Ukuvinjelwa Kwendlela Yokulwa

-Delile

• Izinhlobo zamapayipi enyongo
• Yini ebangela ukuvinjelwa kwe-biliary?
• Yiziphi izinto eziyingozi?
• Ziyini izimpawu zokuvinjelwa kwe-biliary?
• Kutholakala kanjani ukuvinjelwa kwe-biliary?
• Ukuhlolwa kwegazi
• I-Ultrasonography
• Ukuskena kwe-bion radionuclide (ukuskena kwe-HIDA)
• Cholangiography
• Ukuskena kweMRI
• I-Magnetic resonance cholangiopancreatography (MRCP)
• I-Endoscopic retrograde cholangiopancreatography (ERCP)
• Yiluphi ukwelashwa kokuvinjelwa kwe-biliary?
• Izinkinga zokuvinjelwa kwe-biliary duct
• Ingabe ukuvinjelwa kwe-biliary kungavinjelwa?

Kuyini ukuvinjelwa kwe-biliary?

Ukuvinjelwa kwe-biliary ukuvinjelwa kwamapayipi e-bile. Amapayipi e-bile athwala i-bile kusuka esibindini kanye nenyongo nge-pancreas kuya e-duodenum, okuyingxenye yamathumbu amancane. I-Bile iluketshezi oluhlaza okotshani noma ophuzi onsundu olufihlwe isibindi ukugaya amafutha. Ngemuva kokudla, i-gallbladder ikhipha i-bile ukusiza ekugayeni nasekumuncweni kwamafutha. UBile usiza nokusula isibindi semikhiqizo kadoti.

Ukuvinjelwa kwanoma iyiphi yale mibhobho ye-bile kubhekiswa njengokuvinjelwa kwe-biliary. Izimo eziningi ezihlobene nokuvinjelwa kwe-biliary zingelashwa ngempumelelo. Kodwa-ke, uma ukuvinjelwa kungalashwa isikhathi eside, kungaholela ezifweni ezisongela impilo zesibindi.

Izinhlobo zamapayipi enyongo

Unezinhlobo eziningana zamapayipi e-bile. Lezi zinhlobo ezimbili zemibhobho yenyongo esibindini yimibhobho ye-intrahepatic ne-extrahepatic.

• Amapayipi we-Intrahepatic: Amapayipi we-Intrahepatic uhlelo lwamashubhu amancane ngaphakathi kwesibindi aqoqa futhi ahambise i-bile emadokodweni e-extrahepatic.
• Amapayipi we-Extrahepatic: Amapayipi e-extrahepatic aqala njengezingxenye ezimbili, enye ingakwesokudla kwesibindi kanti enye ingakwesobunxele. Njengoba zehla esibindini, ziyahlangana zenze umgudu ovamile wesibindi. Lokhu kugijimela ngqo emathunjini amancane.

Umgudu we-biliary, noma umgudu ovela ku-gallbladder, nawo uvuleka ungene emgudwini ovamile we-hepatic. I-bile duct kusuka kuleli phuzu kuye phambili yaziwa njenge-bile duct ejwayelekile noma i-choledochus. Ngaphambi kokuthulula emathunjini amancane, umgudu ovamile we-bile udlula emanyikwe.

Yini ebangela ukuvinjelwa kwe-biliary?

Ukuvinjelwa kwe-biliary kungadalwa yizinto eziningi ezibandakanya:

• Amapayipi enyongo
• isibindi
• inyongo
• amanyikwe
• amathumbu amancane

Okulandelayo ngezinye zezimbangela ezivame kakhulu zokuvinjelwa kwe-biliary:

• ama-gallstones, okuyizimbangela ezivame kakhulu
• ukuvuvukala kwamapayipi enyongo
• ukuhlukumezeka
• ukuqiniswa kwe-biliary, okuwukuncipha okungajwayelekile komsele
• ama-cysts
• ama-lymph node akhulisiwe
• isifo sokuqaqamba kwamalunga
• ukulimala okuhlobene nenyongo noma ukuhlinzwa kwesibindi
• izicubu ezifinyelele esibindini, enyongweni, emanyikwe, noma emithanjeni yenyongo
• izifo, kufaka phakathi i-hepatitis
• izimuncagazi
• i-cirrhosis, noma isibazi sesibindi
• ukulimala okukhulu kwesibindi
• i-choledochal cyst (ekhona ezinganeni lapho izalwa)

Yiziphi izinto eziyingozi?

Izici ezinobungozi bokuvinjelwa kwe-biliary ngokuvamile zixhomeke embangela yokuvinjelwa. Iningi lamacala angumphumela wamatshe enyongo. Lokhu kwenza abesifazane babe sengozini enkulu yokuthola ukuvinjelwa kwe-biliary. Ezinye izinto ezinobungozi zifaka:

• umlando wamatshe enyongo
• i-pancreatitis engapheli
• umdlavuza wepancreatic
• ukulimala engxenyeni efanele yesisu
• ukukhuluphala ngokweqile
• ukulahlekelwa isisindo ngokushesha
• izimo ezihlobene nokuwohloka kwamangqamuzana abomvu egazi, njenge-sickle cell anemia

Ziyini izimpawu zokuvinjelwa kwe-biliary?

Izimpawu zokuvinjelwa kwe-biliary zingancika embangela yokuvinjelwa. Abantu abane-biliary obstruction ngokuvamile bane:

• indle enombala okhanyayo
• umchamo omnyama
• i-jaundice (amehlo aphuzi noma isikhumba)
• ukulunywa
• ubuhlungu ohlangothini olungaphezulu kwesokudla sesisu
• isicanucanu
• ukuhlanza
• ukuncipha komzimba
• imfiva

Kutholakala kanjani ukuvinjelwa kwe-biliary?

Ukuhlolwa okuhlukahlukene kuyatholakala kubantu abangahle bavinjelwe i-biliary. Ngokuya ngesizathu sokuvinjelwa, udokotela wakho angancoma isivivinyo esisodwa noma eziningi ezilandelayo.

Ukuhlolwa kwegazi

Ukuhlolwa kwegazi kufaka ukubalwa okuphelele kwegazi (CBC) kanye nokusebenza kwesibindi. Ukuhlolwa kwegazi kungakhipha imibandela ethile, efana:

• cholecystitis, okuwukuvuvukala kwenyongo
• cholangitis, okuwukuvuvukala komsele ovamile we-bile
• izinga elengeziwe le-bilirubin ehlanganisiwe, okuwumkhiqizo wemfucuza wesibindi
• izinga lenyuka lama-enzyme wesibindi
• izinga lenyukile le-alkaline phosphatase

Noma yikuphi kwalokhu kungakhombisa ukulahleka kokugeleza kwenyongo.

I-Ultrasonography

I-Ultrasonography imvamisa isivivinyo sokuqala esenziwa kunoma ngubani osolwa ngokuvinjelwa kwe-biliary. Ivumela udokotela wakho ukuthi abone ama-gallstones kalula.

Ukuskena kwe-bion radionuclide (ukuskena kwe-HIDA)

Ukuskena i-hepatobiliary iminodiacetic acid scan, noma ukuskena kwe-HIDA, kubizwa nangokuthi yi-biliary radionuclide scan. Isebenzisa okokusebenza okukhipha imisebe ukuhlinzeka ngemininingwane ebalulekile nge-gallbladder nanoma yikuphi ukuvimbela okungaba khona.

Cholangiography

I-cholangiography iyi-X-ray yamapayipi enyongo.

Ukuskena kweMRI

Iskena se-MRI sihlinzeka ngezithombe ezinemininingwane yesibindi, i-gallbladder, amanyikwe, namapayipi enyongo.

I-Magnetic resonance cholangiopancreatography (MRCP)

I-Magnetic resonance cholangiopancreatography (MRCP) isetshenziselwa ukuxilongwa kokuvinjelwa kwama-biliary kanye nesifo se-pancreatic.

I-Endoscopic retrograde cholangiopancreatography (ERCP)

I-endoscopic retrograde cholangiopancreatography (ERCP) ifaka ukusetshenziswa kwe-endoscope ne-X-ray. Kokubili kuyithuluzi lokuxilonga nokwelapha. Ivumela udokotela ohlinzayo ukuthi abone amapayipi enyongo futhi iyasetshenziswa nasekwelapheni. Leli thuluzi lisiza kakhulu ngoba udokotela wakho angalisebenzisa ukususa amatshe futhi athathe amasampula e-biopsy uma kunesidingo.

Yiluphi ukwelashwa kokuvinjelwa kwe-biliary?

Ukwelashwa kuhlose ukulungisa imbangela eyimbangela. Inhloso eyinhloko yokwelashwa noma yokuhlinzwa ukunciphisa ukuvinjelwa. Ezinye zezinketho zokwelashwa zifaka i-cholecystectomy ne-ERCP.

I-cholecystectomy ukususwa kwe-gallbladder uma kukhona amatshe enyongo. I-ERCP ingahle yenele ukususa amatshe amancane emgodini ovamile we-bile noma ukubeka i-stent ngaphakathi komgudu wokubuyisela ukugeleza kwe-bile. Lokhu kuvame ukusetshenziswa ezimweni lapho ukuvinjelwa kubangelwa isimila.

Izinkinga zokuvinjelwa kwe-biliary duct

Ngaphandle kokwelashwa, ukuvinjelwa kwe-biliary duct kungasongela impilo. Izinkinga ezingase zivele ngaphandle kokwelashwa zifaka:

• ukwakhiwa okuyingozi kwe-bilirubin
• izifo
• sepsis
• isifo esingalapheki sesibindi
• ukuqina kwesibindi

Xhumana nodokotela wakho uma uthuthukisa i-jaundice noma ubona ushintsho kumbala wesitokisi sakho noma umchamo.

Ingabe ukuvinjelwa kwe-biliary kungavinjelwa?

Nazi izinguquko ezimbalwa ongazenza ukunciphisa amathuba akho okuba nokuvinjelwa kwe-biliary:

• Khulisa inani le-fiber ekudleni kwakho.
• Nciphisa inani likashukela namafutha agcwele ekudleni kwakho. Lokhu kungadala inyongo.
• Uma ukhuluphele ngokweqile, kancane kancane thola isisindo sakho kububanzi obuphilile bobulili bakho, ubudala, nobude.