Yiziphi izindlela zokwelapha ezingenziwa ngobubanzi be-ERCP?
I-Sphincterotomy
I-sphincterotomy ukusika umsipha ozungeze indawo evulekile yamapayipi, noma i-papilla.Lokhu kusikeka kwenzelwa ukukhulisa ukuvuleka.Ukusikwa kwenziwa ngesikhathi udokotela wakho ebheka kububanzi be-ERCP ku-papilla, noma ukuvulwa kwepayipi.Intambo encane ku-catheter ekhethekile isebenzisa amandla kagesi ukusika izicubu.I-sphincterotomy ayibangeli ukungakhululeki, awunazo iziphetho zemizwa lapho.Ukusikwa kwangempela kuncane kakhulu, ngokuvamile kungaphansi kwe-intshi engu-1/2.Lokhu kusikeka okuncane, noma i-sphincterotomy, ivumela ukwelashwa okuhlukahlukene emiseleni.Ngokuvamile ukusikwa kuqondiswe emgudwini wenyongo, obizwa nge-biliary sphincterotomy.Kwesinye isikhathi, ukusikwa kuqondiswe emgudwini we-pancreatic, kuya ngohlobo lokwelashwa oludingayo.
Ukususwa Kwetshe
Ukwelashwa okuvamile ngobubanzi be-ERCP ukususwa kwamatshe epayipi lenyongo.Lawa matshe kungenzeka ukuthi akhe ku-gallbladder futhi angena emgodini we-bile noma angase akhe emgudwini ngokwawo eminyakeni eminingi ngemva kokukhishwa kwe-gallbladder.Ngemva kokuba kwenziwe i-sphincterotomy ukuze kwandiswe ukuvuleka kwe-bile duct, amatshe angadonswa emgudwini aye emathunjini.Izinhlobonhlobo zamabhaluni nobhasikidi abanamathiselwe kuma-catheter akhethekile bangadluliswa kububanzi be-ERCP baye emiseleni evumela ukususwa kwamatshe.Amatshe amakhulu kakhulu angadinga ukuchotshozwa emhubheni ngobhasikidi okhethekile ukuze izingcezu zikhishwe nge-sphincterotomy.
Ukubekwa kwe-Stent
Ama-stents afakwa ku-bile noma ama-pancreas ducts ukuze adlule ama-strictures, noma izingxenye eziwumngcingo zomgudu.Lezi zindawo eziwumngcingo ze-bile noma ze-pancreatic duct zibangelwa izicubu ezibomvu noma izimila ezibangela ukuvaleka kokukhipha okujwayelekile kwemigudu.Kunezinhlobo ezimbili zama-stents ezisetshenziswa kakhulu.Eyokuqala yenziwe ngepulasitiki futhi ibukeka njengotshani obuncane.I-stent yepulasitiki ingaphushwa ngobubanzi be-ERCP ingene epayipini elivinjiwe ukuze kuvunyelwe ukugeleza okujwayelekile.Uhlobo lwesibili lwe-stent lwenziwe ngezintambo zensimbi ezibukeka njengezintambo eziphambanayo zocingo.I-stent yensimbi iyashintshashintsha futhi iziphethu zivulekele ububanzi obukhulu kunama-plastic stents.Kokubili ama-stents epulasitiki nawensimbi avame ukucinana ngemva kwezinyanga ezimbalwa futhi ungase udinge enye i-ERCP ukuthi ibeke i-stent entsha.Ama-stents ensimbi ahlala unomphela kuyilapho ama-stents epulasitiki ekhishwa kalula ngenqubo ephindaphindwayo.Udokotela wakho uzokhetha uhlobo olungcono kakhulu lwe-stent yenkinga yakho.
Ukunwetshwa kwebhaluni
Kunama-catheter e-ERCP afakwe amabhaluni anwebekayo angabekwa endaweni ewumngcingo noma eqinile.Ibhaluni libe selifakwa umoya ukuze lelule ukuncisha.Ukunwetshwa ngamabhaluni kuvame ukwenziwa lapho imbangela yokuncipha ingenabungozi (hhayi umdlavuza).Ngemuva kokwenyuswa kwebhaluni, i-stent yesikhashana ingase ibekwe izinyanga ezimbalwa ukusiza ukugcina ukunwetshwa.
Isampula Yezicubu
Enye inqubo evame ukwenziwa ngobubanzi be-ERCP iwukuthatha amasampula esithishu ku-papilla noma enyongweni noma emiseleni ye-pancreatic.Kukhona amasu amasampula amaningana ahlukene nakuba okuvame kakhulu kuwukuxubha indawo ngokuhlolwa okulandelayo kwamaseli atholiwe.Amasampula ezicubu angasiza ekunqumeni ukuthi ukuqina, noma ukuncipha, kungenxa yomdlavuza.Uma isampula libonisa umdlavuza linembe kakhulu.Ngeshwa, isampula yethishu engabonisi umdlavuza ingase ingabi nembayo.