Kei te hiahia koe ki te mōhio atu mō te whakamātautau ERCP (Endoscopic Retrograde Cholangiopancreatography)? Kaua e mataku, me kōrero tāua!

Ina kī atu tō tākuta me whai ERCP koe, tera pea he maha āu pātai mō te aha te mea, te take e mahia ai, me te mamae rānei. He mea noa tēnā. He maha ngā tāngata ka mataku ina rongo i te ingoa. Engari kāore he mea e wehi ai te ERCP. He whakamātautau tino matatau tēnei e taea ai te kite me te rongoā i ētahi raruraru i roto i tō pūnaha biliary me ngā awa pancreatic. Nō reira, me kōrero tātou mō te ERCP i tēnei rā, āe?

He aha te ERCP (Endoscopic Retrograde Cholangiopancreatography)?

Tērā pea ka pōuri koe i tēnei ingoa roa, engari me wehewehe tātou kia mārama ai.

He whakarāpopototanga noa iho, he tikanga motuhake te ERCP e whakamahia ana e ngā tākuta hei tirotiro i roto i ō awa au me ō awa repeure . Ka haria e ēnei awa au me te wai repeure, hei āwhina i a tātou ki te nakunaku i te kai e kainga ana e tātou.

Anei te tikanga o tēnei ingoa:

• Endoscopic: Ka whakamahia he taputapu e kiia nei ko te endoscope. He ngongo angiangi, ngāwari hoki, he kāmera iti me te mārama i tetahi pito. Ka whakaurua mā roto i tō waha, ka tukuna ki raro ki te wāhanga o runga o tō whekau (te duodenum). Ka hoatu he rongoā whakamoe ki a koe hei āwhina i a koe ki te moe, kia kore ai koe e pāngia e te mamae.
• Whakamuri: I tēnei, ka whakauruhia tētahi atu ngongo iti mā roto i te endoscope, ā, ka werohia he wai motuhake (tae rerekē) ki roto i ngā awaawa o te ate me ngā awaawa o te pancreas. Ko te tikanga o te "Whakamuri" ko te "whakamuri" nā te mea ka werohia te wai ki te taha ke e rere ana i te tikanga.
• Cholangiopancreatography: E pā ana tēnei ki ngā whakaahua i tangohia. Ko te tikanga o "Cholangio" he hononga ki ngā awaawa o te ate. Ko te tikanga o "Pancreato" he hononga ki te repe taiaki. Ko te tikanga o "Graphy" he tango whakaahua.

Nō reira, mā te tae rerekē ka kitea mārama ngā awaawa o tō ate me ō awaawa repeure i runga i ngā whakaahua hihi-X. Mā tēnei ka taea e ngā tākuta te kite mēnā he mea kei te ārai i ēnei awaawa - pērā i ngā kōhatu o te ate, ngā pukupuku, te whaiti rānei o ngā awaawa nā te kiko whara . Ko te mea pai rawa atu ko ētahi o ēnei raruraru ka taea te rongoā i reira tonu, mā te endoscope.

I roto i ēhea āhuatanga e hiahiatia ana he ERCP?

Tērā pea ka tonoa he ERCP e tō tākuta mēnā kei te whakapae rātou he raruraru kei roto i tō pūnaha biliary. Hei tauira:

• Mena kei te mamae tō puku o runga kāore i te whakamāramatia, kei te pāngia rānei koe e te biliary colic.
• Mena he āhuatanga kei reira e aukatia ai te rere o te au, he tohu rānei kei te turuturu te au, hei tauira, te jaundice .

Ka taea e te whakamātautau ERCP te āwhina i te tautuhi me te rongoā i ngā raruraru noa e pā ana ki ō awaawa au, pēnei i:

• Te mumura o ngā awaawa au (cholangitis) me ngā mate pāwera e pā ana.
• Te whaiti o ngā awaawa au i puta mai i te kiko kua kowhakina (te kōpiko o te au) .
• Te aukati kohatu i roto i te awaawa aukume noa .
• Te mumura o te repe taiaki i puta mai i ngā kōhatu (pancreatitis o te kapia) .
• Ngā pukupuku, te mate pukupuku rānei o ngā awaawa au.
• Ngā turuturu o te awaawa ngote , ngā aituā rānei.

Me pēhea te mahi a te ERCP?

E rua ngā tikanga matua e whakakotahihia ana e te ERCP: te endoscopy me te fluoroscopy . He rite te fluoroscopy ki ngā whakaahua hihi-X neke. Whakaarohia he rite ki te hihi-X ataata.

Mā tēnei whakamātautau fluoroscopy ka taea e te tākuta te kite i te nekehanga o te wai motuhake (tae rerekē) i roto i ō awaawa au me ō awaawa repeure. Ka taea e ia te whakaatu mārama i ngā turuturu, i ngā aukati rānei.

Mā te endoscope te tākuta (endoscopist) e taea ai te toro atu ki te wāhi. Ka werohia te tae rerekē mā roto i tēnei. Waihoki, ki te kitea he raruraru, ka taea te whakauru i ngā taputapu iti mā roto i tēnei endoscope hei rongoā.

Ko wai ka mahi i te ERCP?

Ko te tikanga, ka mahia te ERCP e te tohunga puku . He tohunga ēnei tākuta ki te rongoā i ngā mate o tō pūnaha nakunaku me tō pūnaha biliary. Kua whakangungua hoki rātou ki te mahi i te endoscopy. Kua whakangungua hoki rātou ki ngā tikanga endoscopic ka taea te whakamahi hei whakakapi i ngā pokanga iti.

Me pēhea te whakarite mō te ERCP?

Ka hoatu e tō tākuta ētahi tohutohu motuhake hei whai māu i mua i tō ERCP. Ko te tikanga whānui, ko ēnei:

• Me mutu te momi hikareti, te kai, te ngaungau kapia, me te inu i tetahi mea ehara i te wai e waru hāora i mua i te whakamātautau.
• Me kōrero koe ki tō tākuta mō ētahi atu mate hauora kei a koe me ngā rongoā e tangohia ana e koe . Tērā pea me mutu te tango i ētahi rongoā, pērā i ngā rongoā whakaiti toto, mō ētahi rā i mua i te whakamātautau.
• Kōrero ki tō tākuta mēnā kua pāngia koe e te mate pāwera ki te tae rerekē, ki te rongoā whakamoe rānei i whakamahia i te wā o te whakamātautau.
• Me whakarite e koe he waka hei hoki ki te kāinga i muri i te whakamātautau, nā te mea e 24 hāora te roa ka memeha rawa ngā pānga o te rongoā whakamoe. Nō reira, kāore e taea e koe te taraiwa.

He aha ngā mea ka tupu i te wā o te whakamātautau ERCP?

He tikanga ā-waho te ERCP. Ko te tikanga ka taea e koe te hoki ki te kāinga i taua rā anō. Ko te tikanga ka roa te tikanga i te haora, e rua rānei.

Ka hoatu he rongoā ki a koe ka tukuna ki roto i te uaua (mā te "IV") hei whakamoe i a koe (hei whakangāwari i a koe) . Tērā pea kei te moe hōhonu koe, kāore rānei koe i te ara ake. Heoi, kāore koe e mahara ki te whakamātautau.

I te wā o te whakamātautau tātaritanga, ka mahia e te tākuta ngā mahi e whai ake nei:

• Ki te hiahia koe, ka taea te pania he rongoā whakamoe wai hei whakaiti i te mamae o te korokoro.
• Ka whakaurua he endoscope mā te waha, ā, ka ata tukuna mā roto i te esophagus me te puku ki te wāhanga o runga o te whekau iti (duodenum). Ka whakaaturia ngā whakaahua e kitea ana i te kāmera o te endoscope ki runga i te mata.
• Mā te mātakitaki i aua ataata, ka kitea e koe te whakatuwheratanga o te awa au me te awa repeure i roto i te whekau iti.
• Ka whakaurua tētahi atu ngongo iti mā te catheter i roto i te endoscope ki roto i te whakatuwheratanga.
• Ka werohia te tae rerekē ki roto i ngā oko toto mā roto i taua ngongo iti.
• Kātahi ka tangohia ngā ataata hihi-X mā te whakamahi i te hangarau fluoroscopy hei tirotiro i te nekehanga o te wai i roto i ngā ngongo. I roto i te fluoroscopy, ka tukuna ngā hihi-X i roto i ngā pakū poto. E kiia ana tēnei he nui haumaru o te irahiko.
• Ka whakamahia ēnei whakaahua hei tirotiro i ngā raruraru o ngā paipa - he aukati, he pupuhi, he turuturu, me ētahi atu.

Whakaarohia tēnei, he rite ki te maka kāmera ki roto i te paipa, te tuku wai tae mā roto, kātahi ka kimihia te wāhi i purua ai, me te wāhi hoki e turuturu mai ana.

Inaianei, ki te kitea e te tākuta he raruraru i tēnei whakamātautau, ka ngana ia ki te rongoā mā te whakauru i ngā taputapu iti mā roto i te endoscope. Ka taea e te tākuta e mahi ana i te endoscopy te mahi i ngā mea penei:

• Te kuru me te tango i ngā kōhatu whatukuhu.
• Te tango i ngā pukupuku, te tango rānei i tētahi tauira kiko (biopsy). (Ina tangohia he biopsy, ka tukuna ki tētahi taiwhanga hei tirotiro mēnā he mate pukupuku, kāore rānei.)
• Hei whakawhanui, hei totoro rānei i ngā oko toto kua whaiti, kua kuiti rānei.
• Te whakanoho i tētahi mea iti rite ki te ngongo (stent) ki roto i tētahi oko toto kia noho tuwhera tonu.
• Te whakatika i te turuturu, i te whara rānei i roto i te paipa.
• He tapahi iti te sphincterotomy i roto i te uaua huri noa i te whakatuwheratanga o te awaawa hei whakanui ake. (Mā tēnei ka ngāwari ake te mimiti o te au me te wai repeure.)

He aha ngā mea ka taea e koe te tumanako i muri i te ERCP?

I muri i te whakamātautau, ka puritia koe ki te hōhipera, ki te pokapū hauora rānei mō te haora, kia ngaro rā anō ngā pānga o te rongoā whakamoe. Kātahi ka taea e te tangata i haere mai ki te tiki i a koe te kawe i a koe ki te kāinga. Tērā pea ka hiamoe koe, ka ngenge, ka noho pōuri rānei i taua rā.

Tērā pea ka puta ngā mamae iti pēnei i ēnei mō te rā kotahi, e rua rānei i muri i te whakamātautau:

• Te korokoro mamae me te uaua ki te horomi: Tērā pea ka mamae tō korokoro i te endoscope. He pai ake te tango wai, ngā kai ngohengohe rānei kia ora rā anō.
• Te mamae o te puku pupuhi, te mamae hau rānei: Ina whakauruhia te endoscope, ka pupuhihia he hau iti ki roto i te ara GI kia pai ake ai te tirohanga. Koinei te take o tēnei mamae. Ka memeha haere i muri i tētahi wā (ina tukuna te hau).
• Whakapairuaki: He pānga taha pea tēnei o te rongoā whakamoe. Ka memeha haere anō hoki i te aonga ake.

He aha ngā mōrearea o te ERCP?

E pā ana ngā raruraru ki te 5% ki te 10% o ngā tikanga ERCP. Ka whakawhirinaki tēnei mōrearea ki ō mate hauora o mua me te momo maimoatanga ka whiwhi koe i te wā o te ERCP. Ka kōrerohia tēnei e tō tākuta ki a koe i mua i te wā. Ko ētahi atu raruraru pea ko:

• Ngā pānga kino ki te rongoā whakamoe: Ka pā mai pea ngā raruraru manawa me ngā pūkahukahu ki te hunga kua pāngia e te mate pūkahukahu, te mate manawa rānei.
• Te mate pāwera ki te tae rerekē: Ki te tupu tēnei, ka hohoro te hoatu e te tākuta he rongoā ki a koe hei whakamutu i te tauhohenga.
• Te whara o tō ara GI mai i te endoscope: Ka puta te toto o roto, i ngā wā kino rānei, he kōhao.
• Te turuturu o te ate nā te whara o ngā awaawa ate i puta mai i ngā taputapu endoscopic.
• Te mate urutā i roto i tō pūnaha biliary: Hei ārai i tēnei, ka hoatu pea e tō tākuta he rongoā paturopi ki a koe i mua.
• Ka taea e te tikanga te whakararuraru me te mumura o te repe taiaki (pancreatitis). Koinei te raruraru tino noa i muri i te ERCP.

Mena kei te hapu koe i te wā o te whakamātautau, he iti noa te mōrearea o te whara ki te tamaiti i te hihi e tukuna ana i te wā o te fluoroscopy, engari he iti noa te mōrearea. Ka pātai atu tō tākuta ki a koe i mua i te wā mēnā he tūponotanga kei te hapu koe. Mena koinā, ka ngana tō tākuta ki te whakarite anō i te whakamātautau, ki te whakaiti rānei i tō pānga ki te hihi mēnā e tika ana.

Kia pēhea te roa o te wā e mōhio ai ki ngā hua o te whakamātautau?

Ki te mea kāore anō koe kia hiamoe i te rongoā whakamoe,Me taea e te tākuta (endoscopist) nāna i mahi te ERCP te kōrero tonu ki a koe mō te whakamātautau. Māna e kōrero ki a koe ngā mea i kitea me ngā mea ka taea te mahi mōna. Mena i tangohia he tauira kiko (biopsy), tera pea ka roa pea ētahi wiki ka puta mai ngā hua.

Ki te kore e kitea he mea i roto i tō ERCP, me whai pea koe i tētahi atu momo whakamātautau. Ki te kore e whakatauhia tō raruraru e te whakamātautau, ki te whakaū rānei ngā hua o te koiora i tētahi raruraru hou, me whai pea koe i tētahi atu momo maimoatanga. Ka kōrero tō tākuta ki a koe mō te mea hei mahi i muri mai.

Āhea koe me waea atu ki te tākuta?

Mena ka pāngia koe e tētahi o ēnei tohu kino, rerekē rānei i muri i te ERCP, waea atu ki tō tākuta tonu:

• Te mamae nui o te puku, te pupuhi rānei.
• Te mamae o te uma, te uaua rānei ki te manawa.
• Te kirika, te ruaki, ētahi atu tohu rānei o te mate pāwera.
• Te toto o te tūtae, te tūtae mangu, te tae rānei.

He aha te rerekētanga i waenga i te ERCP me te endoscopy noa?

He momo endoscopy matatau te ERCP. Ko te esophagogastroduodenoscopy (EGD) noa ka titiro ki tō ara GI o runga anake. Ko te tikanga ka titiro noa ki te esophagus, te puku, me te wāhanga tuatahi o te whekau iti.

Engari i roto i te ERCP, ka whakamahia tētahi atu toronga me te endoscope noa - arā, he ngongo tuarua (catheter) e tomo ana ki roto i te ngongo tuatahi - koinei te mea e tae atu ana ki ō awaawa biliary.

Mā tēnei toronga endoscope iti ka taea e te tākuta te rongoā tika i ō awaawa. Ko te tikanga endoscopic anake ka taea te rongoā tika i ngā awaawa i tēnei ara ko te `ERCP`. Ahakoa ka taea e ētahi atu tikanga endoscopic pērā i te `MRCP` (magnetic resonance cholangiopancreatography) me te `EUS` (endoscopic ultrasound) te kite i ō awaawa bile me ō awaawa pancreatic, kāore i te whakarato i tēnei taumata o te ngāwari mō te rongoā.

He pokanga nui te ERCP?

Ehara te ERCP i te pokanga e ai ki tā tātou e whakaaro nei. Ehara i te mea e tapahi ana i te kiri ka uru ki roto i ngā whekau o roto i te tinana. He tikanga endoscopic te ERCP. Ko tōna tikanga ka uru ki roto i te tinana mā roto i tētahi whakatuwheratanga tūturu - i tēnei wā, ko te korokoro.

Heoi, i te wā e mahi ana i te ERCP, ka taea e te tākuta te mahi i ētahi tikanga pokanga mā te endoscope. I ētahi wā ka kiia ēnei tikanga e mahia ana mā te endoscope he pokanga endoscopic . He tikanga pokanga ēnei nā te mea he tapahi me he tuitui kei roto i te tinana. Heoi, he tikanga iti noa iho ēnei, ā, he iti ake te mōrearea, he poto ake hoki te wā whakaora i te pokanga tuku iho.

Kei te whakahaerehia te ERCP mō te pancreatitis?

Āe, ki te whakaaro tō tākuta kei te aukati tetahi mea i ō awaawa ate, i ō awaawa repeure rānei, ka tono pea ia i tētahi ERCP. Ko ngā kōhatu au e piri ana ki ngā awaawa tetahi o ngā tino take o te pancreatitis whakapeka. Ki te tupu tēnā, me whai ERCP pea koe hei tango i te aukati.

Mena he mate pāwera mau tonu tōu, ka taea e te mumura te whakawhāiti me te whakakōpiko i ngā awaawa o tō repeure (strictures). I roto i ēnei āhuatanga, ka taea e te ERCP te āwhina ki te whakawhanui i ngā awaawa, te whakauru rānei i tētahi stent hei pupuri i a rātou kia tuwhera. Ka āwhina tēnei i ngā wai repeure kia rere tonu mā roto i ngā awaawa.

Kia maumahara ki te mea tino nui (Karere hei kawe ki te kāinga)

Ko te ERCP (Endoscopic Retrograde Cholangiopancreatography) he whakamātautau tātaritanga ka taea hoki te whakamahi hei rongoā i te mate i taua wā tonu mēnā e tika ana. Ahakoa he ahua kaha ake te whakaekenga i te whakamātautau whakaahua noa, he iti ake te whakaekenga i te pokanga nui. Ka taea hoki te whakamahi hei tātaritanga me te rongoā i te mate i te wā kotahi.

Ka taea e te nuinga o te tangata te mahi i tēnei whakamātautau me te kore he uauatanga, ā, he maha ngā painga. Nō reira, ki te tūtohu mai te tākuta i tētahi ERCP māu, kaua e wehi ki te kōrero ki a ia mō tēnei mea, me te pātai atu i ō pātai katoa. Mā tēnei koe e āwhina ki te whakatau i ngā whakatau pai rawa atu mō tō hauora!

` ERCP, endoscopy, awaawa au, repe taiaki, kōhatu, jaundice, pūnaha nakunaku