Zowonongeka za transhepatic cholangiogram

A transcutatic transhepatic cholangiogram (PTC) ndi x-ray yaminyewa ya bile. Awa ndi machubu omwe amanyamula bile kuchokera pachiwindi kupita ku ndulu ndi matumbo ang'onoang'ono.

Kuyesaku kumachitika mu dipatimenti ya radiology ndi radiologist wothandizira.

Mudzafunsidwa kuti mugone chagada pa tebulo la x-ray. Woperekayo amayeretsa kumtunda chakumanja ndi chapakati pamimba mwanu kenako ndikugwiritsa ntchito mankhwala osungunula.

Ma X-ray ndi ultrasound amagwiritsidwa ntchito kuthandiza othandizira azaumoyo kuti apeze ziwindi za chiwindi ndi za ndulu. Kenaka, singano yayitali, yopyapyala, yosinthasintha imalowetsedwa kudzera pakhungu pachiwindi. Wothandizirayo amalowetsa utoto, womwe umatchedwa kuti sing'anga wosiyanitsa, m'mipata ya bile. Kusiyanitsa kumathandizira kuwunikira madera ena kuti awoneke. Ma x-ray ambiri amatengedwa pamene utoto umadutsa m'mayendedwe a bile kupita m'matumbo ang'onoang'ono. Izi zitha kuwonedwa pazowonera makanema wapafupi.

Mupatsidwa mankhwala okutonthozani (sedation) pochita izi.

Adziwitseni omwe akukuthandizani ngati muli ndi pakati kapena muli ndi vuto lakutaya magazi.

Mupatsidwa diresi lachipatala kuti muvale ndipo mudzafunsidwa kuchotsa zodzikongoletsera zonse.

Mudzafunsidwa kuti musadye kapena kumwa chilichonse kwa maola 6 mayeso asanachitike.

Uzani omwe akukuthandizani ngati mukumwa mankhwala ochepetsa magazi monga Warfarin (coumadin), Plavix (clopidogrel), Pradaxa, kapena Xarelto.

Padzakhala mbola pamene mankhwala oletsa ululu adzaperekedwa. Mutha kukhala ndi vuto ngati singano yapita m'chiwindi. Mudzakhala ndi sedation pamachitidwe awa.

Kuyesaku kungathandize kuzindikira zomwe zimayambitsa kutsekeka kwa bile.

Bile ndi madzi otulutsidwa ndi chiwindi. Muli cholesterol, bile salt, ndi zinyalala. Mchere wambiri umathandizira thupi lanu kuwononga (kugaya) mafuta. Kutsekeka kwa ndulu ya bile kumatha kubweretsa matenda a jaundice (kutulutsa khungu khungu), kuyabwa pakhungu, kapena matenda a chiwindi, ndulu kapena kapamba.

Ikamalizidwa, PTC nthawi zambiri imakhala gawo loyamba lazinthu ziwiri kuti muchepetse kapena kutseka chotchinga.

• PTC imapanga "mapu amisewu" ammbali ya bile, yomwe itha kugwiritsidwa ntchito pokonzekera chithandizo.
• Mapu a mseu atachitika, kutsekako kumatha kuthandizidwa mwa kuyika stent kapena chubu chowonda chotchedwa drain.
• Kukhetsa kapena stent kumathandizira kuti thupi lichotse ndulu m'thupi. Njirayi imatchedwa Percutaneous Biliary Drainage (PTBD).

Mitsempha ya bile ndiyabwino kukula ndi mawonekedwe azaka zamunthuyo.

Zotsatira zitha kuwonetsa kuti ma ducts akula. Izi zikutanthawuza kuti mayendedwe amatsekedwa. Kutsekeka kumatha kuyambitsidwa ndi mabala kapena miyala. Ikhozanso kutanthauzanso khansa m'mayendedwe a bile, chiwindi, kapamba, kapena dera la ndulu.

Pali mwayi wocheperako wosakanikirana ndi ayodini wosiyanitsa (ayodini). Palinso chiopsezo chochepa cha:

• Kuwonongeka kwa ziwalo zapafupi
• Kuwonongeka kwa Chiwindi
• Kutaya magazi kwambiri
• Poizoni wamagazi (sepsis)
• Kutupa kwa ma ducts
• Matenda

Nthawi zambiri, kuyesa uku kumachitika pambuyo poyesedwa koyambirira kwa endoscopic retrograde cholangiopancreatography (ERCP). PTC itha kuchitika ngati mayeso a ERCP sangathe kuchitidwa kapena alephera kuchotsa kutsekeka.

Maginito resonance cholangiopancreatography (MRCP) ndi njira yatsopano, yopanda chidwi, yoyerekeza ndi kujambula kwa maginito (MRI). Zimaperekanso malingaliro amipata ya bile, koma sizotheka nthawi zonse kuchita mayeso awa. Komanso, MRCP siyingagwiritsidwe ntchito kuthana ndi kutsekeka.

PTC; Cholangiogram - PTC; PTC; PBD - Percutaneous biliary ngalande; Zochitika zapadera zosinthika zolangiography

• Thupi la gallbladder
• Njira yopanda madzi

Chockalingam A, Georgiades C, Hong K. Njira zopititsira patsogolo matenda a jaundice. Mu: Cameron JL, Cameron AM, olemba, eds. Chithandizo Chamakono Cha Opaleshoni. Wolemba 12. Philadelphia, PA: Elsevier; 2017: 475-483.

Jackson PG, Evans SRT. Dongosolo Biliary. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 54.

Lidofsky Sd. Jaundice. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Matenda a Mimba ndi a Fordtran Amatenda a Chiwindi. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: mutu 21.

Stockland AH, Baron TH. Mankhwala a Endoscopic ndi radiologic a matenda a biliary. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Matenda a Mimba ndi a Fordtran Amatenda a Chiwindi. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 70.