Ingabe nawe uke waba nomsele we-bile onciphile? Ake sifunde nge-Biliary Stricture.

Wake wezwa ngesimo esibizwa ngokuthi i-biliary stricture? Mhlawumbe uke wezwa ubuhlungu engxenyeni ephezulu kwesokudla yesisu sakho kanye nokuphuzi kwesikhumba sakho (njenge -jaundice )? Lokhu kuyinto engase ikuthakazelise. Namuhla sizokhuluma ngesimo esibizwa ngokuthi i-biliary stricture . Ungakhathazeki, ukuqonda lokhu kahle kungakusiza ukuxazulula izinkinga eziningi.

Kuyini i-Biliary Stricture? Masiyiqonde kalula!

Kalula nje, i-Biliary Stricture yilapho imibhobho ye-bile emzimbeni wakho incipha ngenxa yesifo esithile, ukulimala , noma ukuvaleka. Cabanga ngakho njengepayipi lamanzi elivalekile, futhi amanzi azogeleza kancane. Lapho le mibhobho ye-bile iba mincane, ukugeleza kwe-bile kusuka esibindini kuya emathunjini amancane kuyavinjelwa. Kwenzekani-ke? I-Bile iqala ukuqongelela emzimbeni, okwenza kube nzima ukugaya ukudla. Lokhu kubizwa nangokuthi "i-bile duct stricture."

Ngakho-ke ziyini lezi zindlela zokugaya inyongo?

Kulungile, manje ake sibheke ukuthi imibhobho yenyongo iyini. Lawa afana namapayipi amancane axhumanisa izitho ohlelweni lwakho lokugaya ukudla . Isibindi sakho senza uketshezi olubizwa ngokuthi inyongo. Lenyongo ikusiza ukuthi ugaye ukudla. Ngakho-ke, le mibhobho yenyongo ithatha inyongo iyiyise emathunjini akho amancane. Lapho, ama-asidi enyongo aphula amafutha namaprotheni ekudleni kwakho futhi akusize ukuthi ukugaye. Imbobo yakho yenyongo ixhumana nembobo yakho yenyongo. Le mbobo yenyongo ikhipha ama-enzyme, uhlobo lwephrotheni, olukusiza ukuthi ugaye ukudla.

Kuvame kangakanani lokhu kuncipha kwemigudu yenyongo?

Ochwepheshe abazi kahle ukuthi bangaki abantu abathola lokhu kuncipha kwemisele yenyongo minyaka yonke. Kodwa-ke, kubonakala sengathi lesi simo siya ngokuya siba sivame kakhulu. Esinye isizathu kungaba ukwanda kokuhlinzwa kokususwa kwenyongo , ikakhulukazi i-laparoscopic cholecystectomy . Phakathi nalokhu kuhlinzwa, imisele yenyongo ngezinye izikhathi ingalimala futhi ibe nezibazi, okungabangela ukuba inciphe. Kodwa-ke, lesi simo asivamile kakhulu ezinganeni ezincane.

Yiziphi izimbangela eziyinhloko zokuncipha kwe-bile duct?

Akuvamile kakhulu ukuthi umntwana abe nomsele we-bile oncishisiwe lapho ezalwa. Kuyisimo sokuzalwa . Kodwa-ke, ezimweni eziningi, cishe izingane eziyisikhombisa kweziyishumi, lokhu kuncipha komsele we-bile kubangelwa umdlavuza. Lokhu kuyiqiniso ikakhulukazi kumdlavuza we-pancreatic kanye ne -cholangiocarcinoma.Lena imbangela eyinhloko. Lezi zinhlobo zomdlavuza zingabangela nokuvaleka kwemisele yenyongo:

• Umdlavuza wenyongo
• Umdlavuza we-hepatocellular
• Umdlavuza wesibindi
• I-Lymphoma
• Ukusabalala komdlavuza kwezinye izingxenye zomzimba ( i-Metastasis )
• Umdlavuza wamathumbu amancane

Yiziphi ezinye izimo ngaphandle komdlavuza ezingadala lokhu?

Ukuncipha kwe-bile duct kungenzeka ngenxa yezimo ezingezona ezomdlavuza (ezingemnandi), ezibangela cishe amaphesenti angu-30 amacala. Kungabangelwa futhi ukwelashwa okuthile. Ake sibheke ukuthi ziyini:

• Ukulimala kwesisu noma ukuhlukumezeka
• I-Autoimmune pancreatitis kanye ne-pancreatitis (ukuvuvukala kwe-pancreas)
• Izibazi zomsele wenyongo ezivela ematsheni enyongo
• `I-Mirizzi syndrome` (lokhu kwenzeka lapho amatshe enyongo ehlala enyongweni futhi evimba imigudu yenyongo)
• I-cholangitis eyinhloko ye-biliary
• I-cholangitis eyinhloko ye-sclerosing
• Ukwelashwa ngemisebe

Kuyini lokhu `(i-Anastomotic biliary stricture)`?

Ezinye izindlela zokuhlinzwa, njengenqubo kaWhipple (ukuhlinzwa okukhulu komdlavuza we-pancreatic) noma ukufakelwa kwesibindi, kungabangela ukuqina kwe-biliary anastomotic. Kulezi zindlela zokuhlinzwa, udokotela ohlinzayo uxhuma kabusha amapayipi ohlelweni lwakho lokugaya ukudla. Lokhu kuxhuma kabusha kubizwa ngokuthi i-anastomosis. Ngezinye izikhathi, imigudu ye-bile ingonakala noma ibe nezibazi futhi inciphe lapho ixhunywe khona. Lokhu kubizwa ngokuthi i-anastomotic biliary stricture.

Ziyini izimpawu ze-bile duct stenosis?

Uma unalesi simo, ungase ube nezimpawu ezinjengalezi. Khumbula ukuthi ukuba nezimpawu eyodwa noma ezimbili kuphela akusho ukuthi unesifo, kodwa kubalulekile ukuzazi.

• Ubuhlungu ohlangothini oluphezulu kwesokudla lwesisu .
• Uzizwa sengathi uthola umkhuhlane futhi umzimba wakho uyabanda .
• Umbala wesihlalo sakho ungashintsha . Ungaba mpunga noma ukhanye, njengobumba.
• Ukulunywa kwesikhumba njalo (i-Pruritus).
• I-Jaundice : Lokhu kuwukuphuzi kwamehlo nesikhumba okumhlophe.
• Ukulahlekelwa yisifiso sokudla .
• Ukuzizwa unesicanucanu nokuhlanza .

Yiziphi izinkinga ezingavela uma lokhu kuqhubeka?

Uma umsele we-bile uncipha noma uvalekile isikhathi eside, i-bile inganqwabelana esibindini. Uma lokhu kwenzeka, ungaba nezifo , izifo zesibindi , kanye nezibazi esibindini, okungaholela ezimweni ezifana ne -cirrhosis yesibindi . Yingakho kubalulekile ukuqaphela lezi zimpawu.

Hlobo luni lodokotela oludingekayo ukuze kuhlolwe futhi kwelashwe lesi simo?

Uma unalezi zimpawu, kufanele uqale ubonane nodokotela wezifo zamathumbu, udokotela ogxile ezifweni ezihlobene nohlelo lokugaya ukudla . Nguye ongakwazi ukuxilonga nokwelapha lezi zimo ngokunembile.

Odokotela bakuthola kanjani lokhu kuncipha kwemigudu ye-bile?

Uchwepheshe wakho angenza izivivinyo eziningana ukuqinisekisa lesi simo.

• Ukuhlolwa kwegazi:
• Ukuhlolwa kwe-Bilirubin: Lapho imigudu ye-bile iba mincane noma ivalekile, umkhiqizo ongcolile obizwa ngokuthi i-bilirubin e-bile uyaqongelela emzimbeni. Lokhu kuhlolwa kulinganisa lelo zinga.
• Ukuhlolwa kokusebenza kwesibindi: Lokhu kuhlola amazinga aphezulu e-enzyme yesibindi.

• Ukuhlolwa kwezithombe: Lokhu kuhlolwa kungabheka isimo semibhobho yenyongo emzimbeni.
• I-Ultrasound: Lokhu kusebenzisa amaza omsindo ukuthatha izithombe zemibhobho yenyongo ukuze kuboniswe ukuvaleka noma ukuncipha. Ungase futhi ube ne -ultrasound ye-endoscopic ( i-ultrasound eyenziwe ngepayipi ngekhamera), i-ultrasound yesisu, noma i-ultrasound yesibindi.
• I-Endoscopic retrograde cholangiopancreatography (ERCP): Lokhu kuyinhlanganisela ye-endoscopy ephezulu kanye ne-X-ray. Umphimbo wakho uphelelwe amandla futhi kufakwa i-endoscope (ithubhu eguquguqukayo enekhamera) ukuze kubhekwe izitho ezisesiswini sakho kanye nemisele yenyongo. Ngalesi sikhathi, isampula yezicubu ingathathwa kusetshenziswa imishini ekhethekile bese ithunyelwa ukuze kwenziwe i-biopsy . Le biopsy ingasetshenziswa futhi ukuhlola amangqamuzana omdlavuza.
• I-Magnetic resonance cholangiopancreatography (MRCP): Lolu ukuhlolwa kwe-MRI okuthuthukisiwe okungathatha izithombe ezicacile ze-bile ducts yakho, isibindi, i-pancreas, kanye ne-gallbladder.
• I-Percutaneous transhepatic cholangiography (PTC): Lolu ukuhlolwa kwe-X-ray okukhethekile. Kulolu vivinyo, udokotela ufaka idayi ekhethekile (idayi yokungafani) ngesibindi sakho iye emigudwini ye-bile. Ama-X-ray abe esesetshenziselwa ukubona ukuthi idayi ihamba kanjani emigudwini ye-bile iye emathunjini amancane. Idayi ingabonisa noma yikuphi ukuvinjelwa.

Kuphathwa kanjani lokhu kuncipha komsele wenyongo?

Ngezinye izikhathi, odokotela bangase futhi baphathe imbangela yokuvaleka kwe-bile duct ngesikhathi esifanayo njengoba benza i-ERCP noma i-PTC. Kuye ngembangela, udokotela angenza izinto ezinjengalezi:

• Uma kukhona amatshe enyongweni, wahlukanise bese uwasusa.
• Kusetshenziswa idivayisi efana nebhaluni ukuze kwandiswe umsele wenyongo oncishisiwe, kufakwa i -stent (ithubhu elincane elenziwe ngensimbi noma ngepulasitiki) ukuze livimbele ukuthi linganciphi futhi.
• Ukususa izimila, uma zikhona.

Yiziphi izindlela zokwelapha ngokuhlinzwa?

Inani elincane kuphela labantu elidinga ukuhlinzwa ukuze kulungiswe umsele wenyongo onciphile. Uma ukuncipha kubangelwa umdlavuza, ukuhlinzwa kungenzeka. Izinketho zokuhlinzwa zifaka:

• Ukuhlinzwa kwe-bypass kwenziwa ukuze kugwenywe umgudu we-bile ovinjiwe bese kuhanjiswa i-bile emathunjini amancane.
• Ingxenye enesifo yomsele wenyongo iyasikwa bese isuswa (Ukususwa) bese ingxenye ephilile ixhunywa kabusha (i-Anastomosis).

Ingabe lesi simo singaphinde sibuye ngemva kokwelashwa?

Yebo, kungenzeka ukuthi i-bile duct iphinde ibe mncane ngemva kokwelashwa nokuvulwa. Uma lokhu kwenzeka, udokotela wakho angenza ukuhlinzwa kokuhlola i-bile duct ukuze asuse i-bile duct encishisiwe. Ngemva kokususwa, i-bile duct enempilo kanye namathumbu amancane kuyaxhunyaniswa.

Ingabe zikhona izinkinga ngemva kokwelashwa?

Izinkinga ngemva kokwelashwa ziyahlukahluka kuye ngokwelashwa. Abanye abantu bangase babe ne -pancreatitis ebukhali (ukuvuvukala kwe-pancreas) ngemva kwe-ERCP. Ngakho-ke, kubalulekile ukulandela imiyalelo kadokotela wakho ngokucophelela.

Ingabe kukhona esingakwenza ukuvimbela lo msele wenyongo ukuthi unciphe?

Kunezinto ongazenza ukuze unciphise ingozi yakho yokuthola ezinye izimo ezingabangela ukuvaleka kwe-bile duct. Isibonelo:

• Yidla ukudla okunempilo okunezithelo nemifino emisha.
• Yehlisa amazinga akho e-cholesterol . Lokhu kuzosiza ekugcineni impilo yenyongo futhi kuvimbele ukwakheka kwamatshe enyongo.
• Gcina isisindo esinempilo esikufanele.
• Uma unezinkinga ngokusebenzisa utshwala, thola usizo. Lokhu kungasiza ekuvimbeleni i-pancreatitis kanye nokunye ukulimala kwesibindi.

Into ebaluleke kakhulu ukuzama ukugcina indlela yokuphila enempilo. Izinto ezifana nokudla okunempilo nokuzivocavoca umzimba kuzokuvikela ezifweni eziningi.

Iyini inhloso yokululama komuntu onalesi simo?

Amathemba akho okululama ancike embangeni yokuvaleka kwe-bile duct yakho. Ukwelashwa okuvula i-bile duct evalekile kuvame ukuphumelela. Kodwa-ke, isimo esiyisisekelo esibangele ukuvaleka (njengomdlavuza) singadinga ukwelashwa okuyinkimbinkimbi kakhulu.

Sinjani isikhathi sokululama ngemva kokwelashwa?

Isikhathi sakho sokululama, okusho ukuthi ungabuyela ngokushesha kangakanani emsebenzini, esikoleni, kanye nemisebenzi evamile, sizohluka kuye ngohlobo lokwelashwa olutholile. Ukwelashwa okungenasidingo njenge-ERCP kuvame ukuba kusheshe futhi kungabi buhlungu kakhulu kunokuhlinzwa okuvulekile okudinga ukusikwa okukhulu. Kubalulekile ukulandela imiyalelo kadokotela wakho ngokucophelela ukuqinisekisa ukuthi ululama ngokuphephile. Ungase utshelwe ukuthi udle ukudla okumanzi, okungenalutho isikhashana, noma ushintshe ukudla kwakho ukuze ufake ukudla okulula ukukugaya .

Kufanele ngimbone nini udokotela?

Uma unezinye zalezi zimpawu, xhumana nodokotela ngokushesha:

• Umkhuhlane oqhubekayo.
• Ubuhlungu besisu obuphindaphindayo.
• Izimpawu zokutheleleka ngemva kokwelashwa (isib., ukuphuma kobomvu esilondeni, ukubomvu).
• Ukwehlisa isisindo ngaphandle kwesizathu, ukuzizwa unesicanucanu, noma ukuhlanza.
• Amhlophe emehlweni noma esikhumbeni aphenduka abe phuzi (i-jaundice) .

Yini okufanele ngiyibuze udokotela wami?

Ungabuza udokotela imibuzo efana nale:

• Yini ebangela lokhu kuncipha kwemisele yami yenyongo?
• Yikuphi ukwelashwa okungcono kakhulu kimi?
• Ingabe kukhona engingakwenza ukuze nginciphise ingozi yokuthi lolu hlobo lokuncipha kwe-bile duct luphinde lwenzeke?

Izimpawu ezifana nobuhlungu besisu, umkhuhlane, ukubanda, kanye ne-jaundice zingaba yinkinga enkulu, ikakhulukazi uma zivela ngokuzumayo. Uma uhlangabezana nanoma yiziphi zalezi zimpawu, kungcono ukutshela udokotela wakho ngokushesha. Bangenza izivivinyo ukuthola imbangela futhi batuse ukwelashwa okufanele.

Umyalezo Ofanele Uwuthathe Ekhaya: Izinto Ezibaluleke Kakhulu Okufanele Uzikhumbule

Ngakho-ke, ngithemba ukuthi usuyaqonda kangcono inkinga yokuqina kwenyongo esikhulume ngayo namuhla.

• Lokhu kuwukuncishiswa kwemigudu ye-bile, okuvimbela ukugeleza kwe-bile.
• Kungaba nezizathu eziningi; izinto ezifana nezibazi ezibangelwa ukuhlinzwa, amatshe enyongo, kanye nomdlavuza.
• Qaphela izimpawu ezifana nobuhlungu besisu, i-jaundice, ukulunywa, kanye nokushintsha kombala wendle.
• Uma uhlangabezana nalezi zimpawu, thintana nodokotela wezifo zamathumbu ngokushesha.
• Kukhona ukwelashwa, ngakho ungesabi. Uma kusheshe kutholakale futhi kwelashwe, imiphumela iba ngcono.
• Ukuphila impilo enempilo kuhamba ibanga elide ekuvimbeleni izimo ezinjalo.

Uma uneminye imibuzo mayelana nalokhu, ungangabazi ukukhuluma nodokotela wakho. Hlala uphilile!