I-cholangiogram ye-transhepatic enamandla

I-percutaneous transhepatic cholangiogram (PTC) iyi-x-ray yamapayipi enyongo. Lawa amashubhu athwala inyongo kusuka esibindini kuya enyongweni nasemathunjini amancane.

Ukuhlolwa kwenziwa emnyangweni we-radiology ngudokotela we-radiologist ongenelayo.

Uzocelwa ukuba ulale ngomhlane etafuleni le-x-ray. Umhlinzeki uzohlanza indawo engenhla yangakwesokudla naphakathi kwesisu sakho abese esebenzisa umuthi onamafutha.

Ama-X-ray ne-ultrasound asetshenziselwa ukusiza umhlinzeki wezokunakekelwa kwempilo ukuthi athole imithambo yakho yesibindi nenyongo. Inaliti ende, ezacile, eguquguqukayo bese ifakwa esikhunjeni esibindini. Umhlinzeki ujova udayi, obizwa ngokuthi owokuqhathanisa, emiphongolweni ye-bile. Umehluko usiza ukugqamisa izindawo ezithile ukuze zibonakale. Ama-x-ray amaningi ayathathwa njengoba udayi ugeleza ngemigudu ye-bile ungene emathunjini amancane. Lokhu kungabonakala kumqapha wevidiyo oseduze.

Uzonikezwa umuthi wokukudambisa (sedation) ngale nqubo.

Yazisa umhlinzeki wakho uma ukhulelwe noma unenkinga yokopha.

Uzonikezwa ingubo yokugqoka esibhedlela futhi uzocelwa ukuthi ukhiphe bonke ubucwebe.

Uzocelwa ukuthi ungadli noma uphuze noma yini amahora angu-6 ngaphambi kokuhlolwa.

Tshela umhlinzeki wakho uma uthatha noma iziphi izinciphisi zegazi ezifana neWarfarin (coumadin), iPlavix (clopidogrel), Pradaxa, noma iXarelto.

Kuzoba khona udosi njengoba kunikezwa umuthi wokubulala izinzwa. Ungase ube nokungakhululeki njengoba inaliti ithuthukela esibindini. Uzoba ne-sedation yale nqubo.

Lokhu kuhlolwa kungasiza ukuxilonga imbangela yokuvinjelwa kwe-bile duct.

Inyoni iwuketshezi olukhishwa yisibindi. Iqukethe i-cholesterol, usawoti we-bile, nemikhiqizo kadoti. Usawoti we-bile usiza umzimba wakho ukwehla (ukugaya) amafutha. Ukuvaleka komgudu wenyongo kungaholela ku-jaundice (ukushintsha kombala okuphuzi kwesikhumba), ukulunywa kwesikhumba, noma ukutheleleka kwesibindi, i-gallbladder noma amanyikwe.

Uma yenziwa, i-PTC ivame ukuba yingxenye yokuqala yenqubo yezinyathelo ezimbili ukukhulula noma ukwelapha ukuvinjelwa.

• I-PTC yenza "umgwaqo wendlela" wamapayipi enyongo, angasetshenziswa ukuhlela ukwelashwa.
• Ngemuva kokuthi umgwaqo wenziwe, ukuvinjelwa kungalashwa ngokubeka i-stent noma ithubhu elincanyana elibizwa ngokuthi yi-drain.
• Ukukhipha noma i-stent kuzosiza umzimba ukuthi ususe inyongo emzimbeni. Leyo nqubo ibizwa ngokuthi yi-Percutaneous Biliary Drainage (PTBD).

Amapayipi e-bile ajwayelekile ngosayizi nokubukeka kweminyaka yomuntu lowo.

Imiphumela ingakhombisa ukuthi amapayipi akhulisiwe. Lokhu kungasho ukuthi amapayipi avinjiwe. Ukuvinjelwa kungadalwa yisibazi noma ngamatshe. Kungakhombisa nomdlavuza emathangeni e-bile, isibindi, amanyikwe, noma isifunda se-gallbladder.

Kukhona ithuba elincane lokuphendula okweqile kumaphakathi wokuqhathanisa (iodine). Kukhona nengozi encane yoku:

• Ukulimala kwezitho eziseduze
• Ukulimala kwesibindi
• Ukwehla kwegazi ngokweqile
• Ubuthi begazi (sepsis)
• Ukuvuvukala kwemibhobho yenyongo
• Ukutheleleka

Esikhathini esiningi, lolu vivinyo lwenziwa ngemuva kokuhlolwa kwe-endoscopic retrograde cholangiopancreatography (ERCP) kuqala. I-PTC ingenziwa uma ukuhlolwa kwe-ERCP kungenakwenziwa noma kwehlulekile ukususa ukuvinjelwa.

I-magnetic resonance cholangiopancreatreatography (MRCP) iyindlela entsha yokuthwebula engeyona eyokuhlasela, esekwe kwimifanekiso yamagnetic resonance (MRI). Iphinde inikeze ukubukwa kwamapayipi enyongo, kepha akwenzeki njalo ukwenza lokhu kuhlolwa. Futhi, i-MRCP ayinakusetshenziswa ukwelapha ukuvinjelwa.

I-PTC; Cholangiogram - PTC; I-PTC; I-PBD - Amapayipi we-biliary we-Percutaneous; I-Percutaneous transhepatic cholangiography

• I-gallbladder anatomy
• Indlela yeBile

UChockalingam A, uGeorgiades C, uHong K. Ukungenelela kweTranshepatic kwe-jaundice evimbelayo. Ku: UCameron JL, uCameron AM, ama-eds. Ukwelashwa Kwamanje. Umhla ka-12. IPhiladelphia, PA: Elsevier; 2017: 475-483.

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.

ILidofsky SD. I-jaundice. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 21.

IStockland AH, iBaron TH. Ukwelashwa kwe-Endoscopic ne-radiologic yesifo se-biliary. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 70.