Ndi mankhwala ati omwe angachitidwe kudzera mu ERCP?
Sphincterotomy
Sphincterotomy ndi kudula minofu yomwe ili pafupi ndi matope, kapena papilla.Kudula uku kumapangidwa kuti akulitse kutsegula.Kudulidwa kumapangidwa pamene dokotala wanu akuyang'ana kupyolera mu ERCP pa papilla, kapena kutsegula njira.Waya waung'ono pa catheter yapadera amagwiritsa ntchito mphamvu yamagetsi kudula minofu.A sphincterotomy sichimayambitsa kukhumudwa, mulibe mitsempha yomaliza pamenepo.Kudula kwenikweni kumakhala kochepa, nthawi zambiri kumakhala kosakwana 1/2 inchi.Kadulidwe kakang'ono aka, kapena sphincterotomy, amalola mankhwala osiyanasiyana m'njira.Nthawi zambiri odulidwawo amalunjikitsidwa ku njira ya bile, yotchedwa biliary sphincterotomy.Nthawi zina, kudula kumalunjika ku pancreatic duct, kutengera mtundu wa chithandizo chomwe mukufuna.
Kuchotsa Mwala
Chithandizo chofala kwambiri kudzera mu ERCP ndikuchotsa miyala ya bile.Miyala iyi mwina idapangidwa mu ndulu ndikuyenda munjira ya ndulu kapena imatha kupanga munjirayo pakapita zaka ndulu yanu itachotsedwa.Pambuyo pochita sphincterotomy kuti akulitse kutsegula kwa ndulu, miyala imatha kukokedwa kuchokera munjira kupita kumatumbo.Mabaluni ndi madengu osiyanasiyana omwe amalumikizidwa ku ma catheter apadera amatha kudutsa mu ERCP kulowa munjira zolola kuchotsedwa kwa miyala.Miyala yayikulu kwambiri ingafunike kuphwanyidwa mumsewu ndi dengu lapadera kotero kuti zidutswazo zitha kuzulidwa kudzera mu sphincterotomy.
Kuyika kwa Stent
Ma stents amayikidwa mu bile kapena pancreatic ducts kuti alambalale zolimba, kapena mbali zopapatiza za duct.Madera ang'onoang'ono a bile kapena pancreatic duct ndi chifukwa cha zipsera kapena zotupa zomwe zimayambitsa kutsekeka kwa ngalande zabwinobwino.Pali mitundu iwiri ya ma stents omwe amagwiritsidwa ntchito kwambiri.Yoyamba ndi ya pulasitiki ndipo imawoneka ngati kaphesi kakang'ono.Chitsulo cha pulasitiki chikhoza kukankhidwa kudzera mu ERCP kupita munjira yotsekedwa kuti madzi aziyenda bwino.Mtundu wachiwiri wa stent ndi wopangidwa ndi mawaya achitsulo omwe amafanana ndi mawaya odutsa a mpanda.Chitsulo chachitsulo chimakhala chosinthika komanso akasupe otseguka mpaka mainchesi akulu kuposa mapulasitiki apulasitiki.Zonse ziwiri za pulasitiki ndi zitsulo zimatsekeka pakatha miyezi ingapo ndipo mungafunike ERCP ina kuti ikhazikitse stent yatsopano.Mitsuko yachitsulo imakhala yokhazikika pomwe pulasitiki imachotsedwa mosavuta pobwerezabwereza.Dokotala wanu adzasankha mtundu wabwino kwambiri wa stent pavuto lanu.
Dilation ya Baluni
Pali ma catheter a ERCP okhala ndi mabaluni otambalala omwe amatha kuyikidwa padera lopapatiza kapena molimba.Kenako buluniyo imawonjezedwa kuti itambasulire chopapatizacho.Dilation ndi mabuloni nthawi zambiri amachitidwa pamene chifukwa chochepetsera ndi chosaopsa (osati khansa).Pambuyo pa kufalikira kwa baluni, stent yakanthawi imatha kuyikidwa kwa miyezi ingapo kuti ithandizire kukulitsa.
Sampling ya minofu
Njira imodzi yomwe imachitika kawirikawiri kudzera mu ERCP ndikutenga zitsanzo za minofu kuchokera pa papilla kapena kuchokera ku bile kapena pancreatic ducts.Pali njira zingapo zotsatsira zitsanzo ngakhale zofala kwambiri ndikutsuka malo ndikuwunika motsatira ma cell omwe adapezeka.Zitsanzo za minofu zingathandize kudziwa ngati kukhwima, kapena kuchepa, chifukwa cha khansa.Ngati chitsanzocho chili ndi khansa ndicholondola kwambiri.Tsoka ilo, zitsanzo za minofu zomwe siziwonetsa khansa sizingakhale zolondola.