ʻO Choledocholithiasis

ʻO Choledocholithiasis ke kūana o hoʻokahi gallstone ma ke kahe o ka bile maʻamau. Hana ʻia ka pōhaku i nā pigina bile a i ʻole ka calcium a me nā paʻakai kolesterol.

Ma kahi o 1 o 7 mau kānaka me nā pōhaku e hoʻomohala i nā pōhaku i ke kahena o ka bile maʻamau. ʻO kēia ka paipu liʻiliʻi e hāpai ana i ka bile mai ka gallbladder a i ka ʻōpū.

Hoʻopili nā mea pilikia i ka mōʻaukala o nā pōhaku. Eia nō naʻe, hiki i ka choledocholithiasis ke kū i ka poʻe i hoʻoneʻe ʻia kā lākou gallbladder.

ʻO ka pinepine, ʻaʻohe hōʻailona ke ʻole ka pōhaku i ka palaka i ke kaila o ka bile maʻamau. Pākuʻi ʻia paha nā ʻōuli:

• ʻEha ma ka ʻākau ma luna a ma waena o ka ʻōpū ma ka liʻiliʻi no 30 mau minuke. Paʻa mau paha ka ʻeha a ikaika hoʻi. Hiki ke akahai a ʻino hoʻi.
• Fiva.
• Yellowing o ka ʻili a me nā keʻokeʻo o nā maka (jaundice).
• Loaʻa ka ʻai ʻole.
• ʻO Nusea a me ka luaʻi.
• Nā noho waihoʻoluʻu pālolo.

ʻO nā hoʻāʻo e hōʻike ana i kahi o nā pōhaku i ke kahena o ka bile i kēia mau mea:

• Scanner CT ʻōpū
• ʻO ke ultrasound ʻōpū
• ʻO ka endoscopic retrograde cholangiography (ERCP)
• 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
• Helu piha koko (CBC)
• Nā hoʻāʻo hana ate
• ʻO nā enzymes Pancreatic

ʻO ka pahuhopu o ka mālama ʻana e hoʻomāmā i ka poloka.

Hoʻopili paha ka mālama ʻana:

• ʻO ke keʻena hana e wehe i ka gallbladder a me nā pōhaku
• ERCP a me ke kaʻina hana i kapa ʻia he sphincterotomy, kahi e ʻoki ai i kahi ʻokiʻoki i loko o ka mākala ma ke kahena o ka bile maʻamau e ʻae ai i nā pōhaku e hemo a hemo paha.

Hiki ke hoʻoweliweli i ka pale a me nā maʻi i hoʻokumu ʻia e nā pōhaku i ka biliary tract. ʻO ka hapa nui o ka manawa, maikaʻi ka hopena inā ʻike ʻia ka pilikia a mālama mua ʻia.

Komo pū nā pilikia:

• Cirrhosis Biliary
• Cholangitis
• ʻO Pancreatitis

Kāhea i kāu mea hāʻawi inā:

• Hoʻoulu ʻoe i ka ʻeha o ka ʻōpū, me ka ʻole o ka fiva, a ʻaʻohe kumu i ʻike ʻia
• Hoʻolālā ʻoe i ka jaundice
• Loaʻa iā ʻoe nā ʻōuli ʻē aʻe o choledocholithiasis

Gallstone i ke kahena o ka bile; Pōhaku pāpālua ʻo bili

• ʻŌnaehana Digestive
• Pākuʻi hakuʻala me nā koʻohaku - CT scan
• ʻO Choledocholithiasis
• Pākuʻi
• Pākuʻi
• Ala hele bile

Almeida R, Zenlea T. Choledocholithiasis. I: Ferri FF, hoʻoponopono. ʻO Ferri's Clinical Advisor 2019. Piladelapia, PA: Elsevier; 2019: 317-318.

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.