Ina kī atu tō tākuta ki a koe, ki tētahi rānei e tata ana ki a koe me whai koe i te Tukanga Whipple, he mea noa te mataku me te manukanuka. He pokanga nui, he uaua hoki tēnei. Engari koinei te otinga pai rawa atu, ā, he tumanako nui hoki mō ngā mate kino maha, pērā i te mate pukupuku repeure. Nō reira, i tēnei rā, me kōrero māmā noa iho tēnei, kia mārama ai ō pātai katoa.
He aha te tikanga Whipple?
He whakarāpopototanga noa iho, he pokanga te tikanga Whipple hei tango i tētahi pukupuku matepukupuku i te pane o tō repe taiaki, kei te taha matau. Ko te take he uaua rawa, nā te mea kāore e tangohia noa he okana kotahi.
Whakaarohia, ko tā tātou pūnaha nakunaku he kohinga o ngā okana e mahi tahi ana. Ina he raruraru kei tētahi wāhanga, ka pā ki ngā wāhanga kē atu e hono ana ki a ia. Waihoki, ina puta te mate pukupuku i te pane o te repe taiaki, me tango ētahi o ngā okana e tata ana ki a ia.
Ko ngā wāhanga matua ka tangohia i te wā o tēnei pokanga ko:
- Te upoko o te pancreas
- Ko te wāhanga tuatahi o tō whekau iti, te duodenum
- Wāhanga o te awaawa au
- Pūkahukahu katoa
Kātahi ka tangohia e te taote pokanga te toenga o te repe taiaki, te awaawa au, me te puku, ka hono anō ki te toenga o te whekau iti. Pērā i te hanga rori, ka tangohia e rātou he piriti tawhito, ka whakatūria he piriti hou hei hono anō i ngā rori. Mā tēnei hononga anō ka taea e te kai e kainga ana e koe te neke mā roto i tō pūnaha nakunaku me te kore he arai.
Ko tētahi atu ingoa e whakamahia ana e ngā tākuta mō tēnei pokanga ko te 'pancreatoduodenectomy'. He kupu uaua tēnei, koia mātou katoa e kī nei ko te 'tikanga Whipple'.
He aha ngā momo āhuatanga e mahia ai tēnei pokanga?
Ko te mate pukupuku repeure te tino take mō tēnei pokanga. Heoi anō, ka whakamahia hoki tēnei pokanga hei rongoā mō ētahi atu āhuatanga. Me titiro tātou ki ēnei āhuatanga.
| Āhua | He whakaahuatanga poto |
|---|---|
| Matepukupuku Repeure | Ko te take matua mō tēnei pokanga he aukati i te horapa o te mate pukupuku (metastasizing) ki ētahi atu whekau. |
| Ngā Pūngāwerewere o te Pānihi | Hei tango i ngā pukupuku ehara i te matepukupuku engari ka huri hei matepukupuku ā muri ake nei. |
| Te mate pāwera | Hei tango i ngā wāhanga kua pakaru i roto i te pancreatitis kino me te roa. |
| Matepukupuku o te whekau iti | Mō te mate pukupuku o te wāhanga tuatahi o te whekau iti (duodenum). |
| Matepukupuku o te awa au | Mō ngā mate pukupuku e puta ana i te wāhanga o raro o te awaawa au. |
| Ētahi atu momo mate pukupuku me ngā pukupuku | Mō ētahi atu momo mate pukupuku motuhake pērā i te Mate Pukupuku Ampullary me ngā Pūngāwerewere Neuroendocrine Pancreatic. |
| Whara | Ina pakaru te repeure, te whekau iti rānei i tētahi aituā kino. |
Ko te mea nui, ko tēnei pokanga ka mahia anake ki ngā tūroro kāore anō kia horapa te mate pukupuku. Mēnā kua horapa te mate pukupuku ki ētahi atu whekau, pērā i te ate, kāore e whai hua tēnei pokanga.
Me pēhea taku whakarite i mua i te pokanga?
He iti noa te whakarite i mua i tētahi pokanga nui pēnei. Mā tō tākuta ēnei mea katoa e whakamārama ki a koe, engari koinei ngā mea ka tonoa pea koe kia mahi:
- Maimoatanga mate pukupuku: Mena he mate pukupuku tōu, ka tukuna pea he maha ngā wā ki a koe mō te chemotherapy i mua i te pokanga.
- Nohopuku: Me karo rawa koe i te kai, i te inu rānei mō te 8 hāora i mua i te pokanga.
- Te kaipaipa: Mena he kaipaipa koe, he mea tino pai mō te hauora o tō ngākau me ō pukahukahu te whakamutu i te kaipaipa i te iti rawa i ngā wiki e rua i mua i te pokanga.Ka tino whakaitihia e tēnei ngā raruraru i muri i te pokanga.
- Te Whakamutu i te Rongoā: Ka tohutohu tō tākuta kia mutu te tango i ētahi rongoā (ina koa ko ngā rongoā whakaiti toto) i ētahi rā i mua i te pokanga.
- Ngā rongoā kē atu: Mena kei te tango koe i ētahi tāpiringa otaota, me mutu pea te tango i aua mea i te wiki, i ngā wiki e rua rānei i mua i tō pokanga. Me mutu hoki te tango i ngā rongoā pēnei i te Viagra® i ngā haora 24 i mua. Heoi, ka kī atu pea tō tākuta kia tangohia e koe ētahi rongoā mō te toto toto tiketike me te karāhe wai.
He mea tino nui kia tino whai koe i ngā tohutohu a tō tākuta.
Kia ako tātou i ētahi kōrero mō te whakahaeretanga o te pokanga?
Tuatahi, ka hoatu e te tākuta whakamoe koe he rongoā whakamoe ki a koe. Nō reira ka moe pai koe tae noa ki te mutunga o te pokanga.
Kātahi ka tīmata te pokanga mā te tapahi i tētahi tapahi nui ki te puku (pokanga tuwhera) mā te tapahi rānei i ētahi tapahi iti mā te whakamahi i tētahi kāmera (pokanga laparoscopic/robotic).
I te wā o te pokanga, e ai ki tā tātou i kōrero ai i mua ake nei, ka tangohia te pane o te repe taiaki, te duodenum, te wāhanga o te awaawa au, me te pūhā. Kātahi ka honoa anō ngā wāhanga e toe ana o te okana hei whakaora i te ara nakunaku.
E rima ki te waru hāora te roa o te tukanga katoa. Nā te mea he mahi uaua, he mahi ātaahua hoki tēnei.
He aha ngā mea ka tupu i muri i te pokanga? He pēhea te roa o te wā whakaora?
He pokanga nui te pokanga Whipple, nō reira ka roa te wā e ora ai.
I a koe e noho ana i te hōhipera:
- Me noho koe ki te hōhipera mō te 5 ki te 7 ngā rā.
- Ka hoatu he rongoā hei whakahaere i te mamae.
- Kei te tirotirohia tonutia e te tīma hauora ngā mate pāwera, ngā raruraru rānei.
- Mō ngā rā tuatahi, ka hoatu noa he kai wai mārama ki a koe, ā, i te whakapai ake o tō āhua, ka tīmata mārire koe ki te hoatu i ngā kai mārō.
- He mea tino nui te ara ake i te moenga me te hikoi wawe tonu mō te tukanga whakaora. Engari kaua e ngana ki te ara ake ko koe anake, kei hinga pea koe, nō reira kia mahara ki te rapu awhina mai i te nēhi, i te kaiwhakaora tinana rānei.
I te nuinga o te wā, ki te kore he raruraru, ka taea e koe te hoki anō ki ō mahi o ia rā i roto i ngā wiki e 4 ki te 6 .
He aha ngā painga me ngā mōrearea o tēnei pokanga?
Pērā i ngā pokanga nui katoa, he pai, he mōrearea hoki ō te tikanga Whipple. He mea nui kia kōrerotia whānuitia ēnei ki tō tākuta.
| Ngā Painga | Ngā Tūponotanga me ngā Āhuatanga Whakararuraru |
|---|---|
| He whakaora ora: Ki te kitea wawe te mate pukupuku repe taiaki, ko tēnei pokanga te tumanako anake mō te oranga mō te wā roa. | Mate huka: Ka pā mai pea te mate huka mō te wā poto, mō te wā roa rānei. |
| Te whakaora i te mate pukupuku: Ka taea te whakaora rawa i ētahi momo mate pukupuku, pērā i ngā pukupuku neuroendocrine. | Te turuturu o te puku: Te turuturu mai i ngā wāhi kua honoa anō. |
| Te whakapai ake i te kounga o te oranga: Āwhina ki te whakamamae i te mamae me te kore whakamarie i puta mai i ngā āhuatanga ehara i te matepukupuku, me te arahi i te oranga pai ake. | Te Toto me te Mate Pāwera. |
| Te roa o te oranga: Ahakoa kua horapa te mate pukupuku ki ngā kōpū lymph tata, ka taea e tēnei pokanga te whakaroa i te roa o te oranga mō ētahi tau. | Ngā raruraru nakunaku: Te uaua ki te nakunaku i ētahi kai me te ngaronga taumaha. |
| Te kōroke, ētahi atu huringa rānei o te puku. |
Āhea koe me kōrero ki te tākuta?
I muri i tō hokinga ki te kāinga, he mea nui kia whakapā atu koe ki tō rōpū pokanga i te wā tonu mēnā ka kite koe i ētahi tohu whakatūpato.
Ki te kite koe i tētahi mea pēnei, whakamōhio atu ki tō tākuta tonu:
- Mena kua wetekina ō tuitui, kua tuwhera rānei te tapahi.
- Ki te mea he kirika tōu .
- Mena he whero te rohe huri noa i te motu, he pupuhi, he mahana, he wai rite ki te pupuhi rāneiKi te haere mai koe.
- Mena kei te kino haere te mamae o te tapahi.
- Mena he rerekē te nekehanga o tō puku.
Karere Tangohia ki te Kāinga
- He pokanga nui, he pokanga uaua hoki te tikanga Whipple, engari he tumanako whakaora ora mō ngā mate kino pēnei i te mate pukupuku repeure.
- He roa te wā e ora ai i muri i tēnei pokanga, ā, he mea tino nui kia ata whai i ngā tohutohu hauora.
- Ahakoa he mōrearea me ngā uauatanga e pā ana ki te pokanga, i ēnei rā, nā te whanaketanga o te hangarau, e tino angitu ana tēnei pokanga.
- He mate kino te mate pukupuku repeure. Engari ehara i te mea ko koe anake. Rapua te tautoko mai i ō whanaunga me tō tīma hauora.
- Kōrerotia mārire ki tō tākuta ō mataku, ō ruarua, me ō pātai. He tino whakamarie tēnei mōu hinengaro.
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