Kua whaiti hoki te awaawa au? Me ako tātou mō te Biliary Stricture.

Kua rongo koe i tētahi āhuatanga e kiia nei ko te biliary stricture? Tērā pea kua pāngia koe e te mamae i te taha matau o runga o tō puku, me te kōwhai o tō kiri (pērā i te jaundice )? He mea tēnei pea hei pārekareka māu. I tēnei rā ka kōrero tātou mō tētahi āhuatanga e kiia nei ko te biliary stricture . Kaua e manukanuka, mā te mārama tika ki tēnei ka āwhina i a koe ki te whakaoti rapanga maha.

He aha te Biliary Stricture? Kia mārama tātou!

Ki te whakarāpopototanga, ko te Biliary Stricture te wā e whaiti ana ngā awaawa au i roto i tō tinana nā te mate, te whara , te aukati rānei. Whakaarohia he rite ki te paipa wai kua aukatia, ā, ka iti haere te rere o te wai. Ina whaiti ēnei awaawa au, ka herea te rere o te au mai i te ate ki te whekau iti. Ka ahatia i muri mai? Ka tīmata te kohikohi o te au i roto i te tinana, ka uaua ai te nakunaku i te kai. Ka kiia hoki tēnei ko te "bile duct stricture".

Nā, he aha ēnei awaawa au?

Āe, me titiro tātou ki ngā awaawa au. He rite ēnei ki ngā ngongo iti e hono ana i ngā okana i roto i tō pūnaha nakunaku . Ka hangaia e tō ate he wai e kiia nei ko te au. Ka āwhina tēnei au i a koe ki te nakunaku i te kai. Nō reira, ka tangohia e ēnei awaawa au te au ka tukuna ki tō whekau iti. I reira, ka pakaruhia e ngā waikawa o te au ngā ngako me ngā pūmua i roto i tō kai ka āwhina i a koe ki te nakunaku. Ka hono anō hoki tō awaawa au ki tō awaawa repeure. Ka tukuna e tēnei awaawa repeure ngā whākōkī, he momo pūmua, hei āwhina i a koe ki te nakunaku i te kai.

He pēhea te auau o tēnei whakawhāititanga o ngā awa au?

Kāore ngā tohunga i te tino mōhio e hia ngā tāngata e pāngia ana e tēnei whakawhāititanga o ngā awaawa au i ia tau. Heoi, te āhua nei kei te piki haere te kitea o tēnei mate. Ko tētahi take pea ko te pikinga ake o ngā pokanga tango i te auawa au , inā koa ko te laparoscopic cholecystectomy . I roto i ēnei pokanga, ka pakaru pea ngā awaawa au, ka whara, ka whaiti ai. Heoi, he tino onge tēnei mate i roto i ngā tamariki nohinohi.

He aha ngā tino take o te whaiti o te awaawa o te ate?

He tino onge te whaiti o te awaawa o te pēpi i te whānautanga. He mate whānau tēnei. Heoi, i te nuinga o te wā, e whitu i roto i te tekau o ngā pēpi, ko te whaiti o te awaawa o te pēpi nā te mate pukupuku. He pono rawa tēnei mō te mate pukupuku repeure me te cholangiocarcinoma.Koinei te tino take. Ka taea hoki e ēnei momo mate pukupuku te whakawhāiti i te awaawa o te ate:

• Matepukupuku o te pūkahukahu
• Mate pukupuku ate
• Matepukupuku ate
• Lymphoma
• Te horapa o te mate pukupuku ki ētahi atu wāhanga o te tinana ( Metastasis )
• Matepukupuku whekau iti

He aha atu ngā āhuatanga i tua atu i te mate pukupuku ka puta ai tēnei?

Ka pā te whaiti o te awaawa ate ki ngā āhuatanga kāore i te matepukupuku (pai), arā, e 30 ōrau o ngā mate. Ka pā anō hoki ki ētahi maimoatanga hauora. Me titiro tātou ki ēnei āhuatanga:

• Ngā whara o te puku, te whara rānei
• Te pancreatitis ā-aunoa me te pancreatitis (mumura o te pancreas)
• Te whara o te awaawa o te aukume mai i ngā kōhatu aukume
• 'Te mate Mirizzi' (ka puta tēnei ina noho ngā kōhatu i roto i te pūkahukahu, ā, ka ārai i ngā awaawa o te pūkahukahu)
• Te mate pāwera biliary tuatahi
• Ko te cholangitis sclerosing tuatahi
• Te rongoā irahiko

He aha tēnei `(Te whakawhāititanga o te ngongo toto)`?

Ko ētahi pokanga, pērā i te tikanga Whipple (he pokanga nui mō te mate pukupuku repeure) me te whakawhitinga ate rānei, ka puta he uauatanga biliary anastomotic. I roto i ēnei pokanga, ka hono anō te taote pokanga i ngā ngongo i roto i tō pūnaha nakunaku. Ka kiia tēnei hononga anō he anastomosis. I ētahi wā, ka pakaru, ka whara rānei ngā awaawa bile, ka whaiti rānei i te wāhi e hono ana. Ka kiia tēnei he uauatanga biliary anastomotic.

He aha ngā tohu o te stenosis o te awaawa o te ate?

Mena kei a koe tēnei mate, tera pea ka pāngia koe e ēnei tohu. Kia maumahara, ki te mea kotahi, e rua rānei o ēnei tohu anake, ehara i te mea kei a koe te mate, engari he mea nui kia mōhio koe ki ēnei tohu.

• Te mamae i te taha matau o runga o te puku .
• Te āhua nei kei te pāngia koe e te kirika, ā, kei te mātao tō tinana .
• Tērā pea ka rerekē te tae o ō tūtae . He hina, he mārama rānei, pērā i te uku.
• Te mākūkū tonu o te kiri (Pruritus).
• Te kiri māwhero : He kōwhai tēnei o ngā kanohi me te kiri mā.
• Te ngaronga o te hiahia kai .
• Te whakapairuaki me te ruaki .

He aha ngā raruraru ka puta mai mēnā ka haere tonu tēnei?

Ki te whaiti, ki te ārai rānei te awaawa au mō te wā roa, ka taea e te au te hanga i roto i te ate. Ki te tupu tēnei, ka pāngia koe e ngā mate pāwera , te mate ate , me te whara o te ate, ka arahi pea ki ngā āhuatanga pēnei i te cirrhosis o te ate . Koia te mea nui kia mōhio koe ki ēnei tohu.

He aha te momo tākuta e hiahiatia ana hei tātaritanga me te rongoā i tēnei mate?

Mena kei a koe ēnei tohu, me toro atu koe ki tētahi tohunga puku, he tākuta e tohunga ana ki ngā mate e pā ana ki te pūnaha nakunaku . Ko ia te tangata ka taea te tātaritanga me te rongoā tika i ēnei mate.

Me pēhea te tautuhi a ngā tākuta i tēnei whaiti o ngā awaawa o te ate?

Tērā pea ka whakahaerehia e tō tākuta he maha ngā whakamātautau hei whakaū i tēnei āhuatanga.

• Ngā whakamātautau toto:
• Whakamātautau bilirubin: Ina whaiti, ina āraia rānei ngā awaawa au, ka kohia he para e kiia nei ko te bilirubin i roto i te au i roto i te tinana. Mā tēnei whakamātautau e ine taua taumata.
• Ngā whakamātautau mahi ate: Ka tirohia e ēnei ngā taumata whākōkī ate kua teitei.

• Ngā whakamātautau whakaahua: Ka taea e ēnei whakamātautau te tirotiro i te āhua o ngā awaawa au i roto i te tinana.
• Ultrasound: Ka whakamahia e tēnei he ngaru oro hei tango pikitia o ngā awaawa o te ate hei whakaatu i ngā aukati, i te whaiti rānei. Tērā pea ka whai koe i tētahi ultrasound endoscopic ( he ultrasound mā roto i tētahi ngongo me te kāmera), he ultrasound puku, he ultrasound ate rānei.
• Endoscopic retrograde cholangiopancreatography (ERCP): He huinga tēnei o te endoscopy o runga me te hihi-X. Ka whakangāwarihia tō korokoro, ā, ka whakauruhia he endoscope (he ngongo ngāwari me te kāmera) hei tirotiro i ngā whekau i roto i tō puku me ngā awa waikura. I tēnei wā, ka tangohia pea he tauira kiko mā te whakamahi i ngā taputapu motuhake, ā, ka tukuna mō te koiora . Ka taea hoki te whakamahi i tēnei koiora hei tirotiro i ngā pūtau matepukupuku.
• Ko te cholangiopancreatography aukume (MRCP): He whakamātautau MRI matatau tēnei ka taea te tango pikitia tino mārama o ō awa au, te ate, te repe taiaki, me te pūkahukahu.
• Kolangiography whakawhiti-hepatic percutaneous (PTC): He whakamātautau hihi-X motuhake tēnei. I roto i tēnei whakamātautau, ka werohia e te tākuta he tae motuhake (tae rerekē) mā roto i tō ate ki roto i ngā awaawa au. Kātahi ka whakamahia ngā hihi-X hei tirotiro i te haere o te tae mā roto i ngā awaawa au ki roto i te whekau iti. Ka taea e te tae te whakaatu i ngā aukati katoa.

Me pēhea te rongoā mō tēnei whaiti o te awaawa au?

I ētahi wā, ka taea hoki e ngā tākuta te rongoā i te take o te aukati o te awaawa au i te wā kotahi e mahi ana rātou i te ERCP, i te PTC rānei. I runga i te take, ka mahi pea te tākuta i ngā mea penei:

• Mena he kōhatu kei roto i te pūhā, me pakaru, ka tangohia.
• Mā te whakamahi i tētahi taputapu rite ki te poihau hei whakawhanui i te awaawa au kua whaiti, ka whakauruhia he stent (he ngongo iti i hangaia ki te konganuku, ki te kirihou rānei) hei ārai i tōna whaiti anō.
• Te tango i ngā pukupuku, mēnā he.

He aha ngā maimoatanga pokanga?

He tokoiti noa iho ngā tāngata e hiahia ana ki te pokanga hei whakatika i te whaiti o te awaawa wai. Mena nā te mate pukupuku te whaiti, tera pea ka taea te pokanga. Ko ngā kōwhiringa pokanga ko:

• Ka mahia te pokanga taha hei karo i te awaawa aukume kua āraia, ka tukuna te aukume ki roto i te whekau iti.
• Ka tapahia te wāhanga mate o te awaawa au, ka tangohia (Resection) ā, ka honoa anō te wāhanga hauora (Anastomosis).

Ka taea te hoki mai anō tēnei āhuatanga i muri i te maimoatanga?

Ae, tera pea ka whaiti anō te awaawa o te ate i muri i te maimoatanga me te whakatuwheratanga. Mena ka tupu tēnei, ka whakahaerehia pea e tō tākuta he pokanga tirotiro awaawa o te ate hei tango i te awaawa o te ate kua whaiti. Whai muri i te tangohanga, ka honoa anō te awaawa o te ate hauora me te whekau iti.

He raruraru kei muri i te maimoatanga?

Ka rerekē ngā raruraru i muri i te maimoatanga i runga i te maimoatanga. Tērā pea ka pāngia ētahi tāngata e te pancreatitis acute (te pupuhi o te repe taiaki) i muri i te ERCP. Nō reira, he mea nui kia ata whai i ngā tohutohu a tō tākuta.

He aha tā tātou e taea ai te mahi hei ārai i tēnei whaiti o te awaawa au?

He mea ka taea e koe te mahi hei whakaiti i tō tupono ki te whakawhanake i ētahi āhuatanga ka whaiti ai te awaawa o te ate. Hei tauira:

• Kai i tētahi kai hauora me ngā hua hou me ngā huawhenua.
• Whakaitihia ō taumata cholesterol . Mā tēnei ka āwhina i te pupuri i te hauora o te pūkahukahu me te ārai i te hanganga o ngā kōhatu pūkahukahu.
• Kia mau ki te taumaha hauora e tika ana mōu.
• Mena he raruraru tōu ki te inu waipiro, rapua he āwhina. Ka āwhina tēnei ki te ārai i te mate pāwera me ētahi atu kino o te ate.

Ko te mea nui ko te pupuri i tētahi momo noho hauora. Mā ngā mahi pēnei i te kai taurite me te whakakori tinana koe e tiaki i a koe mai i ngā mate maha.

He aha te tirohanga mō te whakaoranga mō te tangata e pāngia ana e tēnei mate?

Ko te tūmanako ka ora koe, ka whakawhirinaki ki te pūtake o te aukati o tō awaawa whekau. Ko ngā maimoatanga e whakatuwhera ana i te awaawa whekau kua aukatia, he angitu tonu. Heoi, ko te mate taketake i puta ai te aukati (pēnei i te mate pukupuku) me whai maimoatanga uaua ake.

He pēhea te roa o te wā whakaora i muri i te maimoatanga?

Ka rerekē te roa o tō whakaoranga, arā, te tere o tō hokinga ki te mahi, ki te kura, me ngā mahi o ia rā, i runga i te momo maimoatanga i whiwhi koe. Ko ngā maimoatanga iti rawa te whakaekenga pēnei i te ERCP he tere ake, he iti ake hoki te mamae i ngā pokanga tuwhera e hiahia ana kia tapahia he nui. He mea nui kia ata whai i ngā tohutohu a tō tākuta kia pai ai te whakaoranga. Tērā pea ka kīia atu ki a koe kia kai i tētahi kai wai, ngāwari mō tētahi wā, kia whakarerekē rānei i tō kai kia uru atu ai ngā kai e ngāwari ana ki te nakunaku .

Āhea ahau me toro atu ki te tākuta?

Mena kei a koe tētahi o ēnei tohu, me toro atu ki te tākuta tonu:

• Te kirika pumau.
• Te mamae tonu o te puku o runga.
• Ngā tohu o te mate i muri i te maimoatanga (hei tauira, te pupuhi e puta mai ana i te patunga, te whero).
• Te ngaronga o te taumaha, te whakapairuaki, te ruaki rānei.
• Ka huri te mā o ngā kanohi, te kiri rānei hei kōwhai (jaundice) .

He aha taku e pātai atu ai ki taku tākuta?

Ka taea e koe te pātai atu ki te tākuta i ngā pātai penei:

• He aha te take o tēnei whaiti o aku awaawa au?
• Ko tēhea maimoatanga te mea pai mōku?
• He aha ngā mea ka taea e au te mahi hei whakaiti i te mōrearea o te whaiti anō o tēnei momo awaawa au?

Ka tino hoha ngā tohu pēnei i te mamae o te puku, te kirika, te makariri, me te jaundice, inā koa ka puta ohorere mai. Mēnā ka pāngia koe e tētahi o ēnei tohu, he pai ake te kōrero tonu atu ki tō tākuta. Kātahi ka taea e rātou te whakahaere whakamātautau hei kimi i te take me te tūtohu i te maimoatanga tika.

Karere mō te Kāinga: Ngā mea tino nui hei maumahara

Nō reira, ko tāku tumanako kua mārama ake koe ki te stricture biliary i kōrerohia e tātou i tēnei rā.

• He whakawhāiti tēnei o ngā awaawa aukume, e aukati ana i te rere o te aukume.
• He maha ngā take; pērā i ngā koha mai i te pokanga, ngā kōhatu i roto i te pūkahukahu, me te mate pukupuku.
• Kia tūpato ki ngā tohu pēnei i te mamae o te puku, te waikura, te mākūkū, me ngā panoni o te tae o te tūtae.
• Mena ka puta mai ēnei tohu, me toro atu ki te gastroenterologist tonu.
• He maimoatanga kei reira, nō reira kaua e mataku. Ko te tere o te tautuhi me te rongoā, ko te pai ake o ngā putanga.
• Mā te noho ora tonu ka āwhina nui ki te ārai i ēnei momo mate.

Mena he pātai anō āu mō tēnei, kaua e mangere ki te kōrero ki tō tākuta. Kia ora tonu koe!