Ukuhlinzwa komdlavuza we-pancreatic

Ukuhlinzwa kwepancreatic kwenziwa ukwelapha umdlavuza wendlala yamanyikwe.

Ama-pancreas atholakala ngemuva kwesisu, phakathi kwe-duodenum (ingxenye yokuqala yamathumbu amancane) nobende, nangaphambi komgogodla. Kuyasiza ekugayeni ukudla. Ama-pancreas anezingxenye ezintathu ezibizwa ngekhanda (ukuphela okubanzi), maphakathi, nomsila. Konke noma ingxenye yamanyikwe kuyasuswa kuya ngendawo yesimila somdlavuza.

Ukuthi inqubo yenziwa nge-laparoscopically (kusetshenziswa ikhamera encane yevidiyo) noma kusetshenziswa ukuhlinzwa ngerobhothi kuncike ku:

• Ubukhulu bokuhlinzwa
• Isipiliyoni nenombolo yokuhlinzwa okwenziwe ngudokotela wakho ohlinzayo
• Isipiliyoni nenombolo yokuhlinzwa okwenziwe esibhedlela ozoyisebenzisa

Ukuhlinzwa kwenziwa esibhedlela nge-anesthesia ejwayelekile ngakho ulele futhi awunazinhlungu. Izinhlobo zokuhlinza ezilandelayo zisetshenziselwa ukwelashwa okuhlinzekwayo komdlavuza we-pancreatic.

Inqubo ye-Whipple - Lokhu ukuhlinzwa okuvame kakhulu komdlavuza we-pancreatic.

• Kuyasikwa esiswini sakho bese ikhanda le-pancreas liyasuswa.
• I-gallbladder, i-bile duct, nengxenye ye-duodenum (ingxenye yokuqala yamathumbu amancane) nayo iyakhishwa. Kwesinye isikhathi, ingxenye yesisu iyasuswa.

I-pancreatectomy ekude ne-splenectomy - Lokhu kuhlinzwa kusetshenziselwa kakhulu izicubu eziphakathi nomsila wamanyikwe.

• Kususwa phakathi nomsila wamanyikwe.
• Ubende bungasuswa futhi.

Ingqikithi yepancreatectomy - Lokhu kuhlinzwa akwenziwa kaningi. Kunenzuzo encane ukukhipha wonke amanyikwe uma umdlavuza ungelashwa ngokususa ingxenye kuphela yendlala.

• Kusikeka esiswini sakho bese kususwa wonke amanyikwe.
• I-gallbladder, ubende, ingxenye ye-duodenum, nama-lymph node aseduze nawo ayasuswa. Kwesinye isikhathi, ingxenye yesisu iyasuswa.

Udokotela wakho angancoma inqubo yokuhlinzwa yokwelapha umdlavuza wamanyikwe. Ukuhlinzwa kungavimbela ukusabalala komdlavuza uma isimila singakakhuli ngaphandle kwamanyikwe.

Izingozi zokuhlinzwa kanye ne-anesthesia ngokujwayelekile yilezi:

• Ukungezwani komzimba nemithi
• Izinkinga zokuphefumula
• Izinkinga zenhliziyo
• Ukopha
• Ukutheleleka
• Amahlule egazi emilenzeni noma emaphashini

Izingozi zalokhu kuhlinzwa yilezi:

• Ukuvuza koketshezi oluvela kumanyikwe, umgudu wenyongo, isisu noma amathumbu
• Izinkinga ngokukhipha isisu
• Isifo sikashukela, uma umzimba ungakwazi ukwenza i-insulin eyanele
• Ukwehla kwesisindo

Hlangana nodokotela wakho ukuqinisekisa ukuthi izinkinga zezokwelapha ezifana nesifo sikashukela, umfutho wegazi ophakeme, nezinkinga zenhliziyo noma zamaphaphu zilawulwa kahle.

Udokotela wakho angakucela ukuthi wenze lezi zivivinyo zokwelashwa ngaphambi kokuhlinzwa kwakho:

• Ukuhlolwa kwegazi (ukubalwa okuphelele kwegazi, ama-electrolyte, ukuhlolwa kwesibindi nezinso)
• I-x-ray yesifuba noma i-electrocardiogram (ECG), yabanye abantu
• I-Endoscopic retrograde cholangiopancreatography (ERCP) yokuhlola imigwaqo ye-bile ne-pancreatic
• Iskena se-CT
• I-Ultrasound

Phakathi nezinsuku ngaphambi kokuhlinzwa:

• Ungacelwa ukuthi uyeke ukuthatha okwesikhashana izinciphisi zegazi ezinjenge-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• Buza udokotela wakho ukuthi yimiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa kwakho.
• Uma ubhema, zama ukuyeka. Ukubhema kunganciphisa ukwelashwa. Buza umhlinzeki wakho wokunakekelwa kwezempilo usizo lokuyeka.
• Vumela umhlinzeki wakho azi nganoma yikuphi ukubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma okunye ukugula ongaba nakho ngaphambi kokuhlinzwa kwakho. Uma ugula, ukuhlinzwa kwakho kungadinga ukuhlehliswa.

Ngosuku lokuhlinzwa:

• Cishe uzocelwa ukuthi ungaphuzi noma ungadli lutho amahora amaningi ngaphambi kokuhlinzwa.
• Thatha noma imiphi imishanguzo udokotela wakho akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Landela imiyalo yokuthi uzofika nini esibhedlela. Qiniseka ukuthi ufika ngesikhathi.

Iningi labantu lihlala esibhedlela isonto elilodwa kuya kwamabili ngemuva kokuhlinzwa.

• Ekuqaleni, uzobe usendaweni yokuhlinzwa noma ukunakekelwa okunamandla lapho ungabhekwa khona.
• Uzothola uketshezi nemithi nge-catheter efakwa emthanjeni (IV) engalweni yakho. Uzoba neshubhu emakhaleni akho.
• Uzoba nezinhlungu esiswini sakho ngemuva kokuhlinzwa. Uzothola umuthi wezinhlungu nge-IV.
• Ungaba nemisele esiswini sakho ukuvimbela igazi nolunye uketshezi ekwakheni. Amashubhu nemisele kuzosuswa lapho uphulukisa.

Ngemuva kokuya ekhaya:

• Landela noma imiphi imiyalo yokukhipha nokunakekela onikezwe yona.
• Uzoba nokuvakashelwa okulandelanayo nodokotela wakho emavikini ayi-1 kuya kwangu-2 ngemuva kokuphuma esibhedlela. Qiniseka ukuthi ugcine lokhu kubekwa.

Ungadinga ukwelashwa okwengeziwe ngemuva kokululama ekuhlinzweni. Buza udokotela wakho ngesimo sakho.

Ukuhlinzwa kwepancreatic kungaba yingozi. Uma ukuhlinzwa kwenziwa, kufanele kwenzeke esibhedlela lapho kwenziwa khona eziningi zalezi zinqubo.

I-Pancreaticoduodenectomy; Inqubo ye-Whipple; Vula i-pancreatectomy ye-distal ne-splenectomy; I-Laparoscopic distal pancreatectomy; I-Pancreaticogastrostomy

UJesu-Acosta AD, uNarang A, Mauro L, uHerman J, uJaffee EM, uLaheru DA. I-Carcinoma yamanyikwe. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 78.

UPucci MJ, uKennedy EP, uYeo CJ. Umdlavuza wepancreatic: izici zomtholampilo, ukuhlolwa nokuphathwa. Ku: Jarnagin WR, ed. Ukuhlinzwa kukaBlumgart kwesibindi, iBiliary Tract, namaPancreas. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2017: isahluko 62.

IShires GT, iWilfong LS. Umdlavuza wepancreatic, ama-cystic pancreatic neoplasms, nezinye izimila zepancreatic ezingezona ezendalo. 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 60.