Wake wazizwa ubuhlungu obungavamile ohlangothini oluphezulu kwesokudla lwesisu sakho, ukuphuzi kwesikhumba sakho namehlo, noma ukuphelelwa yisifiso sokudla? Kungenzeka ukuthi uqaphele ukuthi indle yakho isiphenduke yaba mhlophe. Lezi akuzona nje izinto ezingahleliwe. Esinye isizathu sezokwelapha esingabangela lokhu ukuncishiswa kwemigudu yenyongo. Ngokwezokwelapha lokhu sikubiza ngokuthi `(Biliary Stricture)`. Ungakhathazeki, sizoxoxa ngakho konke ngamagama alula.
Kalula nje, kuyini ukuqina kwe-biliary?
Cabanga uma ipayipi lamanzi livaleka ngothuli noma uma ipayipi licindezelwa, ukugeleza kwamanzi kuyavaleka, akunjalo? Yilokho okwenzekayo nalapha. Inyongo iwuketshezi olubalulekile enqubweni yokugaya ukudla emzimbeni wethu. Lenyongo ikhiqizwa esibindini sethu futhi iya emathunjini amancane ngohlelo lwamapayipi amancane. Lapho amapayipi okugeleza kuwo inyongo eba mancane, ancishisiwe, noma avalekile ngesizathu esithile, lokhu kubizwa ngokuthi i- biliary stricture.
Uma i-bile duct ivalekile ngale ndlela, i-bile iqala ukuqongelela ngaphakathi kwesibindi. Lokhu kwenza kube nzima ngemizimba yethu ukugaya ukudla, ikakhulukazi ukudla okunamafutha. Futhi ezinye izimpawu eziningi ziqala ukuvela.
Yiziphi izimbangela zokuncipha kwe-bile duct?
Kungaba nezimbangela eziningi zalesi simo. Ezinye izimbangela zihlobene nezimo zomdlavuza, kanti ezinye zihlobene nezinye izimo ezingezona ezomdlavuza. Uma sikhuluma nje, cishe u-70% walezi zimo ubangelwa yizimbangela zomdlavuza, kanti u-30% osele ubangelwa yizimbangela ezingezona ezomdlavuza.
Ukuze kube lula ukuqonda, ake sihlukanise lezi zizathu ngezigaba.
| Uhlobo lwesizathu | Incazelo nezibonelo |
|---|---|
| Izimbangela Zomdlavuza | Lena yimbangela evame kakhulu. Isimila somdlavuza singacindezela noma sikhule ngaphakathi komsele wenyongo, okubangela ukuba sibe mncane.
|
| Izimbangela Ezingezona Umdlavuza | Lesi simo singabangelwa nezinye izifo, ukuhlinzwa, noma izingozi. |
Ikakhulukazi, ngemva kokuhlinzwa okuthile, njengokufakelwa kwesibindi noma inqubo ye-Whipple, imithambo yegazi ingancipha ngenxa yezibazi endaweni ethintekile.
Ziyini izimpawu ze-bile duct stenosis?
Uma i-bile duct ivalekile, ithinta imizimba yethu ngezindlela eziningi. Uma unesinye noma ngaphezulu salezi zimpawu, kufanele ukhathazeke.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ukuphuzi kwesikhumba namehlo (i-Jaundice) | Lolu uphawu oluyinhloko nolusobala kakhulu. Lokhu kwenzeka ngoba umbala ophuzi obizwa ngokuthi i-bilirubin enyongweni awukwazi ukukhishwa emzimbeni futhi uqongelela egazini. |
| Isikhumba esilumayo/ukuqaqamba | Usawoti we-bile unganqwabelana ngaphansi kwesikhumba, okubangela ukuba umzimba wonke ulume ngendlela engabekezeleleki. |
| Izitulo ezinombala ophuzi noma obumba | Ngokuvamile, umbala onsundu wendle yethu uvela enyongweni. Uma inyongo iyeka ukufinyelela emathunjini, indle ilahlekelwa umbala wayo bese iba nombala okhanyayo. |
| Ubuhlungu ohlangothini oluphezulu kwesokudla lwesisu | Ubuhlungu obungavamile, obuhlala njalo obuvela endaweni lapho kutholakala khona isibindi kanye nemisele yenyongo. |
| Umkhuhlane kanye nokubanda | Uma inyongo iqoqana futhi itheleleka, kungase kube nomkhuhlane kanye nokubanda. |
| Ezinye izici | Isicanucanu, ukuhlanza, ukuphelelwa yisifiso sokudla, kanye nokwehla kwesisindo nakho kungabonakala. |
Ungasithola kanjani lesi sifo?
Uma ubona udokotela onalezi zimpawu, uzokuhlola futhi enze izivivinyo eziningana ukuze athole lesi simo. Ngokuvamile, udokotela wezifo zamathumbu (udokotela ochwepheshe ohlelweni lokugaya ukudla) uyelapha lezi zifo.
Ukuhlolwa Kwegazi
Okokuqala, kwenziwa ukuhlolwa kwegazi.
- Ukuhlolwa kwe-Bilirubin: Lokhu kulinganisa ukuthi izinga le-bilirubin egazini liphakeme kangakanani.
- Ukuhlolwa Kokusebenza Kwesibindi: Lokhu kuhlolwa kubheka amazinga aphezulu e-enzyme yesibindi ukuze kutholakale ukuthi kukhona yini ukulimala kwesibindi.
Ukuskena nezinye izivivinyo zezithombe
Ngemva kokuhlolwa kwegazi, kwenziwa izikena eziningana ukuze kubhekwe isimo semibhobho yenyongo ngaphakathi.
- Ukuskena nge-Ultrasound: Lokhu ukuhlolwa okulula kakhulu, okungenabuhlungu kakhulu okungenziwa kuqala. Kuthatha izithombe zezitho zesisu futhi kunganikeza umbono oqondile wokuthi imigudu ye-bile ivuvukele, inamatshe, noma ivaliwe.
- I-ERCP (i-Endoscopic Retrograde Cholangiopancreatography): Lolu vivinyo olubaluleke kakhulu olusetshenziselwa kokubili ukuxilongwa kanye nokwelashwa. Unikwa umuthi wokudambisa, bese kufakwa ithubhu elincane elinekhamera elinamathiselwe kulo ngomlomo wakho, esiswini sakho, kanye nomgodi womsele wakho wenyongo. Kufakwa udayi okhethekile emseleni bese kuthathwa ama-X-ray. Lokhu kubonisa lapho ukuvaleka kubonakala khona kahle. Uma kudingeka, kungathathwa ingcezu yezicubu ngalesi sikhathi ukuze kuhlolwe (i-biopsy) kanye nokwelashwa kokuvaleka.
- I-MRCP (i-Magnetic Resonance Cholangiopancreatography): Lokhu kuskena kwe-MRI. Ngaphandle kokufaka noma yimaphi amapayipi emzimbeni, insimu yamagnetic isetshenziswa ukuthola izithombe ezicacile kakhulu ze-ducts ye-bile, isibindi, i-gallbladder, kanye ne-pancreas.
- I-PTC (Percutaneous Transhepatic Cholangiography): Kwezinye izimo, inaliti encane kakhulu ifakwa esikhumbeni iye esibindini, kufakwe idayi emigudwini yenyongo, bese kuthathwa i-X-ray.
Yiziphi izindlela zokwelapha lokhu?
Indlela yokwelapha incike embangeni yokuncishiswa kwemisele yenyongo.
Ezimweni eziningi, ukwelashwa kungenziwa ngesikhathi esifanayo nenqubo ye-ERCP. Lokhu kulula kakhulu esigulini ngoba kungenziwa ngaphandle kokuhlinzwa okukhulu.
Ukwelashwa okungenziwa ngesikhathi se-ERCP kufaka phakathi:
- Ukususwa kwamatshe: Uma amatshe ebhajwe enyongweni, ayaqhekeka noma asuswe ngamathuluzi akhethekile.
- Ukubekwa kwe-Stent: Umthambo oncishisiwe uyandiswa ngokufaka nokufutha into efana nebhaluni. Bese kuthi, ukuze umthambo ugcine uvulekile futhi unganciphi futhi, kufakwa i- stent , ipayipi elincane elifana ne-mesh, ngaphakathi. Lokhu kungenziwa ngepulasitiki noma ngensimbi.
- Ukususwa kwesimila: Uma ukuvaleka kubangelwa isimila esincane, kungenzeka ukuthi sisuswe.
Ukwelashwa Kokuhlinzwa
Kwezinye izimo, ikakhulukazi uma kuyisimo somdlavuza, kungase kudingeke ukuhlinzwa.
- Ukuhlinzwa Kokudlula: Lokhu kuhilela ukudlula umgudu ovalekile nokudala indlela entsha yokugeleza kwenyongo.
- Ukususwa kanye ne-Anastomosis: Ingxenye enesifo yomsele wenyongo iyasikwa futhi isuswe , bese kuthi izingxenye ezimbili ezisele eziphilile zixhunywe kabusha.
Ingabe kukhona esingakwenza ukuvimbela lesi simo?
Asikwazi ukuvimbela zonke izimbangela ze-bile duct stenosis, njengomdlavuza. Kodwa-ke, kunezici ezithile eziyingozi esingazilawula. Ngokuzinakekela, singanciphisa ingozi yokuthola lesi simo.
- Londoloza ukudla okunempilo: Nciphisa ukudla okunamafutha amaningi, bese wengeza izithelo nemifino eminingi ekudleni kwakho.
- Lawula i-cholesterol yakho: I-cholesterol ephezulu ingaholela ematsheni enyongo, ngakho-ke kubalulekile ukulawula amazinga e-cholesterol yakho.
- Gcina isisindo esinempilo: Ukulawula isisindo somzimba nakho kuyazuzisa empilweni yenyongo.
- Gwema ukuphuza utshwala ngokweqile: Ukuphuza utshwala ngokweqile kungalimaza isibindi futhi kubangele i-pancreatitis. Zombili lezi zimo zingaholela ekuncipheni kwemigudu ye-bile.
Kufanele ubonane nini nodokotela?
Uma unezimpawu ezilandelayo, ungazinaki ngaphansi kwanoma yiziphi izimo.Bona udokotela wakho ngokushesha okukhulu bese ucela iseluleko.
| Isici okufanele usiqaphele |
|---|
| Uma isikhumba sakho noma amhlophe amehlo akho ephenduka aphuzi (i-jaundice). |
| Uma unezinhlungu eziqhubekayo noma eziphindaphindayo ohlangothini oluphezulu lwesokudla lwesisu sakho. |
| Uma wehlisa isisindo ngaphandle kwesizathu. |
| Uma kukhona umkhuhlane oqhubekayo kanye nokubanda. |
| Ngemva kokwelashwa, indawo yokuhlinzwa ikhombisa izimpawu zokutheleleka, njengokubomvu, ukuvuvukala, noma ubomvu. |
Umlayezo Wokuya Nawe Ekhaya
- Ukuphuzi kwesikhumba namehlo (i-jaundice), ubuhlungu ohlangothini olungaphezulu kwesokudla lwesisu, kanye nendle ekhanyayo kuyizimpawu eziyisixwayiso eziyinhloko zokuvaleka kwe-bile duct. Ungalokothi ungazinaki lezi.
- Lokhu kungabangelwa izinto eziningi ezahlukene, kusukela ezimweni ezilula ezifana namatshe enyongo kuya ezimweni ezimbi kakhulu njengomdlavuza.
- Ukuhlolwa kwegazi, ama-scan, futhi ikakhulukazi ukuhlolwa okufana ne-ERCP kubaluleke kakhulu ekuxilongweni okunembile.
- Ezimweni eziningi, ipayipi lingavulwa kusetshenziswa i-ERCP ngaphandle kokuhlinzwa.
- Impilo yakho yesikhathi esizayo incike embangweni wokuvaleka kwe-bile duct yakho, ngakho-ke kubalulekile ukufuna iseluleko sezokwelapha ngokushesha okukhulu.
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