E aʻo hou kākou e pili ana i kāu ʻōnaehana biliary. He mea nui loa kēia!

I kēia lā, e kamaʻilio kākou e pili ana i kahi ʻōnaehana kupaianaha i loko o ko kākou kino e kōkua iā kākou e hoʻoheheʻe i ka meaʻai a kākou e ʻai ai. Ua kapa ʻia ʻo ia ʻo ka ʻōnaehana biliary . Ua lohe paha ʻoe i kēia inoa ma mua. I ka ʻōlelo maʻalahi, he pūnaewele ia o nā ʻōkana a me nā kahawai i hoʻopili ʻia i loko o ko kākou kino. Ua like ia me kahi hale hana liʻiliʻi e kōkua ana i ko kākou kino.

He aha ka ʻōnaehana biliary? No ke aha he mea nui ia iā mākou?

ʻAe, e nānā mua kākou i ke ʻano o kēia ʻōnaehana biliary. ʻO kēia ka ʻōnaehana e hana, mālama, a hoʻokuʻu i ka bile i loko o kā mākou ʻōnaehana hoʻoheheʻe i ka wā e pono ai. Ke noʻonoʻo nei paha ʻoe i ke ʻano o ka bile. He wai melemele-ʻōmaʻomaʻo ka Bile i hana ʻia e ko mākou ake . ʻO kāna hana nui ke kōkua i ka hoʻoheheʻe ʻana i ka meaʻai a mākou e ʻai ai, ʻoi aku hoʻi nā meaʻai momona.

No laila, he hana koʻikoʻi ko kēia ʻōnaehana bile. ʻO ia hoʻi, kōkua ia i ka hoʻopau ʻana i kekahi o nā huahana ʻōpala i loko o ko mākou kino mai ke kino ma o kēia bile. ʻO ia hoʻi, ʻaʻole wale kēia ʻōnaehana e kōkua i ka ʻai ʻana, akā kōkua pū kekahi i ka mālama ʻana i ko mākou kino i ka maʻemaʻe. Maopopo iā ʻoe? ʻO ia ke kumu he mea nui loa kēia no mākou.

Aia ma hea ka ʻōnaehana biliary? He aha kona mau ʻāpana nui?

I kēia manawa, e nānā kākou i kahi o kēia ʻōnaehana biliary i loko o ko kākou kino. Aia ia ma ka ʻaoʻao o luna o ko kākou lua ʻōpū. I mea e pololei ai, ʻo ka ʻaoʻao ʻākau kahi o ka hapa nui o nā ʻōkana.

Aia kekahi mau ʻāpana nui o kēia ʻōnaehana:

ʻAkepaʻa: Ke kuke akamai o ko kākou kino!

ʻO ke akepaʻa ka mea nui i kēia ʻōnaehana. Hana ia i ka bile . ʻAʻole wale ia, akā ʻoiai e hoʻomaʻemaʻe ana i ko kākou koko, hoʻokaʻawale pū ia i nā huahana ʻōpala e like me ka cholesterol keu a me ka bilirubin (nāna e hāʻawi i ka bile i kona kala melemele) a hoʻohui iā lākou i ka bile. Hana ʻia nā waikawa bile i loko o ka bile e ke akepaʻa, kahi e hoʻohana pū ai i ka cholesterol. Kōkua kēia mau waikawa bile i ko mākou ʻōpū liʻiliʻi e hoʻoheheʻe i ka meaʻai. ʻO ka bile, ka mea e hōʻiliʻili ma o nā ʻauwai bile maikaʻi loa i loko o ke akepaʻa (`intrahepatic ducts`), a laila hoʻohui ʻia i nā ʻauwai bile nui e puka mai ana mai ke akepaʻa (`extrahepatic ducts`).

Nā ala bile: nā ala maikaʻi e lawe ai i ka bile

ʻO kēia nā ducts e hōʻiliʻili i ka bile i hana ʻia i loko o ke akepaʻa a lawe iā ia i ke koena o ka ʻōnaehana. Hoʻohui pū nā ducts liʻiliʻi a hui pū i loko o kahi duct nui i kapa ʻia ʻo ke duct bile maʻamau . Hoʻopili pololei ʻia kēia duct bile maʻamau i ka ʻāpana mua o ko mākou ʻōpū liʻiliʻi, ʻo ia ka duodenum . Hoʻopili pū ʻia kēia duct bile maʻamau i ke duct hepatic maʻamau mai ke akepaʻa, ke duct cystic mai ka gallbladder, a me ke duct pancreatic mai ka pancreas. E noʻonoʻo iā ia e like me kahi huina kahi e hui ai nā alanui.

ʻŌpū Gall: He lumi mālama liʻiliʻi

Ma kahi o ka hapalua o ka bile e puka mai ana mai ke akepaʻa e hele pololei i ka pancreas ma o ke kahawai bile nui, akā ʻo ka hapalua ʻē aʻe e hele i ka gallbladder . He ʻano ʻeke liʻiliʻi kēia e like me ke ʻeke aia ma lalo pono o ke akepaʻa. Maanei kahi e mālama ʻia ai a hoʻopaʻa ʻia ai ka bile. Ke loaʻa i ko kākou ʻōpū liʻiliʻi ka meaʻai i loaʻa ka momona a me ka protein, pono ia i ka bile hou aʻe e hoʻoheheʻe iā ia. A laila hoʻouna ka ʻōpū liʻiliʻi i kahi hōʻailona i ka gallbladder, me ka ʻōlelo ʻana, "ʻAe, e hoʻouna i kahi bile i kēia manawa." I kēlā manawa, ʻuʻuku ka gallbladder a hoʻokuʻu i ka bile keu ma o ke kahawai.

Pancreas: ʻO kekahi mea kōkua koʻikoʻi

Aia ko kākou pancreas ma hope o ka ʻōpū. Pane pū ka pancreas i nā hōʻailona mai ka pancreas. Akā, ʻaʻole ia e hoʻokuʻu i ka bile. Hoʻokuʻu ia i kahi hui ʻana o nā enzymes e kōkua i ka hoʻoheheʻe ʻana i nā carbohydrates, nā protein, a me nā momona. Hele kēia mau enzymes ma o ka pancreatic duct a hōʻiliʻili ma kahi e hui ai ke kahawai bile nui me ka pancreas. I kekahi manawa, ʻo kēia hōʻiliʻili, kahi waihona liʻiliʻi kahi e hōʻiliʻili ai nā enzymes bile a me ka pancreatic i kekahi manawa, ua kapa ʻia ʻo ka ampulla o Vater .

ʻO ka ʻōpū liʻiliʻi - ʻoi aku ka duodenum: ke kihi kahi e hui pū ai nā mea āpau

ʻO ka hapa mua o ko kākou ʻōpū liʻiliʻi ua kapa ʻia ʻo ka duodenum . ʻO kēia kahi e pili ai ka ʻōnaehana biliary a me ke koena o kā kākou ʻōnaehana hoʻoheheʻe. Ke hiki ka bile i ka ʻōpū liʻiliʻi, hoʻokaʻawale ʻia nā waikawa bile i loko. Hoʻopuka ʻia nā huahana ʻōpala i koe i loko o ka ʻōpala. Kōkua nā waikawa bile i hoʻokaʻawale ʻia i ka wāwahi ʻana i nā momona i loko o ka ʻōpū. A laila, hoʻopili hou ʻia nā waikawa bile ma o nā paia o ka ʻōpū i loko o ke koko a hoʻihoʻi ʻia i ke akepaʻa. Ua like kēia me ka 'hana hou ʻana'.

He aha nā maʻi maʻamau e hiki ke hoʻopilikia i ka ʻōnaehana biliary?

Ma muli o ka pili loa o nā ʻōkana a me nā ducts a pau o kēia ʻōnaehana biliary, inā loaʻa kahi maʻi ma kekahi wahi, hiki iā ia ke hoʻopilikia maʻalahi i nā wahi ʻē aʻe. ʻO ke kikoʻī, hiki i nā maʻi a me ka mumū ke laha i nā ʻōkana kokoke ma nā ducts bile. Eia kekahi, inā keʻakeʻa kekahi mea i ke kahe o ka bile, hoʻopilikia ia i ka ʻōnaehana holoʻokoʻa.

Eia kekahi mau maʻi maʻamau e hiki ke loaʻa i loko o kēia ʻōnaehana:

• Nā Pōhaku ʻAʻa: He kūlana maʻamau kēia i lohe ʻia e ka poʻe he nui. Inā hoʻokumu ʻia nā pōhaku i loko o ka ʻaʻa a paʻa i loko o nā ʻaʻa bile, ʻoi aku hoʻi ka ʻaʻa bile maʻamau, hiki iā lākou ke hōʻeha nui i ka ʻōpū, ka mumū o ka ʻaʻa gallbladder (cholecystitis), a i kekahi manawa hiki i ka pancreas ke mumū, a mākou e kapa nei he gallstone pancreatitis .
• Kolestasis:I ka ʻōlelo maʻalahi, ʻo ia ka manawa e lohi ai ke kahe o ka bile a i ʻole e ālai loa ʻia. Hiki paha kēia no ka mea ʻaʻole hana pono ke akepaʻa i ka bile, a i ʻole ua ālai ʻia paha nā ala bile ma kekahi ʻano.
• ʻO ke koʻikoʻi o ka biliary: ʻO ka mumū lōʻihi o nā ʻauwai bile hiki ke hana i ka ʻiʻo ʻeha, e hoʻohaiki ana a ālai ana i nā ʻauwai. Hiki ke hana ʻia kēia e nā maʻi hoʻoilina a i ʻole nā ​​maʻi autoimmune .
• Maʻi akepaʻa: Hiki i ka maʻi akepaʻa lōʻihi ke hana i ka ʻeha o ka ʻiʻo akepaʻa, e alakaʻi ana i ka hāʻule mālie o ke akepaʻa. Ua kapa ʻia kēia maʻi he cirrhosis . A laila, ʻaʻole hiki i ke akepaʻa ke hana i ka bile lawa.

Ma waho aʻe o kēia, aia kekahi mau maʻi ʻē aʻe:

• ʻO ka pancreatitis mau loa
• Nā cysts pancreatic
• ka hana ʻino o ka gallbladder (biliary dyskinesia)
• ʻO ka cholangitis sclerosing mua
• ʻO ka cholangitis biliary mua
• ʻO ka atresia biliary (kūlana hānau)
• Ka malabsorption o ka waikawa bile
• ʻO ke kanesa o ke auwai bile (ʻO ke kanesa o ke auwai bile / ʻO ke cholangiocarcinoma)
• Ka maʻi ʻaʻai ate
• Ka maʻi ʻaʻai pancreatic
• Ka maʻi ʻaʻai ʻōpū
• Ka maʻi ʻaʻai ampullary

He aha nā hōʻailona o ka maʻi ʻōnaehana biliary? E makaʻala i kēia mau mea!

Inā he pilikia me ka ʻōnaehana biliary, hāʻawi mai ko mākou kino iā mākou i kekahi mau hōʻailona. He mea nui loa ia e ʻike ʻoe i kēia mau hōʻailona.

• Jaundice: He ʻano kēia e melemele ai nā keʻokeʻo o nā maka a me ka ʻili. Hana ʻia kēia ke hiki ʻole i ka bile ke holo pono, ālai ʻia i loko o ka ʻōnaehana, a hōʻiliʻili ʻia i loko o ke koko. Hāʻawi ʻia ka Bile i kona kala melemele e kahi pigment i kapa ʻia ʻo bilirubin .
• ʻO ke kolik biliary: He ʻano ʻeha kikoʻī loa kēia. Loaʻa pinepine ia ma hope koke iho o ka ʻai ʻana. Loaʻa kēia ʻeha i ka wā e ʻūlū ai ka gallbladder a hoʻokuʻu i ka bile i loko o ke ala bile nui, a aia kahi mea e ālai ai (e like me ka pōhaku). Hoʻonui mālie ka ʻeha, hiki i ka piko, a laila emi mālie.
• Ka luaʻi a me ka luaʻi: ​​Hoʻopili pinepine kēia mau hōʻailona ʻelua i ka ʻeha o ka ʻōpū. I kekahi manawa, me ka jaundice, hiki ke loaʻa ka luaʻi mau a me ka luaʻi. Hoʻokumu ʻia kēia e nā mea ʻawahia bile e hōʻiliʻili ana i loko o ke koko.
• ʻO Steatorrhea: Inā ʻaʻole hiki pono ka bile a i ʻole nā ​​waikawa bile i ka ʻōpū liʻiliʻi no kekahi kumu, ʻaʻole i ʻeli ʻia a omo ʻia paha nā momona i loko o ka meaʻai a mākou e ʻai ai e ke kino. A laila, hoʻopuka ʻia nā momona me ka ʻōpala. Hiki i ka ʻōpala ke ʻaila a lana ma luna.

Ma waho aʻe o kēia, aia paha nā hōʻailona ʻē aʻe:

• ʻEha ʻōpū luna.
• Mimi ʻeleʻele.
• Ka huikau a i ʻole ka hemahema iki o ka noʻonoʻo.

Mea nui: Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​e ʻimi pono i ke kōkua lapaʻau. ʻO ka wikiwiki o ka ʻike ʻia ʻana o ka maʻi, ʻo ka maʻalahi ka mālama ʻana.

He aha nā hoʻokolohua e hiki ke kōkua i ka hoʻoholo ʻana i ke olakino o kaʻu ʻōnaehana biliary?

Inā loaʻa iā ʻoe nā hōʻailona i ʻōlelo ʻia ma luna nei, hiki i kāu kauka ke kauoha i nā hoʻokolohua like ʻole e nānā i ke olakino o kēia ʻōnaehana.

• Nā hoʻāʻo koko: Nānā nā hoʻāʻo hana ate (LFT) a me nā hoʻāʻo hana pancreas i nā enzymes akepaʻa a me ka pancreatic i kiʻekiʻe. Hiki i ka helu koko piha (CBC) ke nānā i nā helu cell koko keʻokeʻo i kiʻekiʻe. Hiki i nā helu cell koko keʻokeʻo i kiʻekiʻe ke hōʻike i kahi maʻi a i ʻole ka mumū.
• Nā hoʻāʻo kiʻi: Hiki i nā hoʻāʻo maʻamau e like me ka ultrasound ʻōpū a i ʻole CT scan ke kōkua i ka hoʻoholo ʻana inā he poloka a pehu paha ma nā wahi āpau o ka ʻōnaehana biliary.
• Nā hoʻāʻo kiʻi kūikawā: Aia nā hoʻāʻo kūikawā e hiki ke nānā hohonu i ka ʻōnaehana biliary. ʻO kekahi mau laʻana:
• ʻO ke kani ultrasound endoscopic (EUS)
• ʻO ka scintigraphy hepatobiliary (HIDA scan)
• ʻO ka cholangiopancreatography resonance magnetic (MRCP)
• Endoscopic retrograde cholangiopancreatography (ERCP). Hoʻohana ʻia kēia ma ke ʻano he hoʻāʻo a no kekahi mau lāʻau lapaʻau.

He aha nā lāʻau lapaʻau no nā maʻi o ka ʻōnaehana biliary?

ʻO ka mea maikaʻi loa, aia nā lāʻau lapaʻau kūpono no nā maʻi he nui o ka ʻōnaehana biliary. ʻOkoʻa ke ʻano o ka lāʻau lapaʻau ma muli o ke ʻano o ka maʻi a me kona koʻikoʻi.

• Ka hoʻokahe ʻana o ke kō koko: He hana maʻalahi kēia. Hana ʻia ia e wehe i ka kō koko keu i hōʻiliʻili ʻia i loko o nā ʻauwai kō koko. Hoʻokomo ke kauka i kahi ʻōmole lahilahi (catheter) ma o kou paia ʻōpū i loko o kāu ʻōnaehana kō koko a hoʻokahe i ka kō koko ma o ia mea.
• Lapaʻau Endoscopic: I ka wā o ke kaʻina hana ERCP , hiki ke hana ʻia kekahi mau lāʻau lapaʻau ma o ka endoscope (kahi ʻōmole lahilahi me kahi kāmela i hoʻopili ʻia). No ka laʻana, inā he mea paʻa, hiki ke wehe ʻia, hiki ke lawe ʻia kahi hāpana ʻiʻo (he biopsy), a i ʻole hiki ke hoʻokomo ʻia kahi ʻōmole liʻiliʻi ( he stent ) e mālama i ka wehe ʻana o ke kahawai.

I kekahi mau hihia, ʻoi aku hoʻi no nā kūlana e like me nā pōhaku gall, pono paha ke ʻoki ʻana e wehe i ka gallbladder (cholecystectomy). No ke kanesa, pono paha nā lāʻau lapaʻau paʻakikī e like me ke ʻoki ʻana, radiotherapy, a i ʻole chemotherapy.

He aha kā mākou e hana ai e mālama i ke olakino o kā mākou ʻōnaehana biliary?

"ʻOi aku ka maikaʻi o ka pale ʻana ma mua o ka hoʻōla ʻana." ʻO ia hoʻi, ʻoi aku ka maikaʻi o ka pale ʻana i kahi maʻi ma mua o ka hiki ʻana mai ma mua o ka mālama ʻana ma hope o ka hiki ʻana mai. No laila, aia kekahi mau mea maʻalahi hiki iā kākou ke hana e mālama i ke olakino o kā kākou ʻōnaehana biliary.

• E mālama i ka ʻai olakino: E ʻai i nā meaʻai kūlohelohe i hana ʻole ʻia (nā meaʻai holoʻokoʻa) e like me ka hiki. E hōʻemi i nā meaʻai kiʻekiʻe i ke kō a me nā momona momona. E mālama kēia i kou akepaʻa a kaohi i kāu mau pae cholesterol. E hoʻomanaʻo, hiki i ka cholesterol ke alakaʻi i nā gallstones a me nā maʻi momona o ke akepaʻa.
• E kaupalena i ka waiʻona a me ka hoʻohana ʻana i nā lāʻau lapaʻau pono ʻole: ʻO ka hoʻohana nui ʻana i ka waiʻona a me nā lāʻau lapaʻau, e like me kekahi mau lāʻau ʻeha, nā kumu nui o nā pōhaku gallstones a me nā maʻi akepaʻa. Inā loaʻa iā ʻoe kekahi maʻi ʻōnaehana biliary, hiki i kēia mau mea ke hoʻonui i ka ʻino.
• E kiʻi i nā hoʻokolohua lapaʻau maʻamau: Hiki i kekahi mau maʻi o ka ʻōnaehana biliary ke noho i loko o ke kino no ka manawa lōʻihi me ka ʻole o ka hōʻike ʻana i nā hōʻailona nui. No laila, mai poina i kāu mau hoʻokolohua lapaʻau maʻamau ('nā nānā olakino'). A laila, inā he maʻi, hiki ke ʻike ʻia i ka wā mua. Eia kekahi, e kamaʻilio me kāu kauka e pili ana i nā lāʻau lapaʻau āu e lawe nei a ʻike inā he mea ʻino lākou i ke akepaʻa.

No laila, ʻo ka mea hope loa e hoʻomanaʻo ai! (Leka Lawe-Home)

He ʻāpana koʻikoʻi ko kākou ʻōnaehana biliary o kā kākou ʻōnaehana hoʻoheheʻe ʻana a me kā kākou ʻōnaehana kahe koko. Inā ʻaʻole ia e hana pono, hiki iā ia ke hoʻopilikia i nā mea āpau mai kā kākou hoʻoheheʻe ʻana a hiki i kā kākou meaʻai. Hiki iā ia ke ʻae i nā mea ʻawahia e hōʻiliʻili i loko o ko kākou kino a hoʻi i loko o ko kākou koko.

He nui nā hana ʻē aʻe a nā ʻōkana o kēia ʻōnaehana, e like me ke akepaʻa a me ka pancreas. No laila, inā maʻi kēia mau ʻōkana, ʻaʻole ia e hoʻopilikia wale i ka ʻōnaehana biliary, akā, i nā ʻōnaehana ʻē aʻe e pili ana i kēia mau ʻōkana. No laila, mai poina he mea nui ka ʻōnaehana biliary olakino no ke kino olakino. E mālama i kou kino, a inā ʻike ʻoe i kekahi mea ʻē, mai palaualelo e ʻimi i ke kōkua lapaʻau.

ʻŌnaehana biliary , ʻōpū paʻa, akepaʻa, nā ʻauwai bile, ka ʻai ʻana, ka jaundice, nā pōhaku ʻōpū