Ufuna ukwazi okwengeziwe ngokuhlolwa kwe-ERCP (Endoscopic Retrograde Cholangiopancreatography)? Ungesabi, ake sixoxe!

Uma udokotela wakho ekutshela ukuthi udinga ukwenza i-ERCP, cishe unemibuzo eminingi mayelana nokuthi iyini, kungani yenziwa, nokuthi ingabe izolimaza. Lokho kuvamile. Abantu abaningi bayathuthumela kancane uma bezwa igama. Kodwa i-ERCP ayiyona into okufanele uyesabe. Empeleni iyisivivinyo esithuthuke kakhulu esingabona futhi ngezinye izikhathi selaphe ezinye izinkinga ohlelweni lwakho lwe-biliary kanye ne-pancreatic ducts. Ngakho-ke, ake sixoxe nge-ERCP ngendlela elula namuhla, kulungile?

Kuyini i-ERCP (i-Endoscopic Retrograde Cholangiopancreatography)?

Leli gama elide lingakwenza uzizwe unesiyezi kancane, kodwa ake silichaze kahle futhi siqonde.

Kalula nje, i-ERCP inqubo ekhethekile esetshenziswa odokotela ukubheka ngaphakathi kwemisele yakho ye-bile kanye nemisele ye-pancreatic . Le misele ithwala i-bile kanye nejusi ye-pancreatic, okusisiza ukugaya ukudla esikudlayo.

Nansi incazelo yaleli gama:

• I-Endoscopic: Lokhu kusebenzisa idivayisi ebizwa ngokuthi i-endoscope. Iyipayipi elincane, eliguquguqukayo elinekhamera encane kanye nokukhanya kolunye uhlangothi. Lifakwa ngomlomo wakho bese lidluliselwa engxenyeni engenhla yamathumbu akho (i-duodenum). Uzonikezwa umuthi wokudambisa ukuze ukusize ulale, ukuze ungazizwa ungakhululekile.
• Ukubuyela emuva: Kulokhu, kufakwa elinye ithubhu elincane nge-endoscope bese kufakwa uketshezi olukhethekile (udayi wokungafani) emigudwini ye-bile kanye nemigudwini ye-pancreatic. Igama elithi "Retrograde" lisho "ukubuyela emuva" ngoba uketshezi lufakwa ohlangothini oluphambene nolo oluvame ukugeleza kulo.
• I-Cholangiopancreatography: Lokhu kubhekisela ezithombeni ezithathwe. Igama elithi "Cholangio" lisho ukuthi lihlobene nemigudu ye-bile. Igama elithi "Pancreato" lisho ukuthi lihlobene ne-pancreas. Igama elithi "Graphy" lisho ukuthatha izithombe.

Ngakho-ke, idayi yokungafani yenza imisele yakho ye-bile kanye nemisele ye-pancreatic ibonakale ngokucacile ezithombeni ze-X-ray. Lokhu kuvumela odokotela ukuthi babone ukuthi kukhona yini okuvimba le misele - njengamatshe enyongo, izimila, noma ukuncishiswa kwemisele ngenxa yezicubu zesilonda . Ingxenye engcono kakhulu ukuthi ezinye zalezi zinkinga zingelashwa khona lapho, nge-endoscope.

Kukuziphi izimo lapho kudingeka khona i-ERCP?

Udokotela wakho angase acele i-ERCP uma esola ukuthi kunenkinga ngohlelo lwakho lwe-biliary. Isibonelo:

• Uma unezinhlungu zesisu ezingachazeki, noma uma une-biliary colic.
• Uma kukhona isimo lapho ukugeleza kwenyongo kuvinjiwe noma kunezimpawu zokuvuza kwenyongo, isibonelo i-jaundice .

Ukuhlolwa kwe-ERCP kungasiza ekuxilongeni nasekuphatheni izinkinga ezivamile ezithinta imigudu yakho ye-bile, njenge:

• Ukuvuvukala kwemigudu yenyongo (i-cholangitis) kanye nezifo ezihlobene nayo.
• Ukuncishiswa kwemigudu yenyongo ngenxa yezicubu zesibazi (ukuqina kwenyongo) .
• Ukuvaleka kwamatshe emgudwini wenyongo ovamile .
• Ukuvuvukala kwe-pancreas okubangelwa amatshe (i-gallstone pancreatitis) .
• Izimila noma umdlavuza wemibhobho yenyongo.
• Ukuvuza kwepayipi lenyongo noma ezinye izingozi.

Isebenza kanjani i-ERCP?

I-ERCP ihlanganisa izindlela ezimbili eziyinhloko: i-endoscopy kanye ne-fluoroscopy . I-Fluoroscopy ifana nokuhambisa izithombe ze-X-ray. Cabanga ngayo njenge-X-ray yevidiyo.

Le fluoroscopy ivumela udokotela ukuthi abone ukuthi uketshezi olukhethekile (udayi ohlukile) luhamba kanjani emigudwini yakho ye-bile kanye nemigudwini ye-pancreatic. Ingabonisa ngokucacile noma yikuphi ukuvuza noma ukuvaleka.

I-endoscope yiyo evumela udokotela (i-endoscopist) ukuthi afinyelele endaweni. Idayi yokungafani ifakwa ngalokhu. Futhi, uma kutholakala inkinga, amathuluzi amancane angafakwa ngale endoscope ukuze ayiphathe.

Ubani owenza i-ERCP?

I-ERCP ivame ukwenziwa udokotela wezifo zamathumbu . Laba odokotela bangochwepheshe ekwelapheni izifo zesistimu yakho yokugaya ukudla kanye neye-biliary. Baqeqeshwe futhi ukwenza i-endoscopy. Baqeqeshwe futhi ngezinqubo ze-endoscopic ezingasetshenziswa esikhundleni sokuhlinzwa okuncane.

Ulungiselela kanjani i-ERCP?

Udokotela wakho uzokunikeza imiyalelo ethile okufanele uyilandele ngaphambi kwe-ERCP yakho. Ngokuvamile, lokhu kufaka phakathi:

• Kumelwe uyeke ukubhema, ukudla, ukuhlafuna itshungama, nokuphuza noma yini ngaphandle kwamanzi amahora ayisishiyagalombili ngaphambi kokuhlolwa.
• Kufanele utshele udokotela wakho nganoma yiziphi ezinye izimo zezokwelapha onazo kanye nanoma yimiphi imithi oyiphuzayo . Eminye imithi, njengemithi yokunciphisa igazi, kungadingeka imiswe izinsuku ezimbalwa ngaphambi kokuhlolwa.
• Tshela udokotela wakho uma uke waba nokungezwani komzimba ngaphambilini nedayi yokuhlukanisa noma i-anesthesia esetshenziswe ngesikhathi sokuhlolwa.
• Kuzodingeka uhlele imoto ozoyihamba uye ekhaya ngemva kokuhlolwa, njengoba kuthatha cishe amahora angama-24 ukuthi imiphumela yomuthi wokubulala izinzwa iphele ngokuphelele. Ngakho-ke, ngeke ukwazi ukushayela.

Kwenzekani ngesikhathi sokuhlolwa kwe-ERCP?

I-ERCP inqubo yokulaliswa esibhedlela . Lokhu kusho ukuthi ungaya ekhaya ngalolo suku. Inqubo ivame ukuthatha cishe ihora noma amabili.

Uzonikezwa umuthi ofakwa emthanjeni (ngokusebenzisa i-"IV"`) ukuze ulale (ulale) . Ungase ulele ubuthongo obukhulu, noma ungase uphapheme kancane. Kodwa-ke, ngeke ukhumbule ukuhlolwa.

Ngesikhathi sokuhlolwa kokuxilonga, udokotela uzokwenza okulandelayo:

• Uma ufisa, kungasetshenziswa umuthi wokubulala izinzwa owuketshezi ukuze kuncishiswe ubuhlungu bomphimbo.
• I-endoscope ifakwa ngomlomo bese idluliswa ngokucophelela emphinjeni nasesiswini iye engxenyeni engenhla yamathumbu amancane (i-duodenum). Izithombe ezibonwa kwikhamera ye-endoscope ziboniswa esikrinini.
• Ngokubuka lawo mavidiyo, ungathola ukuvulwa komsele we-bile kanye nomsele we-pancreatic ngaphakathi emathunjini amancane.
• Elinye ithubhu elincane lifakwa nge-catheter ku-endoscope bese lingena embotsheni.
• Idayi yokungafani ifakwa ezitsheni ngaleyo payipi encane.
• Ngemuva kwalokho, kusetshenziswa ubuchwepheshe be-fluoroscopy, kuthathwa amavidiyo e-X-ray ukuze kubonwe ukuthi uketshezi luhamba kanjani emapayipini. Ku-fluoroscopy, ama-X-ray akhishwa ngokushesha. Lokhu kubhekwa njengenani eliphephile lemisebe.
• Lezi zithombe zisetshenziselwa ukuhlola noma yiziphi izinkinga ngamapayipi - ukuvaleka, ukuvuvukala, ukuvuza, njll.

Cabanga ngalokhu, kufana nokufaka ikhamera epayipini, ukuthumela amanzi anombala kuyo, bese uthola ukuthi ivalekile kuphi nokuthi ivuza kuphi.

Manje, uma udokotela ethola noma yiziphi izinkinga phakathi nalokhu kuhlolwa, uzozama ukuzelapha ngokufaka amathuluzi amancane nge-endoscope. Udokotela owenza i-endoscopy angenza izinto ezinjengalezi:

• Ukuchoboza nokususa amatshe enyongo.
• Ukususa izimila noma ukuthatha isampula yezicubu (i-biopsy). (Uma kuthathwa i-biopsy, ithunyelwa elabhorethri ukuze kubonakale ukuthi inomdlavuza noma cha.)
• Ukwandisa noma ukwelula imithambo yegazi emincane noma emincane.
• Ukubeka into encane efana nethubhu (i-stent) ngaphakathi kwesitsha ukuze sihlale sivulekile.
• Ukulungisa ukuvuza noma ukulimala epayipini.
• I-sphincterotomy ukunqunywa okuncane okwenziwa emisipheni ezungeze umgodi womsele ukuze ikhule. (Lokhu kusiza i-bile kanye nejusi le-pancreatic ukuthi liphume kalula.)

Yini ongayilindela ngemva kwe-ERCP?

Ngemva kokuhlolwa, uzogcinwa esibhedlela noma esikhungweni sezokwelapha cishe ihora elilodwa noma amabili, kuze kube yilapho imiphumela yomuthi wokubulala izinzwa iphela. Umuntu oze ukuzokuthatha angakuthatha akuyise ekhaya. Ungase uzizwe ulele kancane, uthukuthele noma ungenaso isikhathi ngalolo suku.

Ukungakhululeki okuncane okufana nalokhu kungase kwenzeke usuku olulodwa noma ezimbili ngemva kokuhlolwa:

• Umphimbo obuhlungu kanye nobunzima bokugwinya: I-endoscope ingabangela ubuhlungu emphinjeni wakho. Kungcono ukuphuza uketshezi noma ukudla okuthambile kuze kube yilapho kuphola.
• Ubuhlungu besisu noma igesi: Uma kufakwa i-endoscope, umoya omncane uvunguzwa ungene emgudwini wesisu ukuze kubonakale kangcono. Yilokhu okubangela lokhu kungakhululeki. Kuzophela ngemva kwesikhashana (uma umoya usukhululiwe).
• Isicanucanu: Lokhu kungaba umphumela we-anesthesia. Kuphinde kuphele ngosuku olulandelayo.

Yiziphi izingozi ze-ERCP?

Izinkinga zenzeka cishe ku-5% kuya ku-10% wezinqubo ze-ERCP. Le ngozi incike ezimweni zakho zezokwelapha ezikhona kakade kanye nohlobo lokwelashwa olutholayo ngesikhathi se-ERCP. Udokotela wakho uzoxoxa nawe ngalokhu kusengaphambili. Izinkinga ezingaba khona zingafaka:

• Ukusabela okubi ku-sedative: Lokhu kungabangela izinkinga zenhliziyo namaphaphu kubantu abanesifo samaphaphu noma senhliziyo esivele sikhona.
• Ukusabela kokungezwani komzimba nodayi wokungafani: Uma lokhu kwenzeka, udokotela uzokunikeza imithi ngokushesha yokumisa ukusabela.
• Ukulimala komgudu wakho wokugaya ukudla nge-endoscope: Lokhu kungabangela ukopha kwangaphakathi noma, ezimweni ezimbi kakhulu, imbobo.
• Ukuvuza kwenyongo ngenxa yokulimala kwemigudu yenyongo okubangelwa amathuluzi e-endoscopic.
• Ukutheleleka ohlelweni lwakho lwenyongo: Ukuze kuvinjelwe lokhu, udokotela wakho angakunikeza ama-antibiotic kusengaphambili.
• Le nqubo ingabangela ukucasuka nokuvuvukala kwe-pancreas (i-pancreatitis). Lena inkinga evame kakhulu ngemva kwe-ERCP.

Uma ukhulelwe ngesikhathi sokuhlolwa, ingozi yokulimala kombungu ngenxa yemisebe ekhishwa ngesikhathi se-fluoroscopy incane, kodwa kunengozi encane. Udokotela wakho uzokubuza kusengaphambili ukuthi kungenzeka yini ukuthi ukhulelwe. Uma kunjalo, udokotela wakho uzozama ukuhlela kabusha ukuhlolwa noma anciphise ukuchayeka kwakho emisebeni uma kudingeka.

Kuthatha isikhathi esingakanani ukwazi imiphumela yokuhlolwa?

Uma ungakafiki ubuthongo ngenxa yokuhlinzwa kwe-anesthesia,Udokotela (udokotela we-endoscopist) owenze i-ERCP kufanele akwazi ukukhuluma nawe ngokuhlolwa ngokushesha. Uzokutshela ukuthi kutholakale ini nokuthi yini engenziwa ngakho. Uma kuthathwe isampula yezicubu (i-biopsy), kungathatha amasonto ambalwa ukuthi imiphumela ibuye.

Uma i-ERCP yakho ingatholi lutho, kungadingeka wenze olunye uhlobo lokuhlolwa. Uma ukuhlolwa kungayixazululi inkinga yakho, noma uma imiphumela ye-biopsy iqinisekisa inkinga entsha, kungadingeka wenze olunye uhlobo lokwelashwa. Udokotela wakho uzokhuluma nawe ngalokho okufanele ukwenze ngokulandelayo.

Kunini lapho kudingeka ushayele khona udokotela ucingo?

Uma uhlangabezana nanoma yiziphi zalezi zimpawu ezinzima noma ezingavamile ngemva kwe-ERCP, shayela udokotela wakho ngokushesha:

• Ubuhlungu obukhulu besisu noma ukuqunjelwa.
• Ubuhlungu esifubeni noma ubunzima bokuphefumula.
• Umkhuhlane, ukuhlanza, noma ezinye izimpawu zokutheleleka.
• Ukopha okubangelwa yi-rectum noma indle emnyama, ephuzi.

Uyini umehluko phakathi kwe-ERCP kanye ne-endoscopy evamile?

I-ERCP iyindlela ethuthukisiwe ye-endoscopy. I-esophagogastroduodenoscopy evamile (EGD) ibheka kuphela indlela yakho ephezulu ye-GI. Lokhu kusho ukuthi ibheka kuphela umphimbo, isisu, kanye nengxenye yokuqala yamathumbu amancane.

Kodwa ku-ERCP, kusetshenziswa esinye isandiso kanye ne-endoscope evamile - okungukuthi, ithubhu yesibili (i-catheter) engena ngaphakathi kwethubhu yokuqala - yilokhu okufinyelela emigudwini yakho yenyongo.

Lesi sandiso esincane se-endoscope sivumela udokotela ukuthi aphathe imibhobho yakho ngqo. Inqubo ye-endoscopic kuphela engayiphatha imibhobho ngqo ngale ndlela yi-`ERCP`. Ngenkathi ezinye izinqubo ze-endoscopic ezifana ne-`MRCP` (magnetic resonance cholangiopancreatography) kanye ne-`EUS` (endoscopic ultrasound) zingabona imibhobho yakho ye-bile kanye nemibhobho ye-pancreatic, azinikezi leli zinga lokunethezeka kokuyelapha.

Ingabe i-ERCP iwukuhlinzwa okukhulu?

I-ERCP akuyona indlela yokuhlinzwa njengoba sivame ukuyicabanga. Akuyona into esika isikhumba bese ingena ezithweni zomzimba. I-ERCP inqubo ye-endoscopic. Kusho ukuthi ingena emzimbeni ngembobo yemvelo - kulokhu, umphimbo.

Kodwa-ke, lapho enza i-ERCP, udokotela angenza izinqubo ezithile zokuhlinzwa nge-endoscope. Odokotela ngezinye izikhathi babiza lezi zinqubo ezenziwa nge-endoscope ngokuthi ukuhlinzwa kwe-endoscopic . Lezi yizinqubo zokuhlinzwa ngoba zihilela ukwenza izimbobo kanye nokuthungwa emzimbeni. Kodwa-ke, lezi ngokuvamile ziyizinqubo ezincane, futhi azinangozi kakhulu futhi zinesikhathi esifushane sokululama kunokuhlinzwa kwendabuko.

Ingabe i-ERCP iyenziwa nge-pancreatitis?

Yebo, uma udokotela wakho ecabanga ukuthi kukhona okuvimba imisele yakho yenyongo noma imisele yenyongo, angase akucele i-ERCP. Amatshe enyongo abhajwe emimiseleni ayimbangela enkulu ye-pancreatitis ebukhali. Uma lokho kwenzeka, kungadingeka ukuthi ube ne-ERCP ukuze ususe ukuvaleka.

Uma une-pancreatitis engapheli, ukuvuvukala kungabangela ukuthi imigudu yakho ye-pancreatic ibe nezibazi futhi inciphe (ama-strictures). Ezimweni ezinjalo, i-ERCP ingasiza ekwandiseni imigudu noma ifake i-stent ukuze ihlale ivulekile. Lokhu kusiza amajusi e-pancreatic ukuthi aqhubeke nokugeleza ngemigudu.

Khumbula into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

I-ERCP (i-Endoscopic Retrograde Cholangiopancreatography) iyisivivinyo sokuxilonga esingasetshenziswa futhi ukwelapha lesi sifo khona manjalo uma kudingeka. Nakuba sihlasela kancane kunokuhlolwa okuvamile kwezithombe, asihlaseli kakhulu kunokuhlinzwa okukhulu. Singasetshenziswa futhi ukuxilonga nokwelapha lesi sifo ngesikhathi esifanayo.

Iningi labantu lingakwenza lokhu kuhlolwa ngaphandle kobunzima obukhulu, futhi kunezinzuzo eziningi. Ngakho-ke, uma udokotela ekusikisela i-ERCP, ungesabi ukukhuluma naye ngayo, futhi ubuze yonke imibuzo yakho. Kuzokusiza ukuthi wenze izinqumo ezinhle kakhulu ngempilo yakho!

` I-ERCP, i-endoscopy, imigudu ye-bile, i-pancreas, amatshe, i-jaundice, uhlelo lokugaya ukudla