Amatshe amatshe amade

Ama-gallstones amadiphozi aqinile akha ngaphakathi kwe-gallbladder. Lokhu kungaba kuncane njengohlamvu lwesihlabathi noma kukhulu njengebhola legalufu.

Imbangela yamatshe enyongo iyahlukahluka. Kunezinhlobo ezimbili eziyinhloko zamatshe enyongo:

• Amatshe enziwe nge-cholesterol - Lolu uhlobo oluvame kakhulu. Ama-cholesterol gallstones awahlobene nezinga le-cholesterol egazini. Ezimweni eziningi, azibonakali kwizikena ze-CT.
• Amatshe enziwe nge-bilirubin - Lawa abizwa ngamatshe e-pigment. Zenzeka lapho amaseli abomvu egazi ebhujiswa futhi i-bilirubin eningi kakhulu isenyameni.

Ama-gallstones ajwayelekile kakhulu ku:

• Ubulili besifazane
• Abomdabu baseMelika kanye nabantu bomdabu waseSpain
• Abantu abangaphezu kweminyaka engama-40
• Abantu abakhuluphele ngokweqile
• Abantu abanomlando womndeni wama-gallstones

Izici ezilandelayo zikwenza ube sethubeni lokuthuthukisa ama-gallstones:

• Umnkantsha wethambo noma ukufakelwa isitho esiqinile
• Isifo sikashukela
• Ukwehluleka kwe-gallbladder ukukhipha inyongo ngendlela efanele (lokhu kungenzeka kakhulu ukuthi kwenzeke ngesikhathi sokukhulelwa)
• Ukutheleleka kwesibindi nokutheleleka kwe-biliary tract (amatshe anombala)
• Izimo zezokwelapha ezibangela ukuthi amaseli abomvu amaningi kakhulu abhujiswe
• Ukwehla kwesisindo okusheshayo ekudleni ukudla okunekhalori eliphansi kakhulu, noma ngemuva kokuhlinzwa kwesisindo
• Ukuthola ukondleka ngomthambo isikhathi eside (ukuphakelwa ngemithambo)
• Ukuphuza amaphilisi okuvimbela inzalo

Abantu abaningi abanezinyongo abanazo izimpawu. Lezi zivame ukutholakala ngesikhathi se-x-ray ejwayelekile, ukuhlinzwa esiswini, noma enye inqubo yezokwelapha.

Kodwa-ke, uma itshe elikhulu livimba ithubhu noma umgudu okhipha i-gallbladder, ungaba nobuhlungu obucindezelayo maphakathi nesisu esiswini sangakwesokudla. Lokhu kwaziwa njenge-biliary colic. Ubuhlungu buyaphela uma itshe lidlula engxenyeni yokuqala yamathumbu amancane.

Izimpawu ezingenzeka zifaka:

• Ubuhlungu esiswini esingaphezulu phezulu noma esiphakathi esiswini okungenani imizuzu engama-30. Ubuhlungu bungaba njalo noma buphikisane. Izwakala icijile noma ifiphele.
• Imfiva.
• Ukuphuzi kwesikhumba nabamhlophe bamehlo (i-jaundice).

Ezinye izimpawu zingafaka:

• Izitulo ezinombala wobumba
• Isicanucanu nokuhlanza

Ukuhlolwa okusetshenziselwa ukuthola amatshe enyongo noma ukuvuvukala kwe-gallbladder kufaka:

• I-Ultrasound, isisu
• I-CT scan, isisu
• I-Endoscopic retrograde cholangiopancreatography (ERCP)
• Isikena se-gallbladder radionuclide
• I-endoscopic ultrasound
• Imagnetic resonance cholangiopancreatography (MRCP)
• I-Percutaneous transhepatic cholangiogram (PTCA)

Umhlinzeki wakho wezokunakekelwa kwempilo anga-oda lokhu kuhlolwa kwegazi okulandelayo:

• I-Bilirubin
• Ukuhlolwa kokusebenza kwesibindi
• Qedela ukubalwa kwegazi
• I-enzyme yePancreatic

UKUHLINZA

Isikhathi esiningi, ukuhlinzwa akudingeki ngaphandle kokuthi kuqale izimpawu. Kodwa-ke, abantu abahlela ukuhlinzwa kwesisindo bangadinga ukuthi kususwe amatshe enyongo ngaphambi kokwenza inqubo. Ngokuvamile, abantu abanezimpawu bazodinga ukuhlinzwa ngokushesha noma ngemuva nje kokutholakala kwetshe.

• Inqubo ebizwa ngokuthi yi-laparoscopic cholecystectomy isetshenziswa kakhulu. Le nqubo isebenzisa ukusikeka okuncane kokuhlinzwa, okuvumela ukululama ngokushesha. Isiguli singaya ekhaya sisuka esibhedlela kungakapheli usuku olungu-1 luhlinziwe.
• Esikhathini esedlule, i-cholecystectomy evulekile (ukususwa kwe-gallbladder) yayijwayele ukwenziwa. Noma kunjalo, le nqubo ayivamile kakhulu manje.

I-Endoscopic retrograde cholangiopancreatography (ERCP) kanye nenqubo ebizwa nge-sphincterotomy ingenziwa ukuthola noma ukwelapha amatshe enyongo emgodleni ovamile we-bile.

IMITHI

Imithi inganikezwa ngefomu lephilisi ukuncibilikisa amatshe enyongo e-cholesterol. Kodwa-ke, le mithi ingathatha iminyaka emi-2 noma ngaphezulu ukusebenza, futhi amatshe angabuya emuva kokuphela kokwelashwa.

Imvamisa, amakhemikhali adluliselwa esinyeni nge-catheter. Amakhemikhali ancibilika ngokushesha amatshe e-cholesterol. Lokhu kwelashwa kunzima ukukwenza, ngakho akwenziwa kaningi. Amakhemikhali asetshenzisiwe angaba nobuthi, futhi ama-gallstones angabuya.

LITHOTRIPSY

I-shock wave lithotripsy (ESWL) ye-gallbladder nayo isetshenziselwe abantu abangakwazi ukuhlinzwa. Le ndlela yokwelapha ayisetshenziswa kaningi njengakuqala ngoba amatshe enyongo avame ukubuya.

Ungadinga ukuthi ube ekudleni oketshezi noma uthathe ezinye izinyathelo ukunikeza i-gallbladder yakho ukuphumula ngemuva kokuphathwa. Umhlinzeki wakho uzokunika imiyalo lapho uphuma esibhedlela.

Ithuba lezimpawu noma izinkinga ezivela ekuhlinzweni kwamatshe enyongo liphansi. Cishe bonke abantu abahlinzwa i-gallbladder abanazo izimpawu zabo ezibuyayo.

Ukuvinjelwa ngamatshe enyongo kungadala ukuvuvukala noma ukutheleleka ku:

• I-gallbladder (cholecystitis)
• I-Tube ethwala inyongo isuka esibindi iye e-gallbladder nasemathunjini (cholangitis)
• Amapancreas (pancreatitis)

Shayela umhlinzeki wakho uma une:

• Ubuhlungu engxenyeni engenhla yesisu sakho
• Ukuphuzi kwesikhumba noma abamhlophe bamehlo

Kubantu abaningi, amatshe enyongo awakwazi ukuvinjelwa. Kubantu abakhuluphele ngokweqile, ukugwema ukulahleka kwesisindo ngokushesha kungasiza ekuvimbeleni ama-gallstones.

Cholelithiasis; Ukuhlaselwa kwe-gallbladder; I-colic Biliary; Ukuhlaselwa kweGallstone; Izibalo ze-biliary: ama-gallstones chenodeoxycholic acid (CDCA); I-Ursodeoxycholic acid (UDCA, ursodiol); Ama-endoscopic retrograde cholangiopancreatography (ERCP) - amatshe enyongo

• Ukususwa kwe-gallbladder - laparoscopic - ukukhipha
• Ukususwa kwe-gallbladder - ukukhishwa okuvulekile
• Amatshe amatshe amatshe - ukukhipha

• Uhlelo lokugaya ukudla
• I-cyst yezinso enama-gallstones - i-CT scan
• Amatshe amatshe enyakatho, i-cholangiogram
• Cholecystolithiasis
• I-Cholelithiasis
• I-gallbladder
• Ukususwa kwe-gallbladder - Series

UFogel EL, uSherman S. Izifo ze-gallbladder ne-bile ducts. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 155.

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.

U-Wang D QH, Afdhal NH. Isifo se-Gallstone. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. ISleisenger neFordtran's Gastrointestinal and Liver Disease: IPathophysiology / Diagnosis / Management. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 65.