Ukuvinjelwa komfula obilisiwe

Ukuvinjelwa komgudu wamanzi ukuvaleka kwamashubhu athwala inyongo kusuka esibindini kuya enyongweni nasemathunjini amancane.

Inyoni iwuketshezi olukhishwa yisibindi. Iqukethe i-cholesterol, usawoti we-bile, nemikhiqizo kadoti efana ne-bilirubin. Usawoti we-bile usiza umzimba wakho ukwehla (ukugaya) amafutha. UBile udlula ngaphandle kwesibindi ngemigudu yenyongo futhi ugcinwe enyongweni. Ngemuva kokudla, ukhishelwa emathunjini amancane.

Lapho amapayipi enyongo evimbekile, inyongo iyakheka esibindini, kuthi i-jaundice (umbala ophuzi wesikhumba) ikhule ngenxa yezinga elandayo le-bilirubin egazini.

Izimbangela ezingaba khona zomgudu we-bile ovinjiwe zifaka:

• Ama-cysts we-bile duct ejwayelekile
• Ama-lymph node akhulisiwe e-porta hepatis
• Amatshe amatshe amade
• Ukuvuvukala kwemibhobho yenyongo
• Ukuncipha kwamapayipi enyongo kusuka ekuqhamukeleni
• Ukulimala kusuka ekuhlinzweni kwe-gallbladder
• Izimila zemibhobho yenyongo noma amanyikwe
• Izimila ezisakazekele ohlelweni lwe-biliary
• Izikelemu zesibindi nenyongo (ukuqubuka)

Izici zobungozi zifaka:

• Umlando wama-gallstones, i-pancreatitis engapheli, noma umdlavuza we-pancreatic
• Ukulimala endaweni yesisu
• Ukuhlinzwa okwenziwe nge-biliary kwakamuva
• Umdlavuza wakamuva we-biliary (njengomdlavuza we-bile duct)

Ukuvaleka nakho kungabangelwa izifo. Lokhu kuvame kakhulu kubantu abanamasosha omzimba abuthakathaka.

Izimpawu zingafaka:

• Ubuhlungu besisu ohlangothini olungaphezulu kwesokudla
• Umchamo omnyama
• Imfiva
• Ukulunywa
• I-jaundice (umbala wesikhumba ophuzi)
• Isicanucanu nokuhlanza
• Izitulo ezinombala onsundu

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuhlola bese ezwa isisu sakho.

Imiphumela elandelayo yokuhlolwa kwegazi ingabangelwa ukuvinjelwa okungenzeka:

• Izinga le-bilirubin elandisiwe
• Izinga le-alkaline phosphatase elandisiwe
• Ukwandisa ama-enzyme wesibindi

Ukuhlolwa okulandelayo kungasetshenziselwa ukuphenya umgudu we-bile ovinjiwe:

• I-ultrasound yesisu
• Iskena se-CT esiswini
• I-Endoscopic retrograde cholangiopancreatography (ERCP)
• I-Percutaneous transhepatic cholangiogram (PTCA)
• Imagnetic resonance cholangiopancreatography (MRCP)
• I-endoscopic ultrasound (EUS)

Umgudu we-bile ovinjiwe ungashintsha nemiphumela yokuhlolwa okulandelayo:

• Ukuhlolwa kwegazi le-Amylase
• Isikena se-gallbladder radionuclide
• Ukuhlolwa kwegazi kukaLipase
• Isikhathi se-Prothrombin (PT)
• Umchamo bilirubin

Inhloso yokwelashwa ukukhulula ukuvinjelwa. Amatshe angasuswa kusetshenziswa i-endoscope ngesikhathi se-ERCP.

Kwezinye izimo, kudingeka ukuhlinzwa ukuze kudlule ukuvinjelwa. I-gallbladder ivame ukususwa ngokuhlinzwa uma ukuvinjelwa kubangelwa ama-gallstones. Umhlinzeki wakho anganikeza ama-antibiotic uma kusolwa ukutheleleka.

Uma ukuvinjelwa kubangelwa umdlavuza, umgudu ungadinga ukunwetshwa. Le nqubo ibizwa ngokuthi yi-endoscopic noma i-percutaneous (ngesikhumba esiseduze kwesibindi). Kungadingeka ukuthi kufakwe ithubhu ukuze kuvunyelwe amanzi.

Uma ukuvinjelwa kungalungiswa, kungaholela ekuthelelekeni okusongela impilo kanye nokwakhiwa okuyingozi kwe-bilirubin.

Uma ukuvinjelwa kuhlala isikhathi eside, kungavela isifo esingalapheki sesibindi. Izithiyo eziningi zingelashwa nge-endoscopy noma ngokuhlinzwa. Izithiyo ezibangelwa umdlavuza zivame ukuba nomphumela omubi kakhulu.

Ukushiywa kungalashwa, izinkinga ezingaba khona zibandakanya ukutheleleka, isifo sepsis, nesifo sesibindi, njenge-biliary cirrhosis.

Shayela umhlinzeki wakho uma:

• Qaphela ushintsho kumbala womchamo wakho nezitulo zakho
• Thuthukisa i-jaundice
• Unezinhlungu zesisu ezingapheli noma ezilokhu zivela njalo

Qaphela noma yiziphi izinto ezinobungozi onazo, ukuze uthole ukuxilongwa nokwelashwa ngokushesha uma umgudu wenyongo uvinjelwa. Ukuvinjelwa uqobo kungenzeka kungavinjelwa.

Ukuvinjelwa kwe-biliary

• Uhlelo lokugaya ukudla
• Izindlala ze-Endocrine
• Indlela yeBile
• Ukuvinjelwa kwe-biliary - uchungechunge

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.

ILidofsky SD. I-jaundice. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 21.