He aha nā lāʻau lapaʻau e hiki ke hana ʻia ma o kahi ākea ERCP?
Sphincterotomy
ʻO ka sphincterotomy ke ʻoki ʻana i ka ʻiʻo e hoʻopuni ana i ka wehe ʻana o nā awāwa, a i ʻole ka papilla.Hana ʻia kēia ʻokiʻoki e hoʻonui i ka puka.Hana ʻia ke ʻoki i ka wā e nānā ai kāu kauka ma ka ERCP scope ma ka papilla, a i ʻole ka wehe ʻana o ke kahawai.Hoʻohana ka uwea liʻiliʻi ma ka catheter kūikawā e ʻoki i ka ʻiʻo.ʻAʻole pilikia ka sphincterotomy, ʻaʻohe ou aʻalolo ma laila.He liʻiliʻi loa ka ʻoki maoli, ma lalo o ka 1/2 iniha.ʻO kēia ʻoki liʻiliʻi, a i ʻole sphincterotomy, e ʻae i nā ʻano lapaʻau like ʻole i loko o nā ducts.ʻO ka mea maʻamau ke kuhikuhi ʻia ka ʻoki ʻana i ka duct bile, i kapa ʻia he biliary sphincterotomy.I kekahi manawa, kuhikuhi ʻia ka ʻoki ʻana i ka duct pancreatic, ma muli o ke ʻano o ka mālama ʻana āu e pono ai.
Wehe Pōhaku
ʻO ka hoʻomaʻamaʻa maʻamau ma o kahi ākea ERCP ʻo ka wehe ʻana i nā pōhaku bile duct.Ua hana ʻia kēia mau pōhaku i loko o ka gallbladder a hele i loko o ka ʻawa bile a i ʻole e hana ʻia i loko o ka auwai ponoʻī mau makahiki ma hope o ka wehe ʻia ʻana o kāu gallbladder.Ma hope o ka hana ʻia ʻana o ka sphincterotomy e hoʻonui i ka wehe ʻana o ka duct bile, hiki ke huki ʻia nā pōhaku mai ka duct i loko o ka ʻōpū.Hiki ke hele ʻia nā ʻano baluna a me nā hīnaʻi i hoʻopili ʻia i nā catheters kūikawā ma o ka ERCP scope i loko o nā awāwa e hiki ai ke wehe i nā pōhaku.Pono paha nā pōhaku nui e ʻoki ʻia i loko o ke awāwa me kahi hīnaʻi kūikawā i hiki ke huki ʻia nā ʻāpana ma o ka sphincterotomy.
Hoʻokomo Stent
Hoʻokomo ʻia nā stents i loko o ka bile a i ʻole ka pancreatic ducts e pale aku i nā strictures, a i ʻole nā ʻāpana liʻiliʻi o ka duct.ʻO kēia mau wahi liʻiliʻi o ka bile a i ʻole ka pancreatic duct ma muli o ka ʻiʻo ʻili a i ʻole nā maʻi maʻi e hoʻopaʻa ʻia ai ka hoʻoheheʻe maʻamau.ʻElua ʻano o nā stents i hoʻohana mau ʻia.Hana ʻia ka mea mua i ka plastic a me ke ʻano o ka mauʻu liʻiliʻi.Hiki ke hoʻokuʻu ʻia kahi stent plastic ma o ka ERCP scope i loko o kahi auwai paʻa e ʻae ai i ka hoʻokahe maʻamau.ʻO ke ʻano ʻelua o ka stent i hana ʻia me nā uea metala e like me nā uea keʻa o ka pā.Hiki ke ma'alahi ka stent metala a hāmama nā pūnāwai i ke anawaena nui a'e ma mua o nā stent plastic.Hiki ke hoʻopaʻa ʻia nā stents plastic a me nā metala ma hope o kekahi mau mahina a makemake paha ʻoe i kahi ERCP hou e kau i kahi stent hou.Paʻa mau nā stent metala ʻoiai e wehe maʻalahi ʻia nā stents plastic ma ke kaʻina hana hou.Na kāu kauka e koho i ke ʻano stent maikaʻi loa no kou pilikia.
Pāʻani Baluna
Aia nā catheters ERCP i hoʻokomo ʻia me nā baluna hoʻomāhuahua i hiki ke kau ʻia ma kahi ʻāpana haiki a i ʻole ke koʻikoʻi.A laila hoʻonui ʻia ka baluna e hoʻohola i ka haiki.Hoʻohana pinepine ʻia ka dilation me nā baluna inā maikaʻi ke kumu o ka hāiki (ʻaʻole he maʻi kanesa).Ma hope o ka hoʻonui ʻia ʻana o ka baluna, hiki ke kau ʻia kahi stent no kekahi mau mahina e kōkua i ka mālama ʻana i ka dilation.
Hoʻolāʻau Tissue
Hoʻokahi kaʻina hana maʻamau e hana ʻia ma o ka ERCP scope ʻo ia ka lawe ʻana i nā laʻana o ka ʻiʻo mai ka papilla a i ʻole mai ka bile a i ʻole ka pancreatic ducts.Nui nā ʻano hana laʻana ʻokoʻa ʻoiai ʻo ka mea maʻamau ʻo ka palaki ʻana i kahi me ka nānā ʻana o nā cell i loaʻa.Hiki ke kōkua i nā laʻana o ka ʻili i ka hoʻoholo ʻana inā he maʻi maʻi ʻaʻai ʻana, a i ʻole ʻokiʻoki paha.Inā maika'i ka hāpana no ka ma'i 'a'ai pololei loa.ʻO ka mea pōʻino, ʻaʻole pololei paha ka laʻana o ka ʻiʻo i hōʻike ʻole i ke kanesa.