ʻOki kino no ka maʻi ʻaʻai pancreatic

Hana ʻia ka ʻoki Pancreatic e mālama i ka maʻi ʻaʻai o ka pancreas gland.

Aia ka pancreas ma hope o ka ʻōpū, ma waena o ka duodenum (ka ʻāpana mua o ka ʻōpū liʻiliʻi) a me ka iwi maha, a ma mua hoʻi o ka iwi kuamoʻo. Kōkua ia i ka meaʻai digestion. ʻEkolu mau ʻāpana o ka pancreas i kapa ʻia ʻo ke poʻo (ka hopena ākea), waena, a me ka huelo. Wehe ʻia a pau a ʻāpana paha o ka pancreas ma muli o kahi o ka maʻi tumo maʻi ʻaʻai.

Ke hana ʻia nei ke kaʻina hana laparoscopically (me ka hoʻohana ʻana i kahi pahu paʻi wikiō liʻiliʻi) a i ʻole ka hoʻohana ʻana i ke kaha robotic e hilinaʻi ʻia:

• ʻO ka nui o ke kaha
• ʻO ka ʻike a me ka helu o nā ʻoki ʻana i hana ai kāu kauka
• ʻO ka ʻike a me ka helu o nā hana i hana ʻia ma ka haukapila āu e hoʻohana ai

Hana ʻia ke ʻoki kino i ka haukapila me ka anesthesia ākea no laila hiamoe ʻoe a manu ʻole ka ʻeha. Hoʻohana ʻia nā ʻano ʻoki aʻe ma ke ʻano o ka hana ʻana o ka maʻi ʻaʻai pancreatic.

Nā hana Whipple - ʻO kēia kahi ʻoki maʻamau loa no ka maʻi ʻaʻai pancreatic.

• Hana ʻia kahi ʻoki i kou ʻōpū a hoʻoneʻe ʻia ke poʻo o ka pancreas.
• Lawe pū ʻia ka gallbladder, bile duct, a me kahi o ka duodenum (ʻāpana mua o ka ʻōpū liʻiliʻi). I kekahi manawa, hemo kahi o ka ʻōpū.

Distal pancreatectomy a me splenectomy - Hoʻohana pinepine ʻia kēia ʻoki no nā tumors ma ka waena a me ka huelo o ka pancreas.

• Lawe ʻia ka waena a me ka huelo o ka pancreas.
• Hiki ke hoʻoneʻe ʻia ka spleen.

Huina pancreatectomy - ʻAʻole pinepine kēia hana ʻana. ʻAʻohe pono iki o ka lawe ʻana i ka pancreas holoʻokoʻa inā hiki ke mālama ʻia ka maʻi ʻaʻai e ka lawe ʻana i kahi ʻāpana o ke gland.

• Hana ʻia kahi ʻoki i kou ʻōpū a hemo ka pancreas holoʻokoʻa.
• Lawe ʻia ka gallbladder, spleen, hapa o ka duodenum, a me nā lymph node kokoke. I kekahi manawa, hemo kahi o ka ʻōpū.

Koi paha kāu kauka i kahi hana ʻoki e mālama i ka maʻi ʻaʻai o ka pancreas. Hiki i ke keʻoki ke hoʻopau i ka hoʻolaha ʻana o ka maʻi ʻaʻai inā ʻaʻole ulu ka tumo ma waho o ka pancreas.

Nā pilikia no ke ʻoki a me ka anesthesia ma ka laulā:

• Nā hopena āpau i nā lāʻau
• Nā pilikia hanu
• Nā pilikia puʻuwai
• Kahena
• Maʻi kīnā
• Hoʻopili ke koko i nā wāwae a i ʻole nā ​​akemāmā

ʻO nā pilikia no kēia ʻoki kino penei:

• ʻO ka liu o nā wai mai ka pancreas, ka lāʻau bile, ʻōpū, a me ka ʻōpū
• Nā pilikia me ka ninini ʻōpū
• Diabetes, inā ʻaʻole hiki i ke kino ke hana i ka nui o ka insulin
• Kaumaha emi

E launa me kāu kauka e hōʻoia i nā pilikia olakino e like me ka maʻi kō, ke koko kiʻekiʻe, a me nā pilikia o ka puʻuwai a i ʻole nā ​​māmā i ka kaohi maikaʻi.

E noi paha kāu kauka iā ʻoe e hana i kēia mau hoʻokolohua olakino ma mua o kou ʻoki ʻana.

• Nā hoʻokolohua koko (helu piha i ke koko, nā electrolytes, nā ake a me nā hoʻokolohua)
• ʻO ka x-ray a i ʻole electrocardiogram (ECG), no kekahi poʻe
• Endoscopic retrograde cholangiopancreatography (ERCP) e nānā i nā aʻa a me nā pancreatic
• CT scan
• Kukuna ultrasound

I nā lā ma mua o ke kaha ʻana:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā mea lahilahi e like me aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• E nīnau i kāu kauka i nā lāʻau e pono ai ʻoe e lawe i ka lā o kou ʻoki ʻana.
• Inā puhi ʻoe, hoʻāʻo e kū. Hiki i ka puhihihi ke hoʻolohi i ka hoʻōla. E noi i kāu mea mālama ola no ke kōkua ʻana e haʻalele.
• E hoʻomaopopo i kāu mea hāʻawi e pili ana i kekahi anuanu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe āu e loaʻa ai ma mua o kāu ʻoki. Inā maʻi ʻoe, pono e hoʻopaneʻe ʻia kāu ʻoki kino.

I ka lā o ke kaha:

• E noi ʻia ʻoe ʻaʻole e inu a ʻai i kekahi mea no kekahi mau hola ma mua o ke ʻoki.
• E lawe i nā lāʻau a kou kauka i ʻōlelo ai iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E hāhai i nā ʻōkuhi i ka hiki ʻana i ka haukapila. E hōʻea pono i ka manawa.

Noho ka hapa nui o ka poʻe i ka haukapila 1 a 2 mau pule ma hope o ke kaha ʻana.

• I ka mua, aia ʻoe i ka wahi ʻoki kino a i ʻole kahi mālama koʻikoʻi kahi e hiki ai ke nānā pono.
• E loaʻa ʻoe i nā wai a me nā lāʻau i loko o ka catheter intravenous (IV) i kou lima. E loaʻa ʻoe i kahi paipu i kou ihu.
• E loaʻa iā ʻoe ka ʻeha ma kou ʻōpū ma hope o ke kahakaha ʻana. E loaʻa iā ʻoe ka lāʻau ʻeha ma o ka IV.
• Loaʻa paha iā ʻoe nā kahawai i loko o kou ʻōpū e pale aku ai i ke koko a me nā wai ʻē aʻe mai ke kūkulu ʻana. E hoʻoneʻe ʻia nā paipu a me nā ʻauwai i kou wā e hoʻōla ai.

Ma hope o kou hoʻi ʻana i ka hale:

• E hāhai i nā ʻōlelo hoʻokuʻu a me nā mālama pono pilikino i hāʻawi ʻia iā ʻoe.
• E kipa hele aku ʻoe me kāu kauka 1 a 2 mau pule ma hope o kou haʻalele ʻana i ka haukapila. E mālama pono i kēia manawa.

Koi paha ʻoe i kahi lāʻau hou aʻe ma hope o kou ola ʻana mai ke ʻoki ʻana. E nīnau i kāu kauka e pili ana i kāu kūlana.

Hiki ke hoʻoweliweli i ke kaha ʻana Pancreatic. Inā hoʻopau ʻia ke ʻoki, pono ia ma kahi haukapila kahi e hana ʻia ai kēia mau kaʻina hana.

Pancreaticoduodenectomy; Nā hana Whipple; E wehe i ka pancreatectomy distal a me ka splenectomy; Laparoscopic distal pancreatectomy; ʻO Pancreaticogastrostomy

ʻO Jesus-Acosta AD, Narang A, Mauro L, Herman J, Jaffee EM, Laheru DA. ʻO Carcinoma o ka pancreas. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. ʻO Oncology Clinical ʻo Abboff. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 78.

ʻO Pucci MJ, Kennedy EP, Yeo CJ. Ka maʻi ʻaʻai Pancreatic: nā ʻano maʻi, ka helu, a me ka hoʻokele. I: Jarnagin WR, hoʻoponopono. ʻO Blumgart's Surgery of the Liver, Biliary Tract, a me Pancreas. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2017: chap 62.

ʻO Shires GT, Wilfong LS. Ka maʻi ʻaʻai Pancreatic, neoplasms pancreatic cystic, a me nā tumere pancreatic nonendocrine. 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 60.