Kolutanogram transhepatic cholangiogram

ʻO kahi cholutanogram transhepatic transutanp percutaneus (PTC) kahi x-ray o nā aʻa aʻa. ʻO kēia nā paipu e hāpai ana i ka bile mai ke akepaʻa a i ka huahuā a me ka ʻōpū liʻiliʻi.

Hana ʻia ka hoʻāʻo ma ke keʻena radiology e kahi radiologist intervenal.

E noi ʻia ʻoe e moe i kou kua ma ka papa ʻaina x-ray. E hoʻomaʻemaʻe ka mea hāʻawi i ka ʻaoʻao ʻākau ma luna a ma waena o kou ʻōpū a hoʻopili i kahi lāʻau numbing.

Hoʻohana ʻia nā kukuna X a me ultrasound e kōkua i ka mea mālama ola e ʻimi i kou ake a me nā aʻa o kou. Hoʻokomo ʻia kahi nila lōʻihi, lahilahi, maʻalahi hoʻi ma o ka ʻili i ke ake. Hoʻokomo ka mea hāʻawi i ka wai kala, i kapa ʻia he medium medium, i loko o nā dule o ka bile. Kōkua ka hoʻohālikelike i kahi mau wahi e hiki ai ke ʻike ʻia. Lawe ʻia nā kukuna hou x i ke kahe ʻana o ke kala ma o nā aʻa oʻa i loko o ka ʻōpū liʻiliʻi. Hiki ke ʻike ʻia kēia ma kahi nānā wikiō kokoke.

Hāʻawi ʻia ʻoe i ka lāʻau e hōʻoluʻolu iā ʻoe (hoʻomaha) no kēia kaʻina hana.

E hoʻomaopopo i kāu mea hāʻawi inā hāpai ʻoe a i ʻole maʻi maʻi kahe.

Hāʻawi ʻia iā ʻoe kahi kapa komo no ka haukapila e komo a noi ʻia ʻoe e hemo i nā mea hoʻonaninani āpau.

E noi ʻia ʻoe ʻaʻole e ʻai a inu paha i kekahi mea no 6 mau hola ma mua o ka hōʻike.

E haʻi i kāu mea hāʻawi inā lawe ʻoe i nā mea lahilahi koko e like me Warfarin (coumadin), Plavix (clopidogrel), Pradaxa, a me Xarelto.

E loaʻa kahi ʻūlū e like me ka hāʻawi ʻia o ka anesthetic. Hiki paha iā ʻoe ke hōʻoluʻolu i ka neʻe ʻana o ka nila i ke ake. E loaʻa iā ʻoe ka sedation no kēia kaʻina hana.

Hiki i kēia hoʻāʻo ke kōkua i ke kuhi ʻana i ke kumu o ka paʻa ʻana o ka palapū.

ʻO ka bile kahi wai i hoʻokuʻu ʻia e ke ake. Loaʻa iā ia ka kolesterol, nā paʻakai bile, a me nā huahana neoneo. Kōkua nā paʻakai ʻoi i kou kino e wāwahi (ʻai) nā momona. Hiki i kahi blockage o ke aʻa aʻa i hiki ke alakaʻi i ka jaundice (melemele discoloration o ka ʻili), ka ʻili o ka ʻili, a i ʻole ka maʻi o ke ake, gallbladder a i ʻole pancreas.

Ke hana ʻia ia, ʻo ka PTC ka mahele pinepine o kahi kaʻina ʻelua ʻelua e hoʻomaha ai a mālama ai i kahi paʻa.

• Hana ka PTC i kahi "roadmap" o nā aʻa bili, i hiki ke hoʻohana ʻia e hoʻolālā i ka lāʻau.
• Ma hope o ka hana ʻia o ka palapala alanui, hiki ke mālama ʻia i ka blockage e ke kau ʻana i kahi stent a i ʻole kahi paipu lahilahi i kapa ʻia he ʻauwaha.
• ʻO ke kahe a stent paha e kōkua i ke kino e hemo i ka iwi mai ke kino. Kāhea ʻia kēlā hana ʻo Percutaneous Biliary Drainage (PTBD).

ʻO nā dile bile he maʻamau i ka nui a me nā hiʻohiʻona no ka makahiki o ke kanaka.

Hōʻike paha nā hopena i ka hoʻonui ʻia ʻana o nā kaula. Pēlā paha i ālai ʻia nā aʻa. Hoʻokumu ʻia paha ka paʻa e ka scarring a i ʻole nā ​​pōhaku. Hōʻike paha ia i ka maʻi ʻaʻai i loko o nā aʻa o ka bile, ate, pancreas, a i ʻole ka ʻāpana o ka gallbladder.

Aia kahi manawa kūpono o kahi hopena maʻi i ka mea hoʻohālikelike (iodine). Aia kekahi pilikia iki no:

• Hoʻopōʻino i nā meaola kokoke
• Poino i ke ake
• Kahe nui o ke koko
• Ka make ʻana o ke koko (sepsis)
• ʻO ka hoʻowahāwahā o nā aʻa aʻa
• Maʻi kīnā

ʻO ka hapa nui o ka manawa, hana ʻia kēia hōʻike ma hope o ka hoʻāʻo mua ʻia o kahi endoscopic retrograde cholangiopancreatography (ERCP). Hana ʻia paha ka PTC inā ʻaʻole hiki ke hoʻokō ʻia kahi hoʻokolohua ERCP a i ʻole holoi ʻole e hoʻomaʻemaʻe i ka paʻa.

ʻO kahi cholangiopancreatography magnetic resonance (MRCP) kahi ʻano kiʻi kiʻi hou ʻole noninvasive, e pili ana i ke kiʻi resonance magnetic (MRI). Hāʻawi pū kekahi ia i nā manaʻo o nā aʻa o ka bile, akā ʻaʻole hiki ke hana i kēia hōʻike. Eia kekahi, ʻaʻole hiki ke hoʻohana ʻia ʻo MRCP e mālama i ka poloka.

PTC; Cholangiogram - PTC; PTC; PBD - Kahe wai biliary pākēneka; ʻO ka cholangiography transhepatic transutanic

• Anatomia Gallbladder
• Ala hele bile

Chockalingam A, Georgiades C, Hong K. Nā hana Transhepatic no ka jaundice ālai. I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 12th ed. Piladelapia, PA: Elsevier; 2017: 475-483.

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.

Lidofsky SD. ʻO Jaundice. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 21.

Stockland AH, ʻo Baron TH. Hoʻomaʻo Endoscopic a me radiologic o ka maʻi biliary. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 70.