Ke makaʻu nei ʻoe i ka ERCP? E kamaʻilio maʻalahi kākou e pili ana i ia mea (ERCP)

Loaʻa iā ʻoe kekahi ʻeha ʻē ma ka ʻōpū o luna i hele mai no kekahi mau lā? Malia paha e melemele ana kou mau maka, me nā hōʻailona e like me ka jaundice? I ka manawa e like me kēia, inā haʻi aku kāu kauka iā ʻoe e pono ʻoe e loaʻa i kahi hoʻāʻo "ERCP", e makaʻu iki paha ʻoe ke lohe ʻoe i kēlā inoa. Akā, ʻaʻole ia he mea weliweli loa. I kēia lā, e kamaʻilio mākou e pili ana i kēia hoʻāʻo i kapa ʻia ʻo ERCP me ka maopopo a me ka maʻalahi.

He aha ka ERCP ma nā huaʻōlelo maʻalahi?

He lōʻihi a paʻakikī ke kani ʻana o ka inoa ERCP, ʻeā? E wehewehe kākou. ʻO ERCP kahi acronym no Endoscopic Retrograde Cholangiopancreatography .

I ka ʻōlelo maʻalahi, he hoʻokolohua kūikawā kēia e nānā ana i loko o kā mākou mau ʻauwai bile a me nā ʻauwai pancreatic . E noʻonoʻo e like me ke kau ʻana i kahi kāmela i loko o kēia mau ʻāpana liʻiliʻi e like me ka paipu o ko mākou kino.

• Endoscopic: Pili kēia i kahi endoscope, ʻo ia hoʻi, ua hoʻohana ʻia kahi ʻōmole lahilahi a maʻalahi me kahi kāmela i hoʻopili ʻia no kēia kumu.
• Retrograde: ʻO ke ʻano kēia "i hope." Ma kēia hoʻāʻo, ua hoʻokomo ʻia kahi wai (ʻano hoʻohālikelike) i loko o kēia mau kīʻaha ma ke ʻaoʻao ʻē aʻe i ke kahe maʻamau.
• ʻO Cholangiopancreatography: Hiki ke hoʻokaʻawale ʻia kēia i ʻelua ʻāpana. ʻO "Cholangio" ke ʻano o nā ʻauwai bile. ʻO "Pancreato" ke ʻano o nā ʻauwai pancreatic. ʻO "Graphy" ke ʻano o ke kiʻi ʻana i nā kiʻi. ʻO ia hoʻi, ke kiʻi ʻana i nā kiʻi X-ray o nā ʻauwai bile a me nā ʻauwai pancreatic.

Hoʻohana kēia hoʻāʻo i kahi kala kūikawā, ka mea e ʻike maopopo ai i loko o kēia mau ducts liʻiliʻi ma ka X-ray. Hiki i ke kauka ke ʻike inā he mea paʻa i loko o kēia mau ducts, e like me nā pōhaku gall , kahi puʻupuʻu, a i ʻole nā ​​​​ʻiʻo scar. ʻO ka mea maikaʻi loa, inā loaʻa kahi pilikia, hiki ke mālama koke ʻia.

No ke aha e pono ai iaʻu kahi hoʻāʻo ERCP?

Aia kekahi mau kumu e paipai ai kāu kauka i kahi ERCP. ʻO ka mea maʻamau ka wā e manaʻo ai lākou he pilikia me kou gallbladder, bile ducts, a i ʻole pancreas.

E nānā kākou i ka papa ma lalo nei e ʻike i nā kumu maʻamau no ka hana ʻana i kahi ERCP.

Pehea e hoʻomākaukau ai au ma mua o ka hoʻokolohua?

He mea nui loa ia e hoʻomākaukau pono ʻoe ma mua o kēia hoʻokolohua. E hāʻawi kāu kauka iā ʻoe i nā kuhikuhi maopopo no ka mea e hana ai. Ma keʻano laulā, pono ʻoe e hahai i kēia mau kuhikuhi:

• ʻAi a me ka Mea Inu: Pono ʻoe e pale i ka ʻai ʻana, ka inu ʻana (koe wale nō ka wai), a i ʻole ka nau ʻana i ka gum no kahi o 8 mau hola ma mua o ka hoʻāʻo. He mea nui ka ʻōpū hakahaka no kahi hoʻāʻo palekana a maopopo.
• E kamaʻilio e pili ana i kāu mau lāʻau lapaʻau: Inā ʻoe e lawe nei i nā lāʻau lapaʻau no nā kūlana olakino ʻē aʻe, e like me ka maʻi diabetes a i ʻole ke koko kiʻekiʻe, ʻoiai nā lāʻau hoʻokahe koko , pono ʻoe e haʻi mua i kāu kauka. E noi paha lākou iā ʻoe e hoʻōki i ka lawe ʻana i kēlā mau lāʻau lapaʻau no kekahi mau lā.
• Nā maʻi ʻaleka:Inā ua loaʻa iā ʻoe kahi maʻi allergy ma mua i ka lāʻau lapaʻau i hoʻohana ʻia no ka anesthesia a i ʻole ka dye contrast, e hoʻomaopopo i kāu kauka e pili ana i kēlā.
• Kekahi e hoʻokele iā ʻoe i ka home: ʻOiai e hāʻawi ʻia ʻoe i ka lāʻau hoʻomaha ma hope o ka hoʻāʻo ʻana, ʻaʻole hiki iā ʻoe ke hoʻokele a hoʻi paha i ka home ma kāu iho. No laila, he mea nui e loaʻa iā ʻoe kekahi e hoʻokele iā ʻoe i ka home.

He aha ka mea e hana ʻia i ka wā o ka hoʻāʻo?

ʻO ka maʻamau, he hoʻāʻo ka ERCP i ka lā hoʻokahi, ʻo ia hoʻi, hiki iā ʻoe ke hoʻi i ka home me ka ʻole o ka noho ʻana i ka haukapila. Hiki ke hala ma kahi o hoʻokahi a ʻelua paha hola.

1. Hoʻomaha: ʻO ka mea mua, hoʻokomo ʻia kahi cannula i loko o kahi aa koko i loko o kou lima a hāʻawi ʻia kahi mea hoʻomaha e hoʻohiamoe iā ʻoe. E pale aku kēia iā ʻoe mai ka manaʻo ʻole i kekahi ʻeha a ʻeha paha i ka wā o ka hoʻāʻo. ʻAʻole paha ʻoe e hoʻomanaʻo i kekahi mea ʻē aʻe i kēia manawa.

2. Ke hoʻokomo ʻana i ka endoscope: ʻO ka mea aʻe, e hoʻokomo mālie ke kauka i ka endoscope (kahi ʻōmole me kahi kāmela) ma kou waha, i lalo i kou esophagus a me ka ʻōpū, a i loko o ka ʻāpana mua o kou ʻōpū liʻiliʻi (duodenum). Hana ʻia kēia mau mea a pau i ka nānā ʻana ma kahi monitor.

3. Ke ʻimi nei i nā ducts: E ʻimi i ka wehe ʻana o nā ducts bile a me nā ducts pancreatic i loko o ka ʻōpū liʻiliʻi.

4. Ke hoʻokomo ʻana i ka Contrast Dye: A laila, hoʻokomo ʻia kekahi ʻōmole lahilahi ʻē aʻe ma o ka endoscope, a hoʻokomo ʻia ka contrast dye i loko o ke kahawai ma o ia mea.

5. X-ray (Fluoroscopy): Ke neʻe nei ka dye ma o ka ʻōmole, ua nānā ʻia me ka hoʻohana ʻana i kahi wikiō X-ray e neʻe ana (fluoroscopy). He palekana loa kēia X-ray no ka mea he haʻahaʻa loa ka nui o ka radiation.

6. Ka ʻike a me ka lāʻau lapaʻau: ʻAe kēia mau kiʻi X-ray i ke kauka e ʻike pono i nā mea i ālai ʻia, nā pōhaku, nā puʻupuʻu, a i ʻole nā ​​​​pilikia ʻē aʻe i loko o nā ʻōmole.

Nā hihia o ka mālama ʻana i ka wā o ka hoʻokolokolo ʻana

ʻO kēia kekahi o nā pono nui o ERCP. Inā ʻike ʻia kahi pilikia, hiki ke hoʻokomo ʻia nā mea hana liʻiliʻi ma o ka endoscope a mālama koke ʻia.

• Ka wehe ʻana i nā pōhaku: Hiki ke kuʻi ʻia a wehe loa ʻia paha nā pōhaku i paʻa i loko o nā ʻauwai bile.
• Biopsy: Inā he puʻupuʻu a ʻiʻo paha e kānalua ʻia, hiki ke lawe ʻia kahi ʻāpana liʻiliʻi no ka hoʻāʻo hou aku.
• Hoʻolaha ʻana o ke koko: Hiki ke hoʻolaha ʻia nā kīʻaha koko i lilo i mea haiki ma muli o ka ʻeha.
• Ke kau ʻana o ka stent: Inā pono e wehe ʻia kahi kīʻaha koko, hiki ke hoʻokomo ʻia kahi ʻōmole mesh liʻiliʻi (stent) i loko.
• ʻO ke kaʻina hana o ka sphincterotomy:Hiki ke hana ʻia kahi ʻoki liʻiliʻi i loko o ke ʻiʻo kahi e wehe ai ke auwai, e hoʻonui ana i ka puka a e ʻae i nā pōhaku a i ʻole ka bile e hele maʻalahi.

He aha kāu e manaʻo ai ma hope o ka hoʻāʻo?

Ma hope o ka hoʻāʻo ʻana, pono ʻoe e noho ma ka haukapila no hoʻokahi a ʻelua paha hola a pau ka hopena o ka lāʻau hoʻomaha. Ma hope o kēlā, hiki iā ʻoe ke hoʻi i ka home me ka mea nāna i hele mai e lawe iā ʻoe i ka home.

Hiki paha iā ʻoe ke loaʻa i kahi ʻeha iki no hoʻokahi a ʻelua paha lā, e like me:

• ʻEha ka ʻāʻī: Hiki i ka endoscope ke hana i kahi ʻeha iki o ka ʻāʻī. Hiki ke hoʻēmi ʻia kēia ma ka ʻai ʻana i nā wai a me nā meaʻai palupalu.
• Hoʻopiha ʻōpū a hoʻoneʻe paha: I ka wā o ka hoʻāʻo ʻana, hoʻokomo ʻia ka ea i loko o ka ʻōpū a me nā naʻau e ʻike maikaʻi aku i loko. Hiki paha i kēia ke hōʻeha iki i ka ʻōpū. E emi iho kēia ma hope o kekahi manawa.
• Luli: Hiki i kekahi poʻe ke ʻike i kahi manaʻo luli iki ma muli o ka lāʻau hoʻomaha. E nalo mālie ana kēia.

He aha nā pilikia o kahi hoʻokolohua ERCP?

E like me nā hana lapaʻau a pau, he liʻiliʻi ka pilikia o ka ERCP. Eia nō naʻe, he kakaikahi nā pilikia koʻikoʻi. Loaʻa nā pilikia i 5% a 10% wale nō o ka poʻe i loaʻa iā ERCP.

ʻO kekahi mau pilikia e hiki ke hana ʻia:

• Pancreatitis: ʻO kēia ka pilikia maʻamau. Hiki i ka hoʻāʻo ke hoʻoulu i ka pehu o ka pancreas.
• Ka maʻi: Hiki ke loaʻa kahi maʻi i loko o nā ʻāpana bile.
• Ke kahe ʻana o ke koko: Hiki ke kahe koko iki inā lawe ʻia kahi hāpana ʻiʻo a hana ʻia paha kahi ʻoki.
• Perforation: He mea kakaikahi loa, hiki i ka endoscope ke hana i kahi puka i loko o ka paia o ka esophagus, ka ʻōpū, a i ʻole ka ʻōpū liʻiliʻi.

He aha nā hōʻailona kūikawā āu e kamaʻilio ai me ke kauka?

Inā, ma hope o ka hoʻi ʻana i ka home ma hope o ka hoʻāʻo ʻana, loaʻa iā ʻoe kekahi mau hōʻailona koʻikoʻi ma waho aʻe o ka ʻoluʻolu iki āu e ʻike mau ai, e kāhea koke i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.

Nā hōʻailona e makaʻala ai:

• ʻEha nui o ka ʻōpū a i ʻole ka pehu ʻana.
• Kuni a i ʻole ke anu.
• Ka luaʻi pinepine ʻana.
• ʻEha ka umauma a i ʻole ka paʻakikī o ka hanu ʻana.
• Ke kahe ʻana o ke koko mai ka ʻōpū a i ʻole ke kahe ʻana o nā ʻōpala ʻeleʻele a ʻala.

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​mai hoʻowahāwahā iā lākou. E ʻimi koke i ke kōkua lapaʻau.