Pyloroplasty

ʻO Pyloroplasty kahi ʻoki e hoʻonui i ka wehe ma ka ʻaoʻao haʻahaʻa o ka ʻōpū (pylorus) i hiki i nā ʻōpū o ka ʻōpū ke hakahaka i loko o ka ʻōpū liʻiliʻi (duodenum).

ʻO ka pylorus kahi mānoanoa, muscular. Ke mānoanoa, ʻaʻole hiki ke hele ka ʻai i loko.

Hana ʻia ke ʻokiʻoki ʻoiai ʻoe ma lalo o ka anesthesia āpau (hiamoe a manu ʻole ka ʻeha).

Inā he ʻoki ākea kāu, ke kauka.

• Hana i kahi ʻoki nui i kou ʻōpū e wehe i kahi.
• ʻOkiʻoki ma o kekahi o nā mākala manoanoa a lilo ia i ākea.
• Pani ka ʻoki i ke ala e wehe ai ka pylorus. ʻAe kēia i ka ʻōpū e hakahaka.

Hiki i nā kauka hana ke hana i kēia ʻoki me ka hoʻohana ʻana i ka laparoscope. ʻO kahi laparoscope kahi kāmele liʻiliʻi i hoʻokomo ʻia i loko o kou ʻōpū ma o kahi ʻoki liʻiliʻi. E ʻike ʻia ke wikiō mai ka pahu paʻi kiʻi ma kahi monitor ma ka lumi lumi. ʻIke ke kauka lāʻau i ka mea nānā e hana i ke ʻoki. Ma ke ʻoki kino:

• ʻEkolu a ʻelima mau ʻoki liʻiliʻi e hana ʻia i kou ʻōpū. E hoʻokomo ʻia ka pahu paʻi kiʻi a me nā pono hana ʻē aʻe ma o kēia mau ʻoki.
• E hoʻopiha ʻia kou ʻōpū i ka ʻaila e hiki ai i ka mea lōkō ke ʻike i ka wahi a hana i ke ʻoki me kahi lumi hou e hana ai.
• Hana ʻia ka pylorus e like me ka mea i hōʻike ʻia ma luna.

Hoʻohana ʻia ʻo Pyloroplasty e mālama i nā pilikia i loko o ka poʻe me nā maʻi maʻi peptic a i ʻole nā ​​pilikia ʻōpū ʻē aʻe i hiki ke ālai i ka ʻōpū.

Nā pilikia no ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena i nā lāʻau a i ʻole nā ​​pilikia hanu
• Kahe ʻana o ke kahe, ke koko koko, a i ʻole ka maʻi

ʻO nā pōʻino no kēia ʻoki ʻana:

• Poino i ka ʻōpū
• Hernia
• Kulu o nā ʻōpū o ka ʻōpū
• Pohā lōʻihi
• Kaʻai pono ʻole
• Haehae i ka lining o nā mea pono kokoke (mucosal perforation)

E haʻi i kāu kauka.

• Inā ʻoe a hāpai paha
• He aha nā lāʻau āu e lawe nei, e like me nā lāʻau, nā mea hoʻopili, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau

I nā lā ma mua o kou ʻoki kino:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā mea lahilahi. Hoʻopili kēia i nā NSAIDs (aspirin, ibuprofen), vitamina E, warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), a me clopidogrel (Plavix).
• E noi i kāu kaukipona i nā lāʻau e pono ai e lawe i ka lā o ke ʻoki.
• Inā puhi ʻoe, hoʻāʻo e kū. E noi i kāu kauka a kahu hānai paha no ke kōkua ʻana e haʻalele.

I ka lā o kou ʻoki kino:

• E hāhai i nā ʻōkuhi e pili ana i ka ʻai ʻole a me ka inu.
• E lawe i nā lāʻau a kāu kauka lāʻau i kauoha ai iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E hōʻea i ka haukapila i ka manawa.

Ma hope o ke kahakaha ʻana, e nānā ka pūʻulu mālama ola i kou hanu ʻana, ke kahe o ke koko, ka mahana, a me ka helu o ka puʻuwai. Hiki i ka hapa nui o ka poʻe ke hoʻi i ka home ma waena o 24 mau hola.

ʻO ka hapa nui o ka poʻe e ola wikiwiki a pau loa. ʻO ka noho maʻamau o ka haukapila ʻo 2 a 3 mau lā. Maliʻa paha hiki iā ʻoe ke hoʻomaka lohi i kahi papaʻai maʻamau i kekahi mau pule.

Ulcer peptic - pyloroplasty; PUD - pyloroplasty; Pyloric ālai - pyloroplasty

ʻO Chan FKL, Lau JYW. Maʻi maʻi peptic I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 53.

ʻO Teitelbaum EN, Hungness ES, Mahvi DM. ʻŌpū. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 48.