Kuchita opaleshoni ya khansa ya kapamba

Kuchita opaleshoni ya pancreatic kumachitika pofuna kuchiza khansa ya kapamba.

Pancreas ili kumbuyo kwa m'mimba, pakati pa duodenum (gawo loyamba la m'matumbo ang'ono) ndi ndulu, komanso kutsogolo kwa msana. Amathandiza mu chakudya chimbudzi. Mphunoyi ili ndi mbali zitatu zotchedwa mutu (kumapeto kwake), pakati, ndi mchira. Mpheta zonse kapena gawo zimachotsedwa kutengera komwe kuli chotupa cha khansa.

Kaya njirayi imagwiritsidwa ntchito laparoscopically (pogwiritsa ntchito kamera yaying'ono yamakanema) kapena kugwiritsa ntchito ma robotic kumadalira:

• Kukula kwa opaleshoniyi
• Chidziwitso ndi kuchuluka kwa maopaleshoni omwe dokotala wanu adachita
• Zomwe akumana nazo ndi kuchuluka kwa maopaleshoni omwe achitika kuchipatala komwe mugwiritse ntchito

Kuchita opareshoni kumachitika mchipatala ndimankhwala opatsirana ambiri kotero kuti mukugona ndipo simumva kupweteka. Mitundu yotsatirayi ya opaleshoni imagwiritsidwa ntchito pochiza khansa ya kapamba.

Ndondomeko ya Whipple - Uwu ndiye opaleshoni wofala kwambiri wa khansa ya kapamba.

• Amacheka m'mimba mwanu ndipo mutu wa kapamba umachotsedwa.
• Ndulu, ndulu ya ndulu, ndi gawo la duodenum (gawo loyamba lamatumbo ang'onoang'ono) amatulutsidwanso. Nthawi zina, gawo lina la m'mimba limachotsedwa.

Pancreatectomy yakutali ndi splenectomy - Opaleshoni imeneyi imagwiritsidwa ntchito nthawi zambiri pazotupa pakati ndi mchira wa kapamba.

• Pakati ndi mchira wa kapamba amachotsedwa.
• Ndulu imathanso kuchotsedwa.

Chiwombankhanga chonse - Kuchita opaleshoniyi sikuchitika kawirikawiri. Palibe phindu lochulukitsa kapamba ngati khansara itha kuchiritsidwa pochotsa gawo limodzi lokhalo.

• Cheka chimapangidwa m'mimba mwanu ndipo kapamba wonse amachotsedwa.
• Ndulu, ndulu, gawo la duodenum, ndi ma lymph node omwe ali pafupi nawonso amachotsedwa. Nthawi zina, gawo lina la m'mimba limachotsedwa.

Dokotala wanu angakulimbikitseni kuchitira opaleshoni khansa ya kapamba. Opaleshoni imatha kuletsa kufalikira kwa khansa ngati chotupacho sichinakule kunja kwa kapamba.

Kuopsa kochita opareshoni ndi anesthesia ambiri ndi awa:

• Thupi lawo siligwirizana ndi mankhwala
• Mavuto opumira
• Mavuto amtima
• Magazi
• Matenda
• Magazi amaundana m'miyendo kapena m'mapapu

Zowopsa za opaleshoniyi ndi izi:

• Kutuluka kwa madzi kuchokera ku kapamba, ndulu ya ndulu, m'mimba, kapena m'matumbo
• Mavuto ndikutsuka m'mimba
• Matenda ashuga, ngati thupi silingathe kupanga insulin yokwanira
• Kuchepetsa thupi

Kumanani ndi dokotala wanu kuti muwonetsetse kuti zovuta zamankhwala monga matenda ashuga, kuthamanga kwa magazi, komanso mavuto amtima kapena mapapo zikuyenda bwino.

Dokotala wanu akhoza kukupemphani kuti muyesedwe mayeso awa asanachitike opaleshoni yanu:

• Kuyesa magazi (kuwerengera kwathunthu kwamagazi, ma electrolyte, mayeso a chiwindi ndi impso)
• X-ray pachifuwa kapena electrocardiogram (ECG), ya anthu ena
• Endoscopic retrograde cholangiopancreatography (ERCP) kuti mufufuze ma bile ndi kapamba
• Kujambula kwa CT
• Ultrasound

M'masiku asanachitike opareshoni:

• Mutha kupemphedwa kuti musiye kumwa mopepuka magazi monga aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• Funsani dokotala wanu mankhwala omwe muyenera kumwa patsiku la opareshoni yanu.
• Ngati mumasuta, yesetsani kusiya. Kusuta kumatha kuchepetsa kuchira. Funsani wothandizira zaumoyo wanu kuti akuthandizeni kusiya.
• Lolani wothandizira wanu adziwe za chimfine, chimfine, malungo, kuphulika kwa herpes, kapena matenda ena omwe mungakhale nawo musanachite opareshoni. Mukadwala, opareshoni yanu imafunika kuimitsidwa kaye.

Patsiku la opaleshoniyi:

• Muyenera kuti mudzafunsidwa kuti musamwe kapena kudya chilichonse kwa maola angapo opaleshoniyo isanakwane.
• Tengani mankhwala aliwonse omwe adakuuzani kuti mumwe ndi madzi pang'ono.
• Tsatirani malangizo pa nthawi yobwera kuchipatala. Onetsetsani kuti mwafika nthawi.

Anthu ambiri amakhala mchipatala masabata 1 kapena 2 atachitidwa opaleshoni.

• Poyamba, mudzakhala kumalo opareshoni kapena mosamalitsa komwe mutha kuyang'anitsitsa.
• Mutha kupeza zamadzimadzi ndi mankhwala kudzera mu catheter yamitsempha (IV) yomwe ili m'manja mwanu. Mudzakhala ndi chubu m'mphuno mwanu.
• Mudzakhala ndi ululu m'mimba mwanu mukatha opaleshoni. Mupeza mankhwala opweteka kudzera mu IV.
• Mutha kukhala ndi zotupa m'mimba mwanu kuti magazi ndi zinthu zina zamadzimadzi zisamange. Machubu ndi ngalande zimachotsedwa mukamachira.

Mukapita kunyumba:

• Tsatirani malangizo aliwonse otulutsidwa ndi kudzisamalira omwe mwapatsidwa.
• Mudzakhala ndi ulendo wotsatira ndi dokotala wanu 1 mpaka 2 masabata mutatuluka kuchipatala. Onetsetsani kuti mwasunga nthawi imeneyi.

Mungafunike chithandizo china mukachira. Funsani dokotala wanu za vuto lanu.

Kuchita opaleshoni ya pancreatic kumatha kukhala koopsa. Ngati opareshoni yachitika, iyenera kuchitika kuchipatala komwe njira zambiri zimachitidwira.

Pancreaticoduodenectomy; Ndondomeko ya Whipple; Open distal pancreatectomy ndi splenectomy; Laparoscopic distal pancreatectomy; Pancreaticogastrostomy

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Pucci MJ, Kennedy EP, Yeo CJ. Khansa ya Pancreatic: zochitika zamankhwala, kuwunika, ndi kasamalidwe. Mu: Jarnagin WR, Mkonzi. Opaleshoni ya Blumgart ya Chiwindi, Biliary Tract, ndi Pancreas. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2017: mutu 62.

Ma Shires GT, Wilfong LS. Khansara ya pancreatic, zotupa zam'mimba zotupa m'mimba, ndi zotupa zina za pancreatic. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Fordtran's Mimba ndi Matenda a Chiwindi: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 60.