Koj puas tau muaj ib txoj hlab zis nqaim lawm thiab? Cia peb kawm txog Biliary Stricture.

Koj puas tau hnov ​​​​​​dua txog ib qho mob hu ua biliary stricture? Tej zaum koj tau hnov ​​​​​​mob nyob rau sab xis saum toj ntawm koj lub plab thiab koj daim tawv nqaij daj (zoo li jaundice )? Yog li qhov no yog ib yam dab tsi uas koj yuav txaus siab. Hnub no peb yuav tham txog ib qho mob hu ua biliary stricture . Tsis txhob txhawj, kev nkag siab qhov no kom zoo tuaj yeem pab koj daws ntau yam teeb meem.

Biliary Stricture yog dab tsi? Cia peb nkag siab yooj yim!

Hais yooj yim xwb, Biliary Stricture yog thaum cov kav dej hauv koj lub cev nqaim vim muaj kab mob, raug mob , lossis raug thaiv. Xav txog nws zoo li cov kav dej uas raug thaiv, thiab cov dej yuav ntws tsawg dua. Thaum cov kav dej hauv cov kav dej no nqaim, cov dej ntws ntawm cov kua qaub los ntawm lub siab mus rau txoj hnyuv me me raug txwv. Tom qab ntawd yuav ua li cas? Cov kua qaub pib sib sau ua ke hauv lub cev, ua rau nws nyuaj rau zom zaub mov. Qhov no kuj hu ua "bile duct stricture."

Yog li cov ducts no yog dab tsi?

Zoo, tam sim no cia peb saib seb cov kav dej kua tsib yog dab tsi. Cov no zoo li cov raj me me uas txuas cov kab mob hauv koj lub cev zom zaub mov . Koj lub siab ua cov kua hu ua kua tsib. Cov kua tsib no pab koj zom zaub mov. Yog li, cov kav dej kua tsib no coj cov kua tsib thiab xa mus rau koj txoj hnyuv me. Nyob ntawd, cov kua qaub hauv cov kua tsib zom cov rog thiab cov protein hauv koj cov zaub mov thiab pab koj zom nws. Koj cov kav dej kua tsib kuj txuas rau koj cov kav pancreatic. Cov kav pancreatic no tso tawm cov enzymes, ib hom protein, uas pab koj zom zaub mov.

Qhov kev nqaim ntawm cov kua tsib no feem ntau tshwm sim li cas?

Cov kws tshaj lij tsis paub tseeb tias muaj pes tsawg tus neeg uas muaj cov hlab ntsha hauv lub zais zis no txhua xyoo. Txawm li cas los xij, zoo li qhov mob no tau dhau los ua ntau dua. Ib qho laj thawj yuav yog qhov kev phais tshem cov hlab ntsha hauv lub zais zis ntau ntxiv , tshwj xeeb tshaj yog laparoscopic cholecystectomy . Thaum lub sijhawm phais no, cov hlab ntsha hauv lub zais zis qee zaum yuav raug puas tsuaj thiab muaj qhov txhab, uas tuaj yeem ua rau lawv nqaim. Txawm li cas los xij, qhov mob no tsis tshua muaj rau cov menyuam yaus.

Dab tsi yog cov laj thawj tseem ceeb uas ua rau cov kua tsib nqaim?

Tsis tshua muaj ib tug me nyuam uas muaj cov kua tsib nqaim thaum yug los. Nws yog ib qho mob uas muaj txij thaum yug los . Txawm li cas los xij, feem ntau, kwv yees li xya ntawm kaum tus me nyuam, cov kua tsib nqaim no yog los ntawm mob qog noj ntshav. Qhov no yog qhov tseeb tshwj xeeb rau mob qog noj ntshav pancreatic thiab cholangiocarcinoma.Qhov no yog qhov ua rau mob qog noj ntshav no. Cov mob qog noj ntshav no kuj tseem ua rau cov kua tsib nqaim:

• Mob qog nqaij hlav ntawm lub zais zis
• Mob qog nqaij hlav hauv siab
• Mob qog nqaij hlav
• Lymphoma
• Kev kis mob qog nqaij hlav mus rau lwm qhov ntawm lub cev ( Metastasis )
• Mob qog nqaij hlav me

Lwm yam mob dab tsi ntxiv rau mob qog noj ntshav uas ua rau muaj qhov no?

Qhov nqaim ntawm cov hlab ntsha hauv lub cev tuaj yeem tshwm sim vim yog cov mob uas tsis yog mob qog noj ntshav (benign), uas yog li ntawm 30 feem pua ​​​​​​ntawm cov neeg mob. Nws kuj tseem tuaj yeem tshwm sim los ntawm qee yam kev kho mob. Cia peb saib seb lawv yog dab tsi:

• Kev raug mob plab lossis kev raug mob
• Kab mob autoimmune pancreatitis thiab pancreatitis (mob ntawm lub txiav)
• Cov tsos mob ntawm cov kab mob gallstone los ntawm cov kab mob ntawm cov kua tsib
• 'Mirizzi syndrome' (qhov no tshwm sim thaum cov pob zeb hauv lub zais zis nkag mus rau hauv lub zais zis thiab thaiv cov hlab ntsha hauv lub zais zis)
• Kab mob biliary cholangitis thawj zaug
• Kab mob cholangitis thawj zaug
• Kev kho mob hluav taws xob

Qhov no yog dab tsi (Anastomotic biliary stricture)?

Qee qhov kev phais mob, xws li Whipple procedure (kev phais mob loj rau mob qog nqaij hlav pancreatic) lossis kev hloov siab, tuaj yeem ua rau muaj kev sib txuas ntawm cov biliary anastomotic. Hauv cov kev phais mob no, tus kws phais mob rov txuas cov raj hauv koj lub cev zom zaub mov. Qhov kev sib txuas no hu ua anastomosis. Qee zaum, cov raj bile tuaj yeem puas tsuaj lossis muaj qhov txhab thiab nqaim ntawm qhov chaw uas lawv txuas. Qhov no hu ua anastomotic biliary stricture.

Cov tsos mob ntawm cov hlab ntsha hauv cov kua tsib yog dab tsi?

Yog koj muaj tus mob no, tej zaum koj yuav muaj cov tsos mob zoo li no. Nco ntsoov tias muaj ib lossis ob qho ntawm cov tsos mob no xwb tsis tau txhais hais tias koj muaj tus mob, tab sis nws yog ib qho tseem ceeb uas yuav tsum paub txog lawv.

• Mob rau sab xis saum toj ntawm lub plab .
• Zoo li koj kub taub hau thiab koj lub cev txias .
• Cov xim ntawm koj cov quav yuav hloov pauv . Nws tuaj yeem yog xim grey lossis dawb, zoo li av nplaum.
• Khaus tawv nqaij tas li (Pruritus).
• Jaundice : Qhov no yog daj ntawm cov dawb ntawm lub qhov muag thiab daim tawv nqaij.
• Tsis qab los noj mov .
• Xav tias xeev siab thiab ntuav .

Yog qhov no txuas ntxiv mus, yuav muaj teeb meem dab tsi tshwm sim?

Yog tias cov kua tsib nqaim lossis raug thaiv ntev, cov kua tsib tuaj yeem sib sau ua ke hauv lub siab. Yog tias qhov no tshwm sim, koj tuaj yeem kis kab mob , kab mob siab , thiab ua rau lub siab caws pliav, uas tuaj yeem ua rau muaj mob xws li mob siab cirrhosis . Yog vim li ntawd nws thiaj li tseem ceeb kom paub txog cov tsos mob no.

Yuav tsum tau tus kws kho mob zoo li cas los kuaj mob thiab kho tus mob no?

Yog koj muaj cov tsos mob no, koj yuav tsum mus ntsib kws kho mob plab ua ntej, tus kws kho mob uas tshwj xeeb hauv cov kab mob ntsig txog lub cev zom zaub mov . Nws yog tus uas tuaj yeem kuaj mob thiab kho cov mob no tau zoo.

Cov kws kho mob kuaj mob li cas txog qhov kev nqaim ntawm cov hlab ntsha hauv lub cev?

Koj tus kws kho mob tshwj xeeb yuav ua ntau yam kev kuaj mob kom paub meej tias muaj tus mob no.

• Kev kuaj ntshav:
• Kev kuaj Bilirubin: Thaum cov kav dej ntawm cov kua tsib nqaim lossis raug thaiv, cov khoom pov tseg hu ua bilirubin hauv cov kua tsib yuav sib sau ua ke hauv lub cev. Qhov kev kuaj no ntsuas qhov ntawd.
• Kev kuaj mob siab: Cov no kuaj seb puas muaj cov enzyme hauv siab ntau.

• Kev kuaj duab: Cov kev kuaj no tuaj yeem saib xyuas qhov xwm txheej ntawm cov kav dej hauv lub cev.
• Kev Siv Ultrasound: Qhov no siv cov suab nthwv dej los thaij duab ntawm cov kav dej kua tsib kom pom qhov txhaws lossis nqaim. Koj kuj tseem yuav muaj kev siv endoscopic ultrasound ( kev siv ultrasound ua los ntawm lub raj nrog lub koob yees duab), kev siv ultrasound plab, lossis kev siv ultrasound daim siab.
• Kev kuaj mob Endoscopic retrograde cholangiopancreatography (ERCP): Qhov no yog kev sib xyaw ua ke ntawm kev siv endoscopy sab saud thiab kev siv X-ray. Koj lub caj pas yuav loog thiab muab ib lub endoscope (ib lub raj uas muaj lub koob yees duab) ntxig rau hauv los saib cov kab mob hauv koj lub plab thiab cov kav dej kua tsib. Lub sijhawm no, yuav muab cov qauv nqaij coj los siv cov khoom siv tshwj xeeb thiab xa mus rau kev kuaj mob . Kev kuaj mob no kuj siv tau los kuaj xyuas cov hlwb qog noj ntshav.
• Kev kuaj mob Magnetic resonance cholangiopancreatography (MRCP): Qhov no yog kev kuaj MRI siab heev uas tuaj yeem thaij duab meej heev ntawm koj cov hlab ntsha hauv lub cev, daim siab, lub qog pancreas, thiab lub zais zis.
• Kev kuaj mob Percutaneous transhepatic cholangiography (PTC): Qhov no yog kev kuaj mob X-ray tshwj xeeb. Hauv kev kuaj mob no, tus kws kho mob txhaj tshuaj tshwj xeeb (contrast dye) hla koj lub siab mus rau hauv koj cov kav dej zis. Tom qab ntawd siv cov duab X-ray los saib seb cov xim mus li cas los ntawm cov kav dej zis mus rau hauv txoj hnyuv me. Cov xim tuaj yeem pom txhua qhov kev thaiv.

Yuav kho qhov kev nqaim ntawm cov kua tsib no li cas ?

Qee zaum, cov kws kho mob kuj tseem tuaj yeem kho qhov ua rau cov kua tsib txhaws tib lub sijhawm thaum lawv ua ERCP lossis PTC. Nyob ntawm seb qhov ua rau muaj qhov ua rau, tus kws kho mob yuav ua tej yam xws li:

• Yog tias muaj pob zeb hauv lub gallbladder, rhuav lawv thiab tshem tawm.
• Siv ib lub cuab yeej zoo li lub npuas dej los nthuav cov kav dej kua tsib uas nqaim lawm, ib lub stent (ib lub raj me me ua los ntawm hlau lossis yas) raug ntxig rau hauv kom tiv thaiv nws kom tsis txhob nqaim dua.
• Tshem tawm cov qog nqaij hlav, yog tias muaj.

Cov kev kho mob phais yog dab tsi?

Tsuas muaj ob peb tug neeg xwb uas yuav tsum tau phais kom kho qhov nqaim ntawm cov kua tsib. Yog tias qhov nqaim ntawd yog los ntawm mob qog noj ntshav, tej zaum yuav phais tau. Cov kev xaiv phais muaj xws li:

• Kev phais mob bypass yog ua los ntawm kev hla cov kav dej kua tsib uas raug thaiv thiab xa cov kua tsib mus rau hauv txoj hnyuv me.
• Qhov uas muaj kab mob ntawm cov kav dej kua tsib raug txiav tawm thiab tshem tawm (Kev phais) thiab qhov uas noj qab nyob zoo raug txuas rov qab (Anastomosis).

Tus mob no puas rov tshwm sim dua tom qab kho mob lawm?

Yog, nws muaj peev xwm ua rau cov kav dej kua tsib rov qab nqaim dua tom qab kho thiab qhib. Yog tias qhov no tshwm sim, koj tus kws kho mob yuav ua phais tshawb nrhiav cov kav dej kua tsib kom tshem tawm cov kav dej kua tsib uas nqaim. Tom qab tshem tawm, cov kav dej kua tsib noj qab haus huv thiab cov hnyuv me me rov txuas dua.

Puas muaj teeb meem dab tsi tom qab kho mob lawm?

Cov teeb meem tom qab kev kho mob sib txawv nyob ntawm seb koj kho li cas. Ib txhia neeg yuav mob pancreatitis (o ntawm lub pancreas) tom qab ERCP. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia kom zoo.

Puas muaj dab tsi uas peb ua tau los tiv thaiv kom txoj hlab ntshav no nqaim?

Muaj tej yam uas koj ua tau los txo koj txoj kev pheej hmoo ntawm kev muaj qee yam mob uas ua rau cov kua tsib nqaim. Piv txwv li:

• Noj zaub mov zoo nrog txiv hmab txiv ntoo thiab zaub tshiab.
• Txo koj cov roj cholesterol . Qhov no yuav pab tswj kev noj qab haus huv ntawm lub zais zis thiab tiv thaiv kev tsim cov pob zeb hauv lub zais zis.
• Tswj koj qhov hnyav kom noj qab nyob zoo thiab haum rau koj.
• Yog koj muaj teeb meem haus dej cawv, nrhiav kev pab. Qhov no yuav pab tiv thaiv kom tsis txhob muaj kab mob pancreatitis thiab lwm yam kev puas tsuaj rau lub siab.

Qhov tseem ceeb tshaj plaws yog sim ua kom koj lub neej noj qab nyob zoo. Tej yam xws li kev noj zaub mov kom zoo thiab kev tawm dag zog yuav tiv thaiv koj ntawm ntau yam kab mob.

Yuav ua li cas thiaj nrhiav tau kev kho mob zoo rau ib tus neeg uas muaj tus mob no?

Koj txoj kev kho mob yuav zoo li cas nyob ntawm seb ua rau koj cov hlab ntsha hauv lub cev txhaws. Cov kev kho mob uas qhib cov hlab ntsha hauv lub cev txhaws feem ntau ua tau zoo. Txawm li cas los xij, qhov mob uas ua rau muaj kev txhaws (xws li mob qog noj ntshav) yuav xav tau kev kho mob nyuaj dua.

Lub sijhawm rov zoo tom qab kev kho mob yog li cas?

Koj lub sijhawm rov zoo, uas txhais tau tias koj tuaj yeem rov qab mus ua haujlwm, kawm ntawv, thiab ua ub ua no li cas sai, yuav txawv nyob ntawm hom kev kho mob uas koj tau txais. Kev kho mob tsawg kawg nkaus xws li ERCP feem ntau ua sai dua thiab tsis mob dua li kev phais qhib uas xav tau qhov txiav loj. Nws yog ib qho tseem ceeb uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia kom zoo kom ntseeg tau tias koj rov zoo. Tej zaum yuav hais kom koj noj cov zaub mov uas tsis muaj roj ntau , lossis hloov koj cov zaub mov kom suav nrog cov zaub mov uas yooj yim zom .

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog koj muaj ib qho ntawm cov tsos mob no, mus ntsib kws kho mob tam sim ntawd:

• Kub taub hau tas li.
• Mob plab sab saud tas li.
• Cov cim qhia tias muaj kev kis kab mob tom qab kho mob (piv txwv li, kua paug tawm ntawm qhov txhab, liab).
• Poob phaus yam tsis muaj laj thawj, xeev siab, lossis ntuav.
• Cov dawb ntawm lub qhov muag lossis daim tawv nqaij tig daj (jaundice) .

Kuv yuav tsum nug kuv tus kws kho mob li cas?

Koj tuaj yeem nug cov lus nug ntawm tus kws kho mob zoo li no:

• Dab tsi ua rau kuv cov kua tsib nqaim no?
• Kev kho mob twg zoo tshaj plaws rau kuv?
• Puas muaj tej yam uas kuv ua tau los txo qhov kev pheej hmoo ntawm hom kev nqaim ntawm cov kua tsib no dua?

Cov tsos mob xws li mob plab, kub taub hau, mob khaub thuas, thiab mob daj ntseg tuaj yeem ua rau koj ntxhov siab heev, tshwj xeeb tshaj yog tias lawv tshwm sim sai sai. Yog tias koj muaj cov tsos mob no, nws yog qhov zoo tshaj plaws los qhia koj tus kws kho mob tam sim ntawd. Tom qab ntawd lawv tuaj yeem kuaj xyuas kom paub qhov ua rau thiab pom zoo rau kev kho mob tsim nyog.

Cov Lus Qhia Txog Kev Nqa Mus Tsev: Tej yam tseem ceeb tshaj plaws uas yuav tsum nco ntsoov

Yog li, kuv vam tias koj tam sim no nkag siab zoo dua txog qhov mob biliary stricture uas peb tau tham txog hnub no.

• Qhov no yog qhov nqaim ntawm cov ducts ntawm lub bile, uas thaiv cov dej ntws ntawm cov kua tsib.
• Muaj ntau yam ua rau; tej yam xws li cov qhov txhab los ntawm kev phais, pob zeb hauv lub zais zis, thiab mob qog noj ntshav.
• Paub txog cov tsos mob xws li mob plab, mob daj ntseg, khaus, thiab hloov xim quav.
• Yog tias koj muaj cov tsos mob no, mus ntsib kws kho mob gastroenterologist tam sim ntawd.
• Muaj kev kho mob, yog li ntawd tsis txhob ntshai. Thaum kuaj pom thiab kho sai npaum li cas, qhov tshwm sim yuav zoo dua.
• Kev ua neej noj qab haus huv pab tau ntau yam hauv kev tiv thaiv cov mob zoo li no.

Yog koj muaj lus nug ntxiv txog qhov no, tsis txhob yig los nrog koj tus kws kho mob tham. Nyob kom noj qab nyob zoo!