole ka luaʻi ʻana.
• Melemele nā ​​keʻokeʻo o nā maka a i ʻole ka ʻili (jaundice) .

He aha kaʻu e nīnau aku ai i kaʻu kauka?

Hiki iā ʻoe ke nīnau i ke kauka i nā nīnau penei:

• He aha ke kumu o kēia ʻūlū ʻana o koʻu mau ala bile?
• He aha ka lāʻau lapaʻau maikaʻi loa noʻu?
• Aia kekahi mau mea hiki iaʻu ke hana e hōʻemi i ka pilikia o kēia ʻano ʻūlū ʻana o ka bile duct e hana hou ana?

ʻO nā hōʻailona e like me ka ʻeha o ka ʻōpū, ke kuni, ke anu, a me ka jaundice hiki ke hoʻopilikia maoli, ʻoiai inā hiki koke mai lākou. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ka haʻi koke ʻana i kāu kauka. A laila hiki iā lākou ke hana i nā hoʻokolohua e ʻike i ke kumu a paipai i ka lāʻau kūpono.

ʻŌlelo Lawe-Home: Nā mea nui e hoʻomanaʻo

No laila, ke lana nei koʻu manaʻo ua ʻike maikaʻi ʻoe i ke ʻano o ka stricture biliary a mākou i kamaʻilio ai i kēia lā.

• He ʻūmiʻi kēia o nā ʻauwai bile, kahi e ālai ai i ke kahe ʻana o ka bile.
• Nui nā kumu; nā mea e like me nā ʻeha mai ke ʻoki ʻana, nā pōhaku gallstone, a me ke kanesa.
• E makaʻala i nā hōʻailona e like me ka ʻeha o ka ʻōpū, ka jaundice, ka maneʻo, a me nā loli i ke kala o ka ʻōpala.
• Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​e ʻike koke aku i kahi gastroenterologist .
• Aia nā lāʻau lapaʻau, no laila mai hopohopo. ʻO ka wikiwiki o ka ʻike ʻia a me ka mālama ʻia ʻana, ʻoi aku ka maikaʻi o nā hopena.
• ʻO ka noho ʻana i kahi nohona olakino e kōkua nui i ka pale ʻana i ia mau ʻano maʻi.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai kānalua e kamaʻilio me kāu kauka. E noho olakino!