I-ERC ne-MRCP

Ukwelashwa Kwenqubo ye-ERCP/MRCP e-Hyderabad, India

I-Endoscopic retrograde cholangiopancreatography (ERCP) inqubo yokuxilonga izinkinga ezihlobene ne-gallbladder, i-bile ducts, nama-pancreas. Isibindi sikhiqiza uketshezi olwaziwa nge-bile, olusiza ukugaya. I-bile igcinwa ku-gallbladder kuze kube yilapho idingeka ekugayeni ukudla. Ukusuka esibindini, i-bile igeleza iye ku-gallbladder kanye namathumbu amancane ku-bile duct. Isihlahla se-biliary siqukethe la mapayipi. Ngaphandle kokukhiqiza ama-enzyme awusizo ekugayeni ukudla, amanyikwe aphinde akhiphe amahomoni anjenge-insulin. Ukwelashwa Kwenqubo ye-ERCP e-Hyderabad kuyatholakala kubantu abahlangabezana nezinkinga ezihlobene nalezi zitho zokugaya.

Ukuxilongwa kwe-ERCP

I-endoscope ekhanyisiwe ifakwa emlonyeni wesiguli ngesikhathi se-ERCP yokuxilonga. Ngemva kokudlula ngomminzo, isisu, nokuvuleka kwamathumbu amancane, lokhu bese kuphuma ngokuphepha. Ukuze ufake i-endoscope kumgudu we-pancreatic kanye nezimbobo ze-biliary ngasikhathi sinye, kuzodingeka ukuthi kufakwe ishubhu enkabeni ye-endoscope.

Kuwo wonke amashubhu kusetshenziswa udayi owaziwa ngokuthi i-contrast medium. Uma i-contrast medium isisetshenzisiwe i-X-ray iyathathwa. Ngokungeziwe ekusizeni ukugqamisa izindawo ezithakaselwayo, indawo ehlukile ingase inikeze udokotela ulwazi mayelana nokuvinjwa noma enye inkinga engase ingabonakali ngenye indlela. Imishini yevidiyo nayo ifakwe kuma-endoscopes esimanje, ihlinzeka udokotela ngezinketho ezengeziwe zokuxilonga.

I-ERCP yenziwa ukuze

• Ukuxilongwa nokwelapha izifo ze-pancreatic noma ze-bile duct (njengamatshe)

• I-ultrasound noma i-CT scan isiza ukuhlonza izimpawu (okungukuthi ukuqunjelwa kwesisu noma i-jaundice) noma icacise imiphumela engavamile evela emsebenzini wegazi, ama-ultrasound, noma ama-CT scan.

• Ngesikhathi noma ngemva kokuhlinzwa kwe-gallbladder.

• Ngokusebenzisa amashubhu epulasitiki ahlala ngaphakathi abizwa ngokuthi ama-stents, izimila zingaxilongwa futhi imigudu yenyongo evimbekile ingadlulwa.

• Kanye nokuthola nokwelapha izinkinga ngemva kokuhlinzwa kwenyongo, i-ERCP ingathola futhi yelaphe ezinye izimo zezempilo.

Inqubo

Indlela ye-Endoscopic Retrograde Cholangiopancreatography (ERCP) isebenzisa i-endoscope kanye ne-X-ray. Lokhu kufezwa ngokusebenzisa ishubhu elikhanyayo nelide eliguquguqukayo. Udokotela wakho usebenzisa i-endoscope ukuze abone ngeso lengqondo isihlahla se-biliary namanyikwe, kanye nokujova udayi emiseleni ukuze uwabone ngeso lengqondo kuma-X ray.

Kuyinqubo edinga ukuthi ulale etafuleni. Ngesikhathi senqubo, sizosebenzisa i-anesthesia yendawo kanye ne-sedation ukuze uphumule. I-endoscope iqondiswa ngommizo wakho, isisu, kanye ne-duodenum ize ifike ku-duodenum kanye ne-bile duct. Imishini ye-X-ray ithatha izithombe ngemva kokuba udayi ujovwe futhi udayi ujovwe. Kuzokwazi ukunquma ukuthi ama-ducts ancishisiwe noma avinjwe yile ndlela. Ukuhlolwa kungase kuqhutshekwe nge-biopsy, noma ngisho nokususwa kwetshe le-gallbladder noma ukuvinjelwa kungenziwa. I-endoscope izokhishwa uma inqubo isiqediwe.

I-MRCP

I-Magnetic resonance cholangiopancreatography (MRCP) iwuhlobo lokuhlolwa kwe-magnetic resonance imaging (MRI) okukhiqiza izithombe ezinemininingwane yezinhlelo ze-pancreatic, biliary, nesibindi. Ukuhlolwa kokuxilonga okufana ne-magnetic resonance imaging (MRI) izindlela ezingavamisile zokuthola izimo zezokwelapha.

I-Magnetic resonance imaging (MRI) isebenzisa inkambu kazibuthe enamandla, ama-radiofrequency pulses, kanye nekhompyutha ukuze inikeze izithombe ezinemininingwane yezakhiwo zomzimba. Ayikho imisebe ehilelekile (ama-x-ray awasetshenziswa). Isithombe se-MR sinikeza odokotela imininingwane enemininingwane ngomzimba futhi sibasize ukuba babone izifo.

Yiziphi ezinye zezindlela ezivamile zokusetshenziswa kwenqubo?

I-Magnetic Resonance Cholangiopancreatography noma i-MRCP isetshenziswa odokotela ukuze:

• Hlaziya izifo zesibindi, i-gallbladder, i-bile ducts, amanyikwe, kanye ne-pancreatic duct. Lokhu kuhlanganisa izimila, amatshe, ukuvuvukala, nezinye izifo.

• Thola i-pancreatitis ngokuya ngembangela eyisisekelo. Ezigulini ezine-pancreatitis, i-MRCP ingenziwa ngokusetshenziswa kwesidakamizwa i-Secretin ukuze kunqunywe ukuthi ngabe isibazi sesikhathi eside senzeka yini nokuthi ingabe kukhona ukusebenza okwanele kwe-pancreas kanye nokuphuma kwayo.

• Thola ubuhlungu besisu obungachazwanga.

• I-ERCP ingenye indlela engahlaseli ku-endoscopic retrograde cholangiopancreatography (ERCP). Inqubo ye-endoscopic retrograde cholangiopancreatography ihlanganisa i-endoscopy, esebenzisa ithuluzi elikhanyayo ukuze libheke ngaphakathi emzimbeni, ngemijovo yokuqhathanisa ene-iodine kanye nezithombe ze-X-ray ukuze kuhlonzwe isifo. Ukuhlolwa kwe-biliary kanye/noma kwe-pancreatic duct kwenziwa phakathi nenqubo ye-ERCP.

Inqubo

• Ukuhlolwa kwe-MRI kungenziwa njengenqubo yokulaliswa ngaphandle.

• Uzobekwa phezu kwetafula lezivivinyo elinyakazayo nguchwepheshe. Ukukugcina unganyakazi futhi usesimweni, amabhande namabolster angasetshenziswa.

• Lapho ehlola umzimba, uchwepheshe angase asebenzise izinto eziqukethe amakhoyili akwazi ukudlulisa nokwamukela amaza omsakazo.

• Kungase kube nokugijima okuningana (ukulandelana) ekuhlolweni kwe-MRI, okunye okungahlala imizuzu embalwa. Kuzoba nemisindo ehlukene ehlotshaniswa nokugijima ngakunye.

• Uzodinga i-catheter ye-intravenous (umugqa we-IV) ukuze uthole okuhlukile ngesikhathi sokuhlolwa kwakho. I-catheter izofakwa emthanjeni osesandleni noma engalweni yakho. Le IV izosetshenziselwa ukujova okubalulekile kokugqamayo.

• Ngesikhathi se-MRI, uzofakwa kumagnet. Njengoba kuhlolwa, uchwepheshe uzobe esebenza kukhompuyutha ngaphandle kwegumbi. I-intercom izokuvumela ukuthi ukhulume nochwepheshe.

• Ngemva kochungechunge lokuqala lweskena, uchwepheshe uzojova okuhlukile emgqeni wokungena emthanjeni (IV). Ngemva komjovo, uchwepheshe uzothatha izithombe eziningi.

• I-MRCP ithatha cishe amaminithi angu-10-15, kodwa ngokuvamile yenziwa ngokuhambisana ne-MRI yesisu evamile, engathatha imizuzu elinganiselwa kwe-30 futhi ihilela ukusetshenziswa kwezinto ezihlukile. Uma inqubo isiqediwe ngale ndlela, ngokuvamile kuthatha cishe imizuzu engama-45.

Kuhluke kanjani ukulungiselela izinqubo?

Ngaphambi kokuba wenze noma iyiphi inqubo, udokotela wakho uzohlola ukungezwani komzimba wakho kanye nezimo zezokwelapha ezikhona. Lokhu kucatshangelwa kubalulekile njengoba kungase kukhuphule ingozi yezinkinga ezihlobene nokusetshenziswa kodayi wokuqhathanisa, osetshenziselwa ukuthuthukisa ukuthwebula izithombe kukho kokubili i-ERCP nokuhlolwa okuthile kwe-MRCP.

Kuye ngezici zakho eziyingozi, udokotela wakho angase athathe izinyathelo zokuphepha ezengeziwe ekuhleleni inqubo. Inqubo yokulungiselela nayo iyahlukahluka kuye ngohlobo lokuhlolwa:

Ukulungiselela i-ERCP:

• Ama-sedative ahilelekile, ngakho-ke kungadingeka ukuthi uyeke okwesikhashana ukuphuza imithi ethile esebenzisana nama-sedative. Lokhu kungase kuhlanganise imithi elawula ukujiya kwegazi.
• Hlela ukuba umngane omethembayo noma ilungu lomndeni likusize lapho ufika ekhaya, njengoba uzokwaziswa ukuthi uyeke ukushayela amahora angu-24 ngemva kwenqubo.
• Yeka ukudla, ukuphuza, ukubhema, noma ukuhlafuna ushingamu amahora angu-8 ngaphambi kwe-ERCP ukuze uqinisekise ukubonwa okucacile komgudu wakho wamathumbu.

Ukulungiselela i-MRCP:

• Ukulungiselela i-MRCP akuqinile kangako ngenxa yesimo sayo sokuhlasela kancane.
• Gqoka izingubo ezikhululekile futhi ukhiphe bonke ubucwebe.
• Yazisa udokotela wakho uma unomshini otshaliwe.
• Kungase kudingeke ukuthi uyeke ukudla noma ukuphuza amahora ambalwa ngaphambi kwenqubo.

Isisetshenziswa

Umshini we-MRI wendabuko uqukethe isilinda esikhulu esizungezwe uzibuthe oyindilinga. Etafuleni, kunomhubhe oshelela kuwo uqonde enkabeni kazibuthe. Amasistimu we-short-bore amanye amayunithi e-MRI angasivaleli ngokugcwele isiguli ngozibuthe. Iziguli ezinkulu noma ezine-claustrophobic zingase zithole imishini emisha ye-MRI inethezeke kakhudlwana ngenxa yokuthi inobubanzi obukhulu be-bore. Amayunithi avulekile ezinhlangothini abhekwa njenge-MRI "evulekile". Iziguli ezine-claustrophobia noma iziguli ezinkulu zingazithola ziwusizo ngokukhethekile. Izithombe zekhwalithi ephezulu zingatholwa ngamayunithi e-MRI avulekile okuhlola okuhlukahlukene. Okunye ukuhlola kungase kungafaneleki i-MRI evuliwe. 

Izibhedlela ze-CARE zinikeza i-ERCP & MRCP Hospital e-Hyderabad ngemishini engcono kakhulu nodokotela abanekhono eliphezulu nabanolwazi.