Ukuqiniswa kwemigwaqo emide

Ukuqiniswa kwe-bile duct kungukunciphisa okungavamile komgudu ovamile we-bile. Lena ithubhu ehambisa inyongo kusuka esibindini iye emathunjini amancane. Inyoni yinto esiza ngokugaya.

Ukuqiniswa kwe-bile duct kuvame ukubangelwa ukulimala emibhedeni ye-bile ngesikhathi sokuhlinzwa. Isibonelo, kungenzeka ngemuva kokuhlinzwa ukususa i-gallbladder.

Ezinye izimbangela zalesi simo zifaka:

• Umdlavuza we-bile duct, isibindi noma amanyikwe
• Ukulimala nokusikeka ngenxa yetshe lenyongo emgodleni we-bile
• Ukulimala noma ukusikeka ngemuva kokususwa kwe-gallbladder
• I-Pancreatitis
• I-primary sclerosing cholangitis

Izimpawu zifaka:

• Ubuhlungu besisu ohlangothini olungakwesokudla kwesisu
• Amakhaza
• Imfiva
• Ukulunywa
• Ukuzizwa okuvamile kokungahambi kahle
• Ukuphelelwa isifiso sokudla
• I-jaundice
• Isicanucanu nokuhlanza
• Izitulo ezinombala ophuzi noma ezinobumba

Ukuhlolwa okulandelayo kungasiza ukuxilonga lesi simo:

• I-Endoscopic retrograde cholangiopancreatography (ERCP)
• I-Percutaneous transhepatic cholangiogram (PTC)
• Imagnetic resonance cholangiopancreatography (MRCP)
• I-endoscopic ultrasound (EUS)

Ukuhlolwa kwegazi okulandelayo kungasiza ukuveza inkinga ngohlelo lwe-biliary.

• I-alkaline phosphatase (ALP) iphakeme kunokujwayelekile.
• Izinga le-enzyme le-GGT liphakeme kunokujwayelekile.
• Izinga leBilirubin liphakeme kunokujwayelekile.

Lesi simo singashintsha nemiphumela yokuhlolwa okulandelayo:

• Izinga le-Amylase
• Izinga leLipase
• Umchamo bilirubin
• Isikhathi se-Prothrombin (PT)

Umgomo wokwelashwa ukulungisa ukunciphisa. Lokhu kuzovumela i-bile ukuthi igeleze isuka esibindini iye emathunjini.

Lokhu kungabandakanya:

• Ukuhlinzwa
• I-Endoscopic noma i-percutaneous dilation noma ukufakwa kwama-stents ngokuqina

Uma ukuhlinzwa kwenziwa, ukuqina kuyasuswa. Umgudu ovamile we-bile uzohlanganiswa namathumbu amancane.

Kwezinye izimo, insimbi encane noma ipulasitiki (mesent tube) ibekwa ngaphesheya kwesibopho se-bile duct ukuyigcina ivulekile.

Ukwelashwa kuyaphumelela isikhathi esiningi. Impumelelo yesikhathi eside incike embangela yokuqina.

Ukuvuvukala nokuncipha komsele we-biliary kungabuya kwabanye abantu. Kukhona ingozi yokutheleleka ngaphezu kwendawo encishisiwe. Ukuqina okuhlala isikhathi eside kungaholela ekulimaleni kwesibindi (i-cirrhosis).

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma izimpawu zibuya ngemuva kwe-pancreatitis, i-cholecystectomy, noma okunye ukuhlinzwa kwe-biliary.

Ukuqiniswa kwemigwaqo emide; Ukuqina kwe-biliary

• Indlela yeBile

I-Anstee QM, uJones DEJ. I-hepatology. Ku: Ralston SH, ID Penman, Strachan MWJ, Hobson RP, eds. Izimiso zikaDavidson kanye Nokuzijwayeza Kwezokwelapha. Umhla ka-23. IPhiladelphia, PA: Elsevier; 2018: isahluko 22.

UFogel EL, uSherman S. Izifo ze-gallbladder ne-bile ducts. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 146.

U-Ibrahim-zada I, Ahrendt SA. Ukuphathwa kwezimpawu ze-biliary ezinobungozi. Ku: UCameron AM, uCameron JL, ama-eds. Ukwelashwa Kwamanje. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: isahluko 462-466.

UJackson PG, u-Evans SRT. Uhlelo Biliary. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 54.