Ukutsalwa kweBiliary: Kutheni kwaye Kwenziwa Njani?

Ngaba amehlo akho nolusu lwakho luba tyheli kwaye umzimba wakho wonke uyarhawuzelela ngendlela enganyamezelekiyo? Ezi ziimpawu zento sonke esiyaziyo njenge-jaundice. Uninzi lwexesha, unobangela woku kukuvaleka kombhobho wenyongo, oluyilwelo oluvela esibindini sethu kwaye lunceda ekugayweni kokutya. Xa oku kuvaliwe, olo lwelo lubuyela esibindini, nto leyo ebangela ukuba kube tyheli kwaye kurhawuzelelwe. Ngoko ke, indlela ekhethekileyo yonyango esetyenziswa ngoogqirha kwiimeko ezinjalo ibizwa ngokuba yi-Biliary Drainage. Ngamafutshane, oku kuquka ukufaka umbhobho omncinci kumbhobho wenyongo ovalekileyo kwaye uvumele inyongo ukuba iphume. Makhe sithethe ngale nto ngokweenkcukacha namhlanje.

Yintoni iBiliary Drainage? Ngaba kukho iintlobo zayo?

Ukukhupha iBiliary Drainage yinkqubo esebenzisa umbhobho othambileyo noguquguqukayo (i-catheter) ukuvumela inyongo ukuba idlule kwindawo evalekileyo kwi-bile duct, esuka esibindini iye emathunjini amancinci. Kufana nokudala indlela entsha yomzila wamanzi ovalekileyo. Oku kwenziwa ngeendlela ezimbini eziphambili. Ugqirha wakho uya kugqiba ukuba yeyiphi indlela efanelekileyo kuwe ngokusekelwe kwimeko yakho.

Yintoni indawo yokufaka i-stent?

Kwezinye iimeko, ingakumbi ukuba ukuvaleka kuhlala kuhleli (umzekelo, ngenxa yomhlaza), ugqirha wakho unokubeka ityhubhu encinci efana ne-mesh, ebizwa ngokuba yi-stent, ngaphakathi kwi-bile duct yakho ukuze ihlale ivulekile. Oku kudla ngokwenziwa emva kweentsuku ezimbalwa emva kokuba ityhubhu yokuqala ifakiwe.

Kutheni umntu edinga olu hlobo lonyango?

Eyona sizathu siphambili sokufuna olu nyango kukuvaleka okanye ukuncitshiswa kombhobho wenyongo (`stricture`). Oku kubangela ukuba ulwelo lwenyongo luqokelele esibindini (`cholestasis`). Khawuthelekelele, into efana naxa umbhobho wokukhupha amanzi endlwini yethu uvalekile, amanzi aqokeleleka apha. Kunokubakho izizathu ezahlukeneyo zokuvaleka kombhobho wenyongo:

• Amatye kwi-gallbladder okanye kwi-bile ducts (i-choledocholithiasis).
• I-Pancreatitis okanye umhlaza we-pancreatic.
• Umhlaza we-bile duct (iCholangiocarcinoma).
• Umhlaza wesibindi okanye umhlaza wenyongo .
• Ukudumba kwama -lymph nodes kufutshane nesibindi okanye i-pancreas ngenxa yomhlaza.
• Ezinye izifo ezibangelwa zizinambuzane .
• Ukonakala kwimibhobho yenyongo ngexesha lotyando olunye.
• Iimeko zokudumba zexesha elide zemibhobho yenyongo, ezifana ne-'primary sclerosing cholangitis'.

Ulungiselela njani ngaphambi konyango?

Kukho izinto ezimbalwa ekufuneka uzenze ngaphambi kolu nyango. Ugqirha wakho uza kukunika imiyalelo ecacileyo malunga noku. Kubaluleke kakhulu ukulandela loo miyalelo ngokuchanekileyo. 1. Ukutya Nesiselo: Kufuneka uyeke ukutya, ukusela, nokutshaya ubuncinane iiyure ezi-6 ngaphambi konyango. Ugqirha wakho angakuxelela ukuba ungasela nini ulwelo, olufana namanzi. 2. Ii-Allergies: Qiniseka ukuba uxelela ugqirha wakho ngazo naziphi na ii-allergies onazo, ingakumbi kwi-anesthetics, idayi yokwahlulahlula esetyenziswa kwi-X-ray, okanye kwiplastiki okanye kwiintsimbi. 3. Amayeza:Xelela ugqirha wakho ngawo onke amayeza owasebenzisayo ngoku (kuquka neevithamini). Ingakumbi ukuba uthatha amayeza okunciphisa igazi (i-anticoagulants) afana ne-aspirin kunye ne-warfarin, buza ukuba kufuneka uyeke na ukuwasebenzisa kwaye nini. 4. Ukukhulelwa: Qiniseka ukuba uxelela ugqirha wakho ukuba ukhulelwe okanye ungakhulelwa. 5. Ukuqhuba: Awuyi kukwazi ukuqhuba emva konyango kuba uza kuba phantsi kwe-anesthesia. Ngoko ke cwangcisa ukuzisa umntu oza kukuthatha akuse ekhaya.

Kwenzeka ntoni ngexesha lonyango?

Amanyathelo oku aya kwahluka kancinci ngokuxhomekeke kwinkqubo oyenzayo (i-PTBD okanye i-EBD). Kodwa ungakhathazeki, ugqirha wakho uza kukuchazela yonke into kwangaphambili.

Indlela eyenziwa ngayo indlela ye-percutaneous (PTBD):

• Okokuqala, ulusu olusesiswini sakho luyacocwa kwaye indawo leyo ayibonakali.
• Emva koko ugqirha ufaka inaliti encinci eluswini iye kwi-bile duct esibindini.
• Kufakwa ulwelo olukhethekileyo (idayi echaseneyo) ukuze kubonakale i-X-ray.
• Xa sele ifunyenwe indawo echanekileyo yokuvaleka, umbhobho wokukhupha amanzi ufakwa kuloo ndawo kwaye ulwelo lwenyongo luyavunyelwa ukuba luphume.
• Elinye icala lale tube liphuma eluswini lwakho kwaye liqhagamshelwe kwingxowa engaphandle. Ulwelo lwenyongo luyaqokelelana kule ngxowa. (Le ngxowa kufuneka ikhutshwe izihlandlo ezininzi ngemini.)

Indlela eyenziwa ngayo inkqubo ye-endoscopic (EBD):

• Kule meko, uza kunikwa i-anesthesia eqhelekileyo okanye i-anesthesia ekhaphukhaphu, ngoko awuyi kuva nto.
• Umphimbo wakho uyaqaqamba.
• Ugqirha ufaka ityhubhu enekhamera (i-endoscope) ngomlomo, ayidlulisele kumbhobho wokutya, aze ayikhokelele kwindawo ekuyo i-bile duct.
• Emva koko, enye ityhubhu (i-catheter) idlula kuloo tyhubhu ize idlule kumbhobho ovalekileyo ukuze kuvunyelwe ukuba inyongo ihambe.
• Ukuba i-phlegm isusiwe ngaphandle, kufakwa ityhubhu ngempumlo ize incamathiselwe kwibhegi. Ukuba isusiwe ngaphakathi, kufakwa i-stent ngaphakathi.

Iingozi kunye nokhathalelo emva konyango

Njengakwezinye iindlela zonyango, kukho iingozi kunye neengxaki ezinokubakho.

• Iingxaki ezinokwenzeka:
• Ukukhululeka, ukujijeka, okanye ukuvaleka kombhobho ofakiweyo ngengozi.
• Intlungu okanye ukungakhululeki.
• Usulelo (ugqirha uya kunika amayeza okubulala iintsholongwane ukuthintela oku).
• Ukopha.
• Utshintsho kwindlela umzimba obumba ngayo i-electrolyte (`ukungasebenzi kakuhle kwe-Electrolyte`).
• Kunqabile kakhulu ukuba kubekho iingxaki zemiphunga (`Pneumothorax`).

Ugqirha uza kukuchazela ngokucacileyo ezi ngozi aze akucebise ngento omawuyenze xa kuvela naziphi na iingxaki.

Ungazinyamekela njani ekhaya?

Ukuba unetyhubhu kunye nebhegi efakwe ngaphandle komzimba wakho, abasebenzi bonyango baya kukufundisa indlela yokunyamekela.

• Musa ukulala ubunzima bakho bubekwe ecaleni apho kukho khona ityhubhu. Oku kunokubangela ukuba ityhubhu ijijeke.
• Ukuba ugqirha wakho ukucebisa ukuba uhlambe ityhubhu ngesisombululo se-saline esincinci imihla ngemihla, yenza njalo.
• Sela iziselo ze-electrolyte ukuze ubuyisele ubungakanani bolwelo oluphuma ebhegini. Buza ugqirha wakho ukuba usele ntoni kwaye usele malini.
• Ungahlamba emva kweeyure ezingama-48 emva konyango. Nangona kunjalo, musa ukudada emachibini okanye elwandle/emlanjeni ngelixa ityhubhu ikwindawo yayo.
• Kuphephe ukuphakamisa iintsimbi ude ugqirha wakho akuxelele ukuba wenze njalo.

Ufanele ufune nini unyango ngokukhawuleza?

Ukuba ufumana naziphi na kwezi mpawu zilandelayo, fowunela ugqirha wakho ngoko nangoko, okanye uye kwiSebe leNgxamiseko (i-ETU) lesibhedlele esikufutshane.

• Ifiva .
• Ukuba kukho intlungu eyandayo, ukudumba, okanye ukubomvu kwindawo yokufaka ityhubhu.
• Ukuba ubomvu okanye olunye ulwelo luphuma kwindawo yombhobho.
• Ukuba iintlungu zesisu ziyanda okanye ziphinda zivele.
• Ukuba ulusu okanye amehlo ajika abe tyheli kwakhona.
• Ukuba uyahlanza.
• Ukuba umbhobho ubonakala ngathi uyakhululeka.
• Ukuba indle ayiphumi okanye umoya awuphumi.

Ukukhupha amanzi enyongweni lunyango olusebenzayo kakhulu lokuvaleka kombhobho wenyongo. Iqela lakho lezonyango liza kukunceda ukhethe eyona ndlela ifanelekileyo kwimeko yakho. Zive ukhululekile ukubabuza nayiphi na imibuzo okanye iinkxalabo onokuba nazo. Ukuqunjelwa kweBiliary, Ukuvaleka kweBile Duct, I-Jaundice, i-PTBD, i-EBD, Izifo zeSibindi, Amatye eGallstone, inqaku lezonyango laseSinhala