Ua hana ʻia anei ke ʻoki kino e wehe i kou ʻōpū? Ke loaʻa nei iā ʻoe ka ʻeha nui i kekahi manawa ma ka ʻaoʻao ʻākau o luna o kou ʻōpū? Ua like anei ia me ka ʻeha āu e loaʻa ai mai nā pōhaku ʻōpū? Manaʻo ka poʻe he nui ma hope o ka wehe ʻia ʻana o ko lākou ʻōpū, ua nalowale loa ka ʻeha o ko lākou ʻōpū. Akā i kekahi manawa ʻaʻole ke kumu o kēia ʻeha ka mea a mākou e manaʻo ai, akā he mea ʻē aʻe. ʻO ia ka mea a mākou e kamaʻilio ai i kēia lā.
I ka ʻōlelo maʻalahi, he aha ka Sphincter o Oddi?
I mea e maopopo ai i kēia, e nānā mua kākou i ke kaʻina hana hoʻoheheʻe i loko o ko kākou kino. He mea paʻakikī loa ia a he mea kupaianaha. He nui nā ʻōkana, e like me ko kākou akepaʻa a me ka pancreas, e hana pū ana e hoʻololi i ka meaʻai a kākou e ʻai ai i ikehu.
- ʻAkepaʻa: ʻO kēia kahi e hana ʻia ai ke kemika i kapa ʻia ʻo bile. Mālama ʻia ia no kekahi manawa i loko o ka gallbladder.
- Pancreas: Hoʻopuka kēia gland i nā enzymes e kōkua i ka hoʻoheheʻe ʻana i ka meaʻai.
Pono e holo pū ka bile mai ke akepaʻa a me nā enzyme mai ka pancreas i loko o ko kākou ʻōpū liʻiliʻi. ʻO ka ʻiʻo liʻiliʻi e kaohi ana i kēlā huakaʻi, ka mea e hana ana e like me ka puka, ua kapa ʻia ʻo Sphincter o Oddi .
Ke hana pono, wehe ʻia kēia ʻiʻo, i kapa ʻia ʻo Sphincter o Oddi, i ka manawa kūpono, e ʻae ana i ka bile a me nā enzymes e komo i loko o ka ʻōpū liʻiliʻi. A laila pani hou ia.
No laila he aha ka Sphincter o Oddi Dysfunction (SOD)?
I ka ʻōlelo maʻalahi, ʻo ka Sphincter of Oddi Dysfunction ka wā e wehe pono ʻole ai ka puka a mākou i kamaʻilio ai, ʻo ka ʻiʻo i kapa ʻia ʻo Sphincter of Oddi, i ka wā e pono ai. He aha ka mea e hana ʻia? ʻAʻole hiki i nā enzymes bile a me pancreatic ke komo i loko o ka ʻōpū liʻiliʻi a paʻa i loko o kēlā paipu. Ke paʻa ia e like me kēia, hoʻoulu ia i ka ʻeha nui o ka ʻōpū, e like me ka mea e hana ʻia ke loaʻa iā ʻoe nā pōhaku gall.
ʻIke pinepine ʻia kēia ʻano i nā poʻe i wehe ʻia ko lākou gallbladder (cholecystectomy). No kēia kumu, ua kapa ʻia ʻo ia he "post-cholecystectomy syndrome."
He aha nā ʻano a me nā mahele nui o kēia maʻi?
Hiki ke hoʻokaʻawale ʻia kēia ʻano i ʻelua ʻano nui a me ʻekolu mau māhele. He mea nui e ʻike i kēia, no ka mea, pili ka lāʻau lapaʻau i kēia ʻano.
| ʻAno / Māhele | Ua wehewehe maʻalahi ʻia |
|---|---|
| ʻElua ʻAno Nui | |
| ʻO ka Dyskinesia Biliary | Hana ʻia kēia i ka wā e ālai ʻia ai nā ala bile, e pale ana i ke kahe ʻana o ka bile i loko o ka ʻōpū liʻiliʻi. |
| ʻO ka maʻi pancreatitis | I kēia hihia, loaʻa ka palaka i loko o ka pancreas, e hōʻeha ana i ka mumū o ka pancreas. |
| ʻEkolu mau Māhele Nui | |
| Nā Māhele I a me II | Ma kēia mau māhele ʻelua, hiki i nā kauka ke loaʻa nā hōʻike maopopo o ka pilikia ma o nā hoʻokolohua. No ka laʻana, nā hoʻokolohua koko maʻamau ʻole a i ʻole kahi scan ultrasound e hōʻike ana i nā ʻauwai bile i hoʻonui ʻia a i ʻole nā ʻauwai pancreatic. |
| Māhele III | ʻO kēia ke ʻano paʻakikī loa e ʻike. No ka mea, ʻaʻohe hōʻike maopopo o kēia ma nā hōʻike koko, nā scan, a pēlā aku. ʻO ka hōʻike wale nō o kēia maʻi ʻo ia ka ʻeha o ka ʻōpū o ka mea maʻi. No laila, he mea paʻakikī iki hoʻi ka mālama ʻana i kēia. |
He aha nā hōʻailona o kēia maʻi?
ʻO ka hōʻailona nui a maʻamau o kēia ʻano, ʻo ia ka ʻeha nui o ka ʻōpū, e like me ka ʻeha i loaʻa i ka wā e hana ʻia ai nā pōhaku gall.
- Kahi i loaʻa ai ka ʻeha: ʻEha wela e hoʻomaka ana ma ka ʻaoʻao ʻākau o luna o ka ʻōpū.
- Ka hohola ʻana o ka ʻeha: I kekahi manawa hiki ke manaʻo ʻia kēia ʻeha e hele ana i ka poʻohiwi ʻākau a i ʻole ke kua.
- Ka lōʻihi o ka ʻeha: Nalo pinepine ka ʻeha ma hope o 30 mau minuke a i hoʻokahi hola. Eia nō naʻe, hiki ke hoʻi hou mai i hoʻokahi lā.
Ma waho aʻe o kēia ʻeha nui, hiki ke ʻike ʻia kekahi mau hōʻailona ʻē aʻe:
- Ka luaʻi a me ka luaʻi
- kuni
- Anuanu
- Ka maʻi pākī
ʻO ka mea nui, ʻaʻole like mau kēia mau hōʻailona. I kekahi mau lā e hele mai a hele aku lākou, a i kekahi mau lā hiki ke hoʻomanawanui ʻole.
No ke aha e hana ʻia ai kēia? He aha nā kumu pilikia?
ʻAʻohe kumu hoʻokahi no kēia. I kekahi manawa hiki i ka ʻeha a i ʻole ka mumū o nā ʻauwai bile ke ālai i ke kahe ʻana o ka bile. I kekahi manawa, me ka ʻole o ka ālai ʻana, hiki ke hana ʻia e kahi pilikia me ka sphincter o ka ʻiʻo Oddi ponoʻī.
Akā aia kekahi mau hui i ʻoi aku ka nui o ka pilikia o kēia maʻi.
- ʻO ka mea maʻamau: ʻO nā wahine ma waena o 20-50 mau makahiki i wehe ʻia ko lākou ʻōpū pehu ma ke ʻoki ʻana.
- Nā kumu pilikia ʻē aʻe:
- ʻO ka poʻe i hana ʻia i ke ʻoki pohō kaumaha (ʻoki bypass Gastric).
- ʻO nā kānaka e hoʻomohala hou ana i ka pancreatitis.
- ʻO ka poʻe i loaʻa nā pōhaku gallstones.
- ʻO ka poʻe i loaʻa i kahi hoʻoili ate.
- ʻO nā kānaka me ka thyroid hana ʻole (Hypothyroidism).
- Nā kānaka me ka maʻi ʻōpū huhū (IBS).
- ʻO ka poʻe e inu nui ana i ka waiʻona.
- ʻO ka poʻe e hoʻohana ana i kekahi mau mea ʻeha (ʻoiai nā opiates).
Hiki ke lilo i mea weliweli inā ʻaʻole mālama ʻia?
ʻAʻole kēia he maʻi e hoʻoweliweli i ke ola, a he kakaikahi nā pilikia nui. Eia nō naʻe, ʻo ka ʻeha nui e hana ai hiki ke lilo i mea keakea nui i kou hiki ke hana maʻamau.
Akā inā hoʻomau ia me ka ʻole o ka mālama ʻia, ʻaʻole paha e loaʻa pinepine nā kūlana penei:
- ʻO ka pancreatitis mau loa: ʻO ka hōʻino hiki ʻole ke hoʻi hou ʻia i ka pancreas i hoʻokumu ʻia e ka hoʻomau ʻana o ka mumū.
- Jaundice: He melemele o ka ʻili a me nā keʻokeʻo o nā maka i hana ʻia e ka hōʻiliʻili ʻana o ka bilirubin, kahi ʻāpana o ka bile, i loko o ke kino.
Pehea e ʻike ai ke kauka i kēia maʻi?
Inā loaʻa iā ʻoe kēia mau hōʻailona, ʻo ka mea mua a kāu kauka e hana ai, ʻo ia ke nānā i nā kūlana ʻē aʻe e hiki ai ke hōʻeha i kou ʻōpū, no ka mea, hiki ke hana ʻia kēia ʻano ʻeha e nā kūlana ʻē aʻe he nui.
Eia kekahi laʻana, pono ʻoe e hōʻoia ʻaʻohe maʻi koʻikoʻi e like me ka maʻi ʻōpū peptic, choledocholithiasis, a i ʻole ke kanesa pancreatic a i ʻole bile duct. ʻO ka mea kupanaha, hiki i ka ʻeha o kekahi mau maʻi puʻuwai (e like me ka angina) ke like me ka ʻeha o ka ʻōpū.
Ma hope o ka hoʻoholo ʻana i kēia mau mea a pau, hiki i kāu kauka ke noi iā ʻoe e hana i kēia mau hoʻokolohua:
- Nā hoʻāʻo koko: E nānā i ke kiʻekiʻe o ka pae enzyme o ke akepaʻa a me ka pancreas.
- Nā hoʻāʻo kiʻi:E nānā i kekahi mau mea ʻino i loko o ka sphincter o ka ʻiʻo a i ʻole nā ducts o Oddi. Hiki i kēia ke komo pū me nā hoʻokolohua e like me ka Abdominal Ultrasound, CT scan, Endoscopic Ultrasound (EUS), Upper Endoscopy, a me Magnetic Resonance Cholangiopancreatography (MRCP).
Hoʻāʻo kūikawā: ERCP me Manometry
I kekahi manawa, inā ʻaʻole i hoʻoholo pono ʻia kēia mau hoʻokolohua a pau, hiki i ke kauka ke kuhikuhi iā ʻoe i kahi hoʻokolohua kūikawā i kapa ʻia ʻo Endoscopic Retrograde Cholangiopancreatography (ERCP) me ka manometry .
Pili kēia i ka hele ʻana i ka Sphincter o Oddi me ke kōkua o kahi endoscope, e hoʻokomo i kahi ʻōmole palakiko liʻiliʻi loa, a me ke ana ʻana i ke kaomi e ʻike ai i ka maikaʻi o ka ʻaelike a me ka hoʻonui ʻana o kēlā ʻiʻo.
Akā hele mai kēia hoʻāʻo ERCP me kahi pilikia liʻiliʻi. Hiki i kekahi poʻe, ma kahi o 15 a 30 mai ka 100, ke loaʻa i ka pancreatitis ma hope o kēia hoʻāʻo. No laila, hana nā kauka i kēia ma hope o ka noʻonoʻo pono ʻana a inā pono loa.
He aha nā lāʻau lapaʻau no kēia?
ʻO ke ʻano o ka mālama ʻana ma muli o ke koʻikoʻi o kāu mau hōʻailona a me ke ʻano āu e noho nei.
1. Inā ʻaʻole koʻikoʻi loa ka ʻeha (ʻoi aku hoʻi no ka māhele III):
Na ke kauka e kuhikuhi iā ʻoe i nā lāʻau ʻeha (ʻaʻole opioid) a me nā lāʻau hoʻomaha ʻiʻo.
2. Inā koʻikoʻi ka ʻeha (no nā māhele I a me II):
Inā paʻakikī ke kāohi me ka lāʻau lapaʻau, hiki i ke kauka ke kuhikuhi iā ʻoe i kahi lāʻau i kapa ʻia ʻo ERCP me ka sphincterotomy . Hana ʻia kēia ma lalo o ka anesthesia a i ʻole ma lalo o ka anesthesia. Hoʻohana ke kauka lapaʻau i kahi endoscope e hele i ka Sphincter o Oddi, ʻoki i kahi ʻāpana liʻiliʻi o ka ʻiʻo i paʻa, a wehe iā ia. I ka manawa like, nānā lākou no nā pōhaku i loko o nā ʻauwai bile.
Nā pilikia o ka mālama ʻana i ka sphincterotomy
Kōkua kēia lāʻau lapaʻau i ka hōʻemi ʻana i ka ʻeha i ka hapa nui o nā maʻi me nā māhele I a me II. Eia nō naʻe, he hana paʻakikī nō hoʻi ia me kekahi mau pilikia.
- Ma kahi o 10% - 15% o nā maʻi e loaʻa i nā pilikia e like me ka pancreatitis.
- ʻOiai he akahai pinepine kēia mumū, i kekahi manawa hiki ke lilo i mea koʻikoʻi a hoʻoweliweli i ke ola.
- I ia mau hihia, pono paha ʻoe e noho i ka haukapila no ka manawa lōʻihi no ka mālama ʻana.
No laila, hoʻohana wale nā kauka i kēia lāʻau lapaʻau inā ʻaʻole hiki ke kāohi ʻia me nā lāʻau lapaʻau ʻē aʻe.
Leka Lawe-Home
- Inā hoʻomau ʻoe i ka ʻeha o ka ʻōpū ma hope o ka wehe ʻia ʻana o kou ʻōpū gallbladder, mai hoʻowahāwahā iā ia. E ʻike pono i ke kauka.
- Hiki ke hana ʻia kēia ʻeha e ka Sphincter of Oddi Dysfunction (SOD), kahi kūlana e hiki ke hana ʻia inā ʻaʻohe ka gallbladder.
- Aia kekahi mau ʻano o kēia maʻi. Hiki ke ʻike maʻalahi ʻia kekahi e nā hoʻokolohua, akā paʻakikī ke ʻike i kekahi (ʻoi aku ka ʻano III).
- Aia nā lāʻau lapaʻau e like me nā pila a me ka ERCP me ka sphincterotomy, i hana ʻia inā pono wale nō. Eia nō naʻe, e hoʻomanaʻo he mau pilikia ko kēia mau ʻano hana.
- E kamaʻilio me kāu kauka e pili ana i kāu mau hōʻailona, pehea lākou e hiki mai ai, a me ke ʻano o kou ʻeha. E kōkua kēia iā ʻoe e koho i ka lāʻau kūpono a palekana loa nāu.
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