ʻO ka paʻa ʻana o ke kaha bile

ʻO ke koʻikoʻi o ka bile duct he mea ʻino ʻole ia o ke dile bile maʻamau. ʻO kēia paipu e neʻe i ka bile mai ke ake a i ka ʻōpū liʻiliʻi. ʻO ka bile kahi mea kōkua i ka digestion.

Hoʻokumu pinepine ʻia kahi paʻa bile duct e ka ʻeha i nā aʻa o ka bile i ka wā o ke ʻoki. ʻO kahi laʻana, hiki ke hana ma hope o ke kahakaha ʻana e wehe i ka gallbladder.

ʻO nā kumu ʻē aʻe o kēia ʻano:

• Ka maʻi ʻaʻai o ke aʻa aʻa, ake a i ʻole pancreas
• ʻO ka hōʻino a me ka scarring ma muli o ka pōhaku i ke kahena o ka bile
• Hoʻopōʻino a scarring paha ma hope o ka hemo ʻana o ka gallbladder
• ʻO Pancreatitis
• ʻO cholangitis sclerosing mua

ʻO nā hōʻailona me:

• ʻEha o ka ʻōpū ma ka ʻaoʻao ʻākau o luna o ka ʻōpū
• ʻO Chills
• Fiva
• Kāwili
• ʻO ka manaʻo hōʻoluʻolu maʻamau
• Loaʻa ka ʻai ʻole
• ʻO Jaundice
• ʻO Nusea a me ka luaʻi
• Nā noho Pale a i ʻole nā ​​pālolo kele

Hiki i nā hōʻike aʻe ke kōkua i ke koho ʻana i kēia ʻano:

• Endoscopic retrograde cholangiopancreatography (ERCP)
• ʻO cholangiogram transhepatic transutanputan (PTC)
• Mākēneki resonance cholangiopancreatography (MRCP)
• Endoscopic ultrasound (EUS)

Hiki i nā hōʻoia koko aʻe ke kōkua i ka hōʻike ʻana i kahi pilikia me ka ʻōnaehana biliary.

• ʻOi aku ka kiʻekiʻe o ka alkali phosphatase (ALP) ma mua o ka maʻamau.
• ʻOi aku ka kiʻekiʻe o ka ʻenemi GGT ma mua o ka maʻamau.
• ʻOi aku ke kiʻekiʻe ʻo Bilirubin ma mua o ka maʻamau.

Hiki i kēia ʻano ke hoʻololi i nā hopena o nā hōʻike aʻe:

• Pae Amylase
• Pae Lipase
• Urine bilirubin
• Ka manawa Prothrombin (PT)

ʻO ka pahuhopu o ka mālama ʻana e hoʻoponopono i ka huina. ʻAe kēia e kahe mai ka ate mai ke ake i loko o ka ʻōpū.

Pili paha kēia:

• ʻOki kino
• Endoscopic a i ʻole percutaneous dilation a i ʻole ka hoʻokomo ʻana i nā stent ma o ke koʻikoʻi

Inā hoʻopau ʻia ke ʻoki, hemo ka paʻakikī. E hui hou ʻia ke kaha bile me ka ʻōpū liʻiliʻi.

I kekahi mau hihia, hoʻonoho ʻia kahi metala liʻiliʻi a i ʻole ke ea mesh tube (stent) ma o ka paʻa ʻana o ke kahena o ka bile e wehe.

Kūleʻa ka mālama ʻana i ka hapa nui o ka manawa. ʻO ka kūleʻa wā lōʻihi e pili ana i ke kumu o ka paʻa.

Hiki ke hoʻi i ka hoʻāla a me ka hoʻopili ʻana o ke aʻa biliary i kekahi mau kānaka. Aia kekahi pilikia no ka maʻi ma luna o ka wahi iiki. ʻO nā kūlia i koe no kahi wā lōʻihi hiki ke alakaʻi i ka hōʻino o ke ake (cirrhosis).

Kāhea i kāu kahu mālama ola inā hoʻi hou nā ʻōuli ma hope o pancreatitis, cholecystectomy, a i ʻole nā ​​ʻoki biliary ʻē aʻe.

ʻO ka paʻa ʻana o ke kaha bile; Hoʻopaʻa Biliary

• Ala hele bile

ʻO Anstee QM, Jones DEJ. Hepatology. I: Ralston SH, Penman ID, Strachan MWJ, Hobson RP, eds. Nā Kumuhana a Davidson a me ka hana o ka lāʻau. 23rd Ed. Piladelapia, PA: Elsevier; 2018: chap 22.

ʻO Fogel EL, Sherman S. Nā maʻi o ka gallbladder a me nā dile bile. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 146.

Ibrahim-zada I, Ahrendt SA. Ka mālama ʻana i nā ʻoi paʻa biliary maikaʻi. I: Cameron AM, Cameron JL, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 13th ed. Piladelapia, PA: Elsevier; 2020: chap 462-466.

Jackson PG, Evans SRT. ʻŌnaehana Biliary. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 54.