Ngaba wakha waziva iintlungu ezingaqhelekanga kwicala eliphezulu lasekunene lesisu sakho, ukuba tyheli kolusu lwakho namehlo, okanye ukuphelelwa ngumdla wokutya? Usenokuba uqaphele ukuba indle yakho itshintshile yaba mhlophe. Ezi ayizizo izinto ezingaqhelekanga nje. Esinye isizathu esinokubakho sezonyango emva koku kuncitshiswa kwemibhobho yenyongo. Ngokwezonyango oku sikubiza ngokuba yi-`(Biliary Stricture)`. Ungakhathazeki, siza kuthetha ngayo yonke into ngokulula.
Ngamafutshane, yintoni i-biliary stricture?
Khawucinge nje ukuba umbhobho wamanzi uvalekile ngumhlaba okanye ukuba umbhobho ucinezelwe, ukuhamba kwamanzi kuyavalwa, akunjalo? Yiloo nto yenzekayo apha. Inyongo lulwelo olubalulekileyo kwinkqubo yokugaya ukutya emzimbeni wethu. Le nyongo iveliswa esibindini sethu kwaye ihamba iye emathunjini amancinci ngenkqubo yeetyhubhu ezincinci. Xa iityhubhu ezihamba ngazo inyongo ziba mxinwa, zincipha, okanye zivaliwe ngesizathu esithile, oku kubizwa ngokuba yi- biliary stricture.
Xa umbhobho wenyongo uvalekile ngale ndlela, inyongo iqala ukuqokelelana ngaphakathi esibindini. Oku kwenza kube nzima emzimbeni wethu ukugaya ukutya, ingakumbi ukutya okunamafutha. Kwaye ezinye iimpawu ezininzi ziqala ukubonakala.
Zithini izizathu zokucutheka kwe-bile duct?
Zininzi izizathu ezibangela le meko. Ezinye izizathu zinxulumene neemeko zomhlaza, ngelixa ezinye zinxulumene nezinye iimeko ezingezizo zomhlaza. Xa sithetha nje, malunga ne-70% yezi meko zibangelwa zizizathu zomhlaza, kwaye ezinye ezingama-30% zibangelwa zizizathu ezingezizo zomhlaza.
Ukuze kube lula ukuqonda, makhe sihlele ezi zizathu ngokweendidi.
| Uhlobo lwesizathu | Inkcazo kunye nemizekelo |
|---|---|
| Izizathu zomhlaza | Le yeyona nto ixhaphakileyo. Ithumba elinomhlaza linokuqhubeka okanye likhule ngaphakathi kwi-bile duct, nto leyo ebangela ukuba libe mxinwa.
|
| Izizathu ezingezizo zomhlaza | Le meko inokubangelwa nazizifo ezithile, utyando, okanye iingozi. |
Ngokukodwa, emva kotyando oluthile, olufana nokufakelwa isibindi okanye inkqubo yeWhipple, imithambo yegazi inokuncipha ngenxa yokuqhekeka kwe-anastomosis.
Zithini iimpawu ze-bile duct stenosis?
Xa i-bile duct ivaliwe, ichaphazela imizimba yethu ngeendlela ezininzi. Ukuba unenye okanye ngaphezulu kwezi mpawu, kufuneka ukhathazeke.
| Uphawu | Ingcaciso elula |
|---|---|
| Ukutyheli kolusu namehlo (i-Jaundice) | Olu lolona phawu luphambili nolucacileyo. Oku kwenzeka kuba umbala otyheli obizwa ngokuba yi-bilirubin kwinyongo awunakukhutshwa emzimbeni kwaye uqokelelana egazini. |
| Ulusu olurhawuzelelayo/Ukurhawuzelela | Iityuwa zenyongo zinokuqokelelana phantsi kolusu, nto leyo ebangela ukuba umzimba wonke urhawuzelele ngendlela enganyamezelekiyo. |
| Izitulo ezimthubi okanye ezinombala wodongwe | Ngokwesiqhelo, umbala omdaka wendle yethu uvela kwinyongo. Xa inyongo ingasafiki emathunjini, indle ilahlekelwa ngumbala wayo ize ibe nombala okhanyayo. |
| Intlungu kwicala eliphezulu lasekunene lesisu | Intlungu engaqhelekanga nehlala ihleli ivela kwindawo apho kukho khona isibindi kunye nemibhobho yenyongo. |
| Umkhuhlane kunye nokubanda | Ukuba inyongo iyaqokelelana ize yosuleleke, umkhuhlane kunye nokubanda kunokubakho. |
| Ezinye iimpawu | Isicaphucaphu, ukuhlanza, ukungabi namdla wokutya, kunye nokuncipha komzimba nako kunokubonwa. |
Indlela yokuxilonga esi sifo?
Xa ubona ugqirha onezi mpawu, uza kukuhlola aze enze iimvavanyo ezininzi ukuze afumanise imeko. Ngokwesiqhelo, ugqirha wezifo zamathumbu (ugqirha ogxile kwinkqubo yokugaya ukutya) unyanga ezi ngxaki.
Uvavanyo lwegazi
Okokuqala, kwenziwa uvavanyo lwegazi.
- Uvavanyo lweBilirubin: Olu vavanyo lulinganisa ukuba inqanaba le-bilirubin egazini liphezulu kangakanani.
- Uvavanyo Lokusebenza Kwesibindi: Olu vavanyo lukhangela amanqanaba aphezulu eeenzyme zesibindi ukuze kubonwe ukuba kukho umonakalo kwisibindi.
Iiskeni kunye nolunye uvavanyo lomfanekiso
Emva kovavanyo lwegazi, kwenziwa iiskeni ezininzi ukujonga imeko yemibhobho yenyongo ngaphakathi.
- I-Ultrasound Scan: Olu lolona vavanyo lulula nolungenabuhlungu olunokwenziwa kuqala. Luthatha imifanekiso yamalungu esisu kwaye lunokunika umbono ocacileyo wokuba imibhobho yenyongo idumbile, inamatye, okanye ivalekile na.
- I-ERCP (i-Endoscopic Retrograde Cholangiopancreatography): Olu luvavanyo olubaluleke kakhulu olusetyenziselwa ukuxilongwa kunye nonyango. Unikwa i-sedative, kwaye ityhubhu encinci enekhamera eqhotyoshelwe kuyo ifakwa ngomlomo wakho, esiswini sakho, nakwindawo evulekileyo yombhobho wakho wenyongo. Emva koko kufakwa idayi ekhethekileyo kumbhobho kwaye kuthathwa ii-X-ray. Oku kubonisa apho ukuvaleka kubonakala khona ngokucacileyo. Ukuba kuyimfuneko, isiqwenga sethishu sinokuthathwa ngeli xesha ukuze kuhlolwe (i-biopsy) kunye nonyango lokuvaleka.
- I-MRCP (iMagnetic Resonance Cholangiopancreatography): Olu luvavanyo lwe-MRI. Ngaphandle kokufaka nayiphi na imibhobho emzimbeni, intsimi yemagnethi isetyenziselwa ukufumana imifanekiso ecacileyo kakhulu yemibhobho yenyongo, isibindi, inyongo kunye nepancreas.
- I-PTC (i-Percutaneous Transhepatic Cholangiography): Kwezinye iimeko, kufakwa inaliti encinci kakhulu eluswini iye esibindini, kufakwe idayi kwimibhobho yenyongo, kuze kuthathwe i-X-ray.
Zithini iindlela zonyango zoku?
Indlela yonyango ixhomekeke kwisizathu sokuncitshiswa kwe-bile ducts.
Kwiimeko ezininzi, unyango lunokwenziwa ngaxeshanye nenkqubo ye-ERCP. Oku kulula kakhulu kwisigulana kuba kungenziwa ngaphandle kotyando olukhulu.
Unyango olunokwenziwa ngexesha le-ERCP luquka:
- Ukususwa kwamatye: Ukuba amatye anamathele kwinyongo, ayaqhekeka okanye asuswe ngezixhobo ezikhethekileyo.
- Ukubekwa kweStent: Umthambo onciphileyo uyandiswa ngokufaka nokuvuthela into efana nebhaluni. Emva koko, ukuze umthambo uhlale uvulekile kwaye unganciphi kwakhona, kufakwa i -stent , ityhubhu encinci efana ne-mesh, ngaphakathi. Ezi zingenziwa ngeplastiki okanye ngesinyithi.
- Ukususwa kwethumba: Ukuba ukuvaleka kubangelwa yithumba elincinci, kusenokwenzeka ukuba lisuswe.
Unyango lotyando
Kwezinye iimeko, ingakumbi ukuba yimeko yomhlaza, utyando lunokufuneka.
- Utyando Lokudlula Kwi-Bypass: Oku kuquka ukudlula umbhobho ovalekileyo nokudala indlela entsha yokuhamba kwenyongo.
- Ukususwa kwesisu kunye neAnastomosis: Icandelo elinesifo le-bile duct liyanqunyulwa lize lisuswe , kwaye amanye amacandelo amabini aphilileyo aphinde adityaniswe.
Ngaba ikho into esinokuyenza ukuthintela le meko?
Asinakuyithintela yonke into ebangela i-bile duct stenosis, njengomhlaza. Nangona kunjalo, kukho izinto ezinobungozi esinokuzilawula. Ngokuzinyamekela, singanciphisa umngcipheko wokufumana le meko.
- Gcina ukutya okunempilo: Nciphisa ukutya okunamafutha amaninzi, kwaye yongeza iziqhamo nemifuno emininzi ekutyeni kwakho.
- Lawula i-cholesterol yakho: I-cholesterol ephezulu inokubangela ukuba kubekho amatye enyongo, ngoko ke kubalulekile ukulawula amanqanaba e-cholesterol yakho.
- Gcina ubunzima obusempilweni: Ukulawula ubunzima bomzimba kukwaluncedo kwimpilo yenyongo.
- Kuphephe ukusela utywala kakhulu: Ukusela utywala kakhulu kunokonakalisa isibindi kwaye kubangele i-pancreatitis. Zombini ezi meko zinokubangela ukucutheka kwe-bile ducts.
Ufanele uye nini kugqirha?
Ukuba unezi mpawu zilandelayo, musa ukuzityeshela phantsi kwayo nayiphi na imeko.Bona ugqirha wakho ngokukhawuleza kwaye ucele ingcebiso.
| Uphawu ekufuneka luqwalaselwe |
|---|
| Ukuba ulusu lwakho okanye amhlophe emehlweni akho ajika abe tyheli (i-jaundice). |
| Ukuba unentlungu engapheliyo okanye ephindaphindayo kwicala eliphezulu lasekunene lesisu sakho. |
| Ukuba unciphisa umzimba ngaphandle kwesizathu. |
| Ukuba kukho umkhuhlane ongapheliyo kunye nokubanda. |
| Emva konyango, indawo yotyando ibonisa iimpawu zosulelo, ezinje ngokuba bomvu, ukudumba, okanye ubomvu. |
Umyalezo Wokuya Ekhaya
- Ukutyheli kolusu namehlo (i-jaundice), iintlungu kwicala eliphezulu lasekunene lesisu, kunye nendle ekhanyayo zezona mpawu ziphambili zokuvaleka kombhobho wenyongo. Ungaze uzityeshele ezi zinto.
- Oku kunokubangelwa zizinto ezahlukeneyo, ukusuka kwiimeko ezilula ezifana namatye enyongo ukuya kwiimeko ezinzulu ezifana nomhlaza.
- Uvavanyo lwegazi, iiskeni, ingakumbi iimvavanyo ezifana ne-ERCP zibaluleke kakhulu ekufumaneni uxilongo oluchanekileyo.
- Kwiimeko ezininzi, umbhobho ungavulwa kusetyenziswa i-ERCP ngaphandle kotyando.
- Impilo yakho yexesha elizayo ixhomekeke kwisizathu sokuvaleka kwe-bile duct yakho, ngoko ke kubalulekile ukufuna iingcebiso zonyango ngokukhawuleza.
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