Nā Pohaku

ʻO nā Gallstones he waihona kālā paʻakikī ia i loko o ka gallbladder. Liʻiliʻi paha kēia mau mea e like me ka palaoa o ke one a nui paha e like me ka pōpō kolepa.

ʻOkoʻa ke kumu o nā gallstones. ʻElua ʻano nui o nā pōhaku ʻelua:

• Nā pōhaku i hana ʻia me ka kolesterol - ʻO kēia ka ʻano maʻamau. ʻAʻole pili ka gallstones o Cholesterol i ka pae kolesterol i ke koko. I ka hapanui o nā hihia, ʻike ʻole ʻia lākou ma ka scan CT.
• Nā pōhaku i hana ʻia me ka bilirubin - Kāhea ʻia kēia mau pōhaku nā pigment. Kū lākou i ka wā e luku ʻia ai nā hunaola ʻulaʻula a nui ka bilirubin i ka pā.

ʻOi aku ka maʻamau o nā Gallstones i:

• Moekolohe wahine
• Nā ʻōiwi ʻAmelika a me nā poʻe o ko lākou kūpuna Hepanika
• ʻO nā kānaka ma luna o 40 mau makahiki
• ʻO ka poʻe kaona kaupaona
• ʻO ka poʻe me ka mōʻaukala ʻohana o nā pōhaku ʻeho

ʻO nā kumuhana aʻe e hoʻonui iā ʻoe i nā gallstones:

• ʻO ka iwi iwi a i ʻole ke koli ʻana o nā mea paʻa
• Diabetes
• ʻO ka holo pono ʻole o ka gallbladder e hakahaka i ka bile (ʻoi aku paha kēia i ka wā o ka hāpai ʻana)
• ʻO ka cirrhosis ate a me nā maʻi maʻi biliary (nā pōhaku pigmented)
• Nā kūlana olakino e hoʻopau ʻia nā hunaola ʻulaʻula nui loa
• ʻO ke kaupaona wikiwiki ʻana mai ka ʻai ʻana i kahi papaʻai calorie haʻahaʻa loa, a ma hope paha o ke kaupaona hōʻemi kino
• Ke loaʻa ʻana o ka meaʻai ma o ka aa no kahi wā lōʻihi (hānai intravenous)
• Ke lawe nei i nā pila hoʻomalu hānau

ʻAʻohe o nā ʻōuli he nui me ka poʻe pōhaku. ʻIke pinepine ʻia kēia mau mea i ka wā x-ray maʻamau, ʻoki kino o ka ʻōpū, a i ʻole nā ​​hana lapaʻau ʻē aʻe.

Eia nō naʻe, inā pōhaku kahi pōhaku nui i kahi paipu a i ʻole ke duct e hoʻokahe i ka gallbladder, loaʻa paha iā ʻoe kahi ʻeha cramping ma waenakonu a i luna o ka ʻōpū o luna. ʻIke ʻia kēia ʻo biliary colic. Hele ka ʻeha inā hele ka pōhaku i ka ʻāpana mua o ka ʻōpū liʻiliʻi.

Nā ʻōuli e kū aʻe paha:

• ʻEha ma ka ʻākau ma luna a ma waena o ka ʻōpū ma ka liʻiliʻi no 30 mau minuke. Mau a ʻeha paha ka ʻeha. Hiki iā ia ke kuʻi a polohi paha.
• Fiva.
• Yellowing o ka ʻili a me nā keʻokeʻo o nā maka (jaundice).

Hiki i nā ʻōuli ʻē aʻe ke:

• Nā noho waihoʻoluʻu pālolo
• ʻO Nusea a me ka luaʻi

Hoʻohana ʻia nā hoʻokolohua e ʻike ai i nā gallstones a i ʻole ka mumū gallbladder:

• Ultrasound, ʻōpū
• CT scan, ʻōpū
• Endoscopic retrograde cholangiopancreatography (ERCP)
• ʻO ke kiʻi ʻana o Gallbladder radionuclide scan
• Endoscopic ultrasound
• Mākēneki resonance cholangiopancreatography (MRCP)
• ʻO cholangiogram transhepatic transutanputan (PTCA)

Hiki i kāu mea mālama ola ke kauoha i nā hoʻokolohua koko aʻe:

• Bilirubin
• Nā hoʻāʻo hana ate
• Helu piha koko
• ʻO ka enzyme Pancreatic

NA MEA HANA

ʻO ka hapa nui o ka manawa, ʻaʻole pono ka ʻōpala ke ʻole e hoʻomaka nā ʻōuli. Eia nō naʻe, pono paha i ka poʻe e hoʻolālā ana i ke kaupaona hōʻemi kaumaha e hemo i nā gallstones ma mua o ka hana ʻana i ke kaʻina hana. Ma ka laulā, ʻo ka poʻe i loaʻa nā ʻōuli e pono ke ʻoki koke a koke paha ma hope o ka loaʻa ʻana o ka pōhaku.

• Hoʻohana ʻia kahi ʻenehana i kapa ʻia laparoscopic cholecystectomy. Hoʻohana kēia kaʻina hana i nā ʻoki lāʻau liʻiliʻi, e ʻae ai i kahi ola wikiwiki. Hiki i ka mea maʻi ke hoʻi pinepine i ka home mai ka haukapila ma waena o 1 lā o ke ʻoki.
• I ka wā ma mua, hana pinepine ʻia ka cholecystectomy hāmama (hemo gallbladder). Eia naʻe, ʻoi aku ka maʻalahi o kēia hana i kēia manawa.

Endoscopic retrograde cholangiopancreatography (ERCP) a me ke kaʻina hana i kapa ʻia he sphincterotomy e hana ʻia e ʻimi a mālama ai paha i nā gallstones ma ke kahe o ka bile maʻamau.

NA LAAU LAPAAU

Hāʻawi ʻia nā lāʻau i loko o ka pila e hoʻopau i nā gallstones kolesterol. Eia nō naʻe, hiki i kēia mau lāʻau ke lilo i 2 mau makahiki a ʻoi paha ka lōʻihi o ka hana, a hoʻi paha nā pōhaku ma hope o ka pau ʻana o ka lāʻau.

Kākaʻikahi wale nō, waiho ʻia nā kemika i loko o ka gallbladder ma o ka catheter. Hoʻopau wikiwiki ke kemika i nā pōhaku kolesterol. He paʻakikī kēia hana ʻana, no laila ʻaʻole hana pinepine ʻia. Hiki ke ʻawahia nā kemika i hoʻohana ʻia, a hoʻi paha nā gallstones.

LITOTOHANA

Ua hoʻohana ʻia ka lithotripsy hawewe shock (ESWL) o ka gallbladder no ka poʻe hiki ʻole ke ʻoki kino. ʻAʻole hoʻohana pinepine ʻia kēia mālama ʻana e like me ka manawa ma mua no ka hoʻi pinepine ʻana o nā gallstones.

Pono ʻoe e noho i kahi papa wai a lawe i nā ʻanuʻu ʻē aʻe e hāʻawi i kāu gallbladder i kahi hoʻomaha ma hope o kou mālama ʻia ʻana. E hāʻawi aku kāu mea hāʻawi iā ʻoe i nā ʻōkuhi ke haʻalele ʻoe i ka haukapila.

ʻO ka manawa kūpono o nā ʻōuli a i ʻole nā ​​pilikia mai ke kaha ʻana o ka gallstones haʻahaʻa Ma kahi kokoke i nā poʻe āpau i loaʻa i ke kaʻi gallbladder ʻaʻole hoʻi e hoʻi kā lākou mau ʻōuli.

Hiki i ke kaohi ʻia e nā gallstones ke kumu i ka pehu a i ʻole ka maʻi i loko o ka:

• ʻO Gallbladder (cholecystitis)
• Tube e lawe bile mai ke akepaʻa a hiki i ka gallbladder a me nā ʻōpū (cholangitis)
• Pancreas (pancreatitis)

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe:

• ʻEha ma ka ʻaoʻao o luna o kou ʻōpū
• Melemele o ka ʻili a i ʻole nā ​​keʻokeʻo o nā maka

I ka hapanui o ka poʻe, ʻaʻole hiki ke pale ʻia nā pōhaku ʻaʻa. I ka poʻe i nui i ka momona, ka pale ʻana i ka pohō kaumaha hiki ke kōkua i ka pale ʻana i nā gallstones.

Cholelithiasis; Hoʻouka Gallbladder; Colic Biliary; Hoʻouka ʻo Gallstone; Ka helu biliary: gallstones chenodeoxycholic acid (CDCA); Ursodeoxycholic acid (UDCA, ursodiol); Endoscopic retrograde cholangiopancreatography (ERCP) - mau pōhaku ʻaʻa

• Wehe i ka gallbladder - laparoscopic - hoʻokuʻu
• Wehe i ka gallbladder - wehe - hoʻokuʻu
• Gallstones - hoʻokuʻu

• ʻŌnaehana Digestive
• Pākuʻi hakuʻala me nā koʻohaku - CT scan
• Gallstones, cholangiogram
• ʻO Cholecystolithiasis
• ʻO Cholelithiasis
• Pākuʻi
• Wehe i ka gallbladder - Pūʻulu

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. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 155.

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.

Wang D Q-H, Afdhal NH. ʻO ka maʻi Gallstone. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi Liver: Pathophysiology / Diagnosis / Management. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 65.