Kuvura amabuye ya ERCP

· Nyuma yo kubagwa LC, imiterere yumuyoboro wa bile ntisanzwe kandi umuyoboro wa bili uragoreka. MugiheERCPimikorere, insinga iyobora "biroroshye gushyira hasi ariko ntibyoroshye kuyishyiraho" (igwa kubwimpanuka nyuma yo kuzamuka), bityo rero iyo insinga iyobora imaze gushyirwaho, igomba kugumaho kugirango ikumire insinga ziyobora kandi zigwe hanze yumuyoboro.

Syndrome ya Mirizz ni anatomique idasanzwe ibura byoroshye kandi ikirengagizwa. Ubushakashatsi bwakozwe: Nyuma yo kubagwa LC, umurwayi ufite amabuye ya cystic yahagaritse imiyoboro isanzwe, itera syndrome ya Mirrizz. Amabuye ntashobora gukurwaho hifashishijwe X-ray. Mu kurangiza, ikibazo cyakemutse nyuma yo kwisuzumisha no kuvanwaho mu iyerekwa ritaziguye hamwe na eyeMAX.

· KuriERCPgukuramo umuyoboro w'amabuye mu barwayi bo mu gifu nyuma yo kubagwa Bi II, urufunguzo ni ukugera ku nsina binyuze mu ntera. Rimwe na rimwe, bisaba igihe kirekire (bisaba imitekerereze ikomeye) kugirango ugere ku nsina, kandi niba umurongo ngenderwaho udakomeje neza, birashobora gusohoka byoroshye.

TherIbindi bihe

Peripapillary diverticulum ihujwe n'amabuye ya ducte ni rusange. Ingorabahizi mubikorwa muriki gihe ningaruka zo gukomeretsa no kwaguka. Izi ngaruka nini cyane ku nsina ziri muri diverticulum, kandi ibyago byo guswera hafi ya diverticulum ni bito.

Muri iki gihe, birakenewe kandi gusobanukirwa urwego rwo kwaguka. Ihame rusange ryo kwaguka ni ukugabanya ibyangiritse bisabwa kugirango ukureho amabuye. Ibyangiritse bito bisobanura ingaruka nto. Muri iki gihe, kwagura imipira (CRE) ya nipple ikikije diverticula ikoreshwa muburyo bwo kwirinda EST.

Abarwayi bafite indwara zifata hematologiya, imikorere yumutima udashobora kwihanganiraERCP, cyangwa uruti rwumugongo rudashobora kwihanganira umwanya muremure wibumoso ukunze guhagarara ugomba kwitonderwa no gusuzumwa mugihe uhuye namabuye atoroshye.

02Imitekerereze yo guhangana n "amabuye atoroshye"

Imitekerereze itari yo iyo uhuye n "" amabuye atoroshye ": umururumba no gutsinda, uburangare, agasuzuguro mbere yo gukora, nibindi.

· Umururumba no gukunda ibyagezweho

Iyo duhuye namabuye yumuyaga, cyane cyane afite amabuye menshi, burigihe dushaka gukuraho amabuye yose. Ubu ni ubwoko bw "umururumba" nitsinzi rikomeye.

Mubyukuri, birakwiye gufata ibyuzuye nibyera, ariko gufata ibyera kubiciro byose ni "byiza" cyane, bikaba bidafite umutekano kandi bizazana ingorane nyinshi ningorane. Amabuye menshi yimyanda igomba guhitamo byimazeyo ukurikije uko umurwayi ameze. Mubihe bidasanzwe, umuyoboro ugomba gushyirwa cyangwa gukurwa mubice.

Iyo amabuye manini manini bigoye kuyakuraho by'agateganyo, "stent dissolution" irashobora gutekerezwa. Ntugahatire gukuraho amabuye manini, kandi ntukishyire mubihe bibi cyane.

· Kwirengagiza

Nukuvuga, imikorere idahwitse idafite isesengura ryuzuye nubushakashatsi akenshi biganisha ku gukuraho amabuye. Kubwibyo, ibibazo byamabuye yimyanda bigomba gusuzumwa neza mbere yo kubagwa, bigasuzumwa neza (bisaba ubushobozi bwaERCPabaganga gusoma amashusho), gufata ibyemezo byitondewe hamwe na gahunda yihutirwa bigomba gukorwa kugirango birinde amabuye atunguranye.

UwitekaERCPgahunda yo gukuramo amabuye igomba kuba siyanse, intego, yuzuye, kandi irashobora kwihanganira gusesengura no gutekereza. Tugomba gukurikiza ihame ryo kugwiza inyungu abarwayi kandi ntitubishaka.

· Agasuzuguro

Amabuye mato mugice cyo hepfo yumuyoboro wa bili biroroshye kwirengagiza. Niba amabuye mato ahuye nibibazo byubatswe mugice cyo hepfo yumuyoboro wumuyoboro no gusohoka, bizagorana cyane gukuramo ibuye.

ERCPkuvura amabuye yimyanda ifite impinduka nyinshi ningaruka nyinshi. Biragoye kandi bishobora guteza akaga cyangwa birenzeERCPkuvura ibibyimba byo mu mara. Kubwibyo, niba utabifata nabi, uzasiga inzira ikwiye yo guhunga.

03Ni gute wakemura "amabuye atoroshye"

Iyo uhuye namabuye atoroshye, hagomba gukorwa isuzuma ryuzuye ryumurwayi, hagomba gukorwa kwaguka bihagije, aigiseke gisubira inyumaigomba guhitamo hamwe na lithotripter yateguwe, kandi gahunda yateguwe na gahunda yo kuvura igomba gutegurwa.

Nkubundi buryo, ibyiza nibibi bigomba gusuzumwa hashingiwe kumiterere yumurwayi mbere yo gukomeza.

Gufungura gutunganya

Ingano yo gufungura ishingiye kumiterere yibuye ryerekanwe hamwe numuyoboro wa bile. Mubisanzwe, gutemagura bito + binini (hagati) kwaguka bikoreshwa mukwagura gufungura. Mugihe cya EST, birakenewe kwirinda binini hanze na bito imbere.

Iyo udafite uburambe, biroroshye gukora incike "nini hanze ariko ntoya imbere", ni ukuvuga, insina isa nini hanze, ariko nta gutembereza imbere. Ibi bizatera gukuraho amabuye kunanirwa.

Mugihe ukora EST, "umuheto utagabanije no gutinda buhoro" bigomba gukoreshwa kugirango wirinde kwangirika. Gutemagura bigomba kwihuta nka buri gutemagura. Icyuma ntigomba "kuguma guma" mugihe cyo gukomeretsa kugirango wirinde kwonsa no gutera pancreatite. .

· Gutunganya isuzuma ryigice cyo hasi no kohereza hanze

Amabuye y'amazi asanzwe akenera gusuzuma igice cyo hepfo no gusohoka k'umuyoboro rusange. Imbuga zombi zigomba gusuzumwa. Ihuriro ryombi rigena ibyago ningorabahizi byimikorere ya nipple.

· Lithotripsy yihutirwa

Kurenza urugero runini kandi rukomeye amabuye adashobora guteshwa agaciro agomba kuvurwa na lithotripter yihutirwa (lithotripter yihutirwa).

Amabuye ya pigment ya bilile arashobora kumenwa mo ibice, kandi ibyinshi mumabuye akomeye ya cholesterol nabyo birashobora gukemurwa murubu buryo. Niba igikoresho kidashobora kurekurwa nyuma yo kugarura, kandi lithotripter ntishobora kumena amabuye, ni "ingorane". Muri iki gihe, eyeMAX irashobora gukenerwa kugirango tumenye neza kandi tuvure amabuye.

Icyitonderwa: Ntukoreshe lithotripsy mugice cyo hepfo no gusohoka mumiyoboro isanzwe. Ntukoreshe lithotripsy yuzuye mugihe cya lithotripsy, ariko usige umwanya wabyo. Lithotripsy yihutirwa irashobora guteza akaga. Mugihe cyihutirwa cya lithotripsy, umurongo wanyuma urashobora kuba udahuye numuyoboro wa bili, kandi impagarara zirashobora kuba nini cyane kuburyo zitatera gutobora.

· Stent gushonga ibuye

Niba ibuye ari rinini kandi ritoroshye kuyikuramo, urashobora gutekereza gusesa stent - ni ukuvuga gushyira stent ya plastike. Tegereza kugeza ibuye rigabanutse mbere yo gukuraho ibuye, noneho amahirwe yo gutsinda azaba menshi cyane.

· Amabuye yimbere

Abaganga bakiri bato bafite uburambe buke nibyiza kudakora endoskopique ivura intrahepatic bile duct amabuye. Kubera ko amabuye yo muri kariya gace adashobora kugwa mu mutego cyangwa ashobora kwiruka cyane kandi akabuza gukomeza gukora, umuhanda ni mubi cyane kandi ni muto.

· Amabuye y'amazi ahujwe na peripapillary diverticulum

Birakenewe gusuzuma ingaruka n'ibiteganijwe kwaguka. Ibyago byo gutobora EST ni byinshi, kuburyo ubu uburyo bwo kwagura imipira bwatoranijwe. Ingano yo kwaguka igomba kuba ihagije kugirango ikureho ibuye. Inzira yo kwaguka igomba kugenda gahoro gahoro, kandi nta kwaguka cyangwa kwaguka byemewe. Siringe yaguka uko bishakiye. Niba hari kuva amaraso nyuma yo kwaguka, birakenewe kuvurwa.

Twebwe, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., Ni uruganda mu Bushinwa ruzobereye mu gukoresha endoskopi, nkabiopsy imbaraga,hemoclip,umutego,inshinge,spray catheter,cytology,kuyobora,igitebo cyo kugarura amabuye,izuru biliary drainage catheter nibindi. zikoreshwa cyane muriEMR,ESD,ERCP. Ibicuruzwa byacu byemewe na CE, kandi ibihingwa byacu byemewe na ISO. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika y'Amajyaruguru, Uburasirazuba bwo hagati ndetse no muri Aziya, kandi bigera ku bakiriya bamenyekana kandi bashimwe!