Amatye egall

Iigallstones ziidipozithi ezinzima ezenzeka ngaphakathi kwenyongo. Oku kunokuba kuncinci njengengqolowa yesanti okanye kukhulu njengebhola yegalufa.

Unobangela wenyongo uyahluka. Zimbini iintlobo eziphambili zamatye enyongo:

• Amatye enziwe ngecholesterol - Olu lolona hlobo luqhelekileyo. Iicholesterol gallstones azihambelani nenqanaba lecholesterol egazini. Kwiimeko ezininzi, azibonakali kwizikena ze-CT.
• Amatye enziwe nge-bilirubin- la abizwa ngokuba ngamatye e-pigment. Zenzeka xa iiseli ezibomvu zegazi zitshatyalalisiwe kwaye i-bilirubin eninzi ikwi-bile.

Iigallstones ziqheleke kakhulu:

• Isini sabasetyhini
• Abemi baseMelika kunye nabantu baseSpanishi
• Abantu abangaphezu kweminyaka engama-40
• Abantu batyebe kakhulu
• Abantu abanembali yosapho yeenyongo

Ezi zinto zilandelayo zikwenza ukuba ube nakho ukuphuhlisa i-gallstones:

• Umongo wethambo okanye ukufakelwa komzimba oqinileyo
• Seswekile
• Ukungaphumeleli kwe-gallbladder ukukhupha i-bile ngokufanelekileyo (oku kunokwenzeka ukuba kwenzeke ngexesha lokukhulelwa)
• Isibindi sokuqina kwesifo kunye nosulelo lwe-biliary tract (amatye anebala)
• Iimeko zonyango ezibangela ukuba iiseli ezibomvu zegazi zitshatyalaliswe
• Ukwehla ngokukhawuleza kwesisindo ekutyeni ukutya okunesikhalori esisezantsi kakhulu, okanye emva kotyando lokulahleka kobunzima
• Ukufumana isondlo ngethambo ixesha elide (ukutya ngaphakathi)
• Ukuthatha iipilisi zolawulo lokuzalwa

Abantu abaninzi abane-gallstones abanazo iimpawu. Ezi zihlala zifumaneka ngexesha le-x-ray yesiqhelo, utyando lwesisu, okanye enye inkqubo yonyango.

Nangona kunjalo, ukuba ilitye elikhulu livimba ityhubhu okanye i-duct ekhupha i-gallbladder, unokuba nentlungu ephazamisayo phakathi kwesokudla esiswini. Oku kwaziwa njenge-bicic colic. Intlungu iyahamba ukuba ilitye lidlula kwinxalenye yokuqala yamathumbu amancinci.

Iimpawu ezinokuthi zenzeke zibandakanya:

• Ubuhlungu kwisisu esikwinqanaba eliphezulu okanye esiphakathi esiswini ubuncinci imizuzu engama-30. Intlungu inokuhlala ihleli okanye icekeceke. Ingaziva ibukhali okanye ibuthuntu.
• Ifiva.
• Ukuthungwa kwesikhumba kunye nabamhlophe bamehlo (i-jaundice).

Ezinye iimpawu zingabandakanya:

• Izitulo zombala wodongwe
• Isicaphucaphu nokugabha

Iimvavanyo ezisetyenziselwa ukufumanisa i-gallstones okanye i-gallbladder inflammation iquka:

• I-Ultrasound, isisu
• Ukuvavanywa kwe-CT, isisu
• I-Endoscopic retrograde cholangiopancreatography (ERCP)
• Ukususwa kwe-gallbladder radionuclide scan
• I-endoscopic ultrasound
• Imagnetic resonance cholangiopancreatography (MRCP)
• Ipolututaticatichephepatic cholangiogram (PTCA)

Umboneleli wakho wezempilo unokuyalela olu vavanyo lwegazi lulandelayo:

• Bilirubin
• Uvavanyo lomsebenzi wesibindi
• Gcwalisa ubalo lwegazi
• I-enzyme yePancreatic

UKUGQIBELA

Uninzi lwexesha, utyando aludingeki ngaphandle kokuba iimpawu ziqala. Nangona kunjalo, abantu abacwangcisa utyando lokulahleka kobunzima banokufuna ukuba kususwe inyongo ngaphambi kokuba kwenziwe inkqubo. Ngokubanzi, abantu abaneempawu baya kufuna utyando ngoko nangoko okanye kwakamsinya emva kokufunyanwa kwelitye.

• Inkqubo ebizwa ngokuba yi-laparoscopic cholecystectomy isetyenziswa kakhulu. Le nkqubo isebenzisa ukusikwa okuncinci kotyando, okuvumela ukubuyela ngokukhawuleza. Isigulana sinokuhlala sibuyele esibhedlele kungaphelanga usuku olu-1 lotyando.
• Kwixesha elidlulileyo, cholecystectomy evulekileyo (ukususwa kwenyongo) yayihlala isenziwa. Nangona kunjalo, obu buchule bungaqhelekanga ngoku.

I-Endoscopic retrograde cholangiopancreatography (ERCP) kunye nenkqubo ebizwa ngokuba yi-sphincterotomy inokwenziwa ukufumana okanye ukunyanga i-gallstones kwi-bile duct.

AMAYEZA

Amayeza anokunikwa kwifom yeepilisi ukuze kunyibilike amatye enyongo e-cholesterol. Nangona kunjalo, la machiza angathatha iminyaka emi-2 okanye ngaphezulu ukuba asebenze, kwaye amatye angabuya emva kokuba unyango luphelile.

Ngokuqhelekileyo, iikhemikhali zidluliselwa kwi-gallbladder ngokusebenzisa i-catheter. Imichiza inyibilikisa ngokukhawuleza amatye e-cholesterol. Olu nyango kunzima ukwenza, ngenxa yoko alwenziwa rhoqo. Iikhemikhali ezisetyenzisiweyo zinokuba yityhefu, kwaye iinyongo zingabuya.

LITHOTRIPSY

Umothuko we-lithotripsy (ESWL) ye-gallbladder ikwasetyenziselwa abantu abangakwaziyo ukwenza utyando. Olu nyango alusetyenziswanga rhoqo njengoko lwalunjalo kuba inyongo ihlala ibuya.

Kuya kufuneka ukuba ube kukutya okungamanzi okanye uthathe amanye amanyathelo okunika inyongo yakho yokuphumla emva kokuba unyangwe. Umboneleli wakho uya kukunika imiyalelo xa uphuma esibhedlele.

Ithuba leempawu okanye iingxaki ezivela kutyando lwenyongo lisezantsi. Phantse bonke abantu abenziwe utyando lwe-gallbladder abanazo iimpawu zabo ezibuyayo.

Ukuvalwa ngamatye enyongo kunokubangela ukudumba okanye usulelo kwi:

• IGallbladder (cholecystitis)
• I-Tube ephethe i-bile ukusuka kwisibindi ukuya kwi-gallbladder kunye namathumbu (cholangitis)
• Iipancreas (pancreatitis)

Fowunela umnikezeli wakho ukuba unayo:

• Intlungu kwinxalenye ephezulu yesisu sakho
• Mthubi ulusu okanye abamhlophe bamehlo

Kwinkoliso yabantu, iinyongo azinakuthintelwa. Kubantu abagqithisileyo, ukuphepha ukulahleka kwesisindo ngokukhawuleza kunokunceda ukukhusela i-gallstones.

Cholelithiasis; Uhlaselo lwenyongo; Colic Biliary; Ukuhlaselwa kweGallstone; Ubalo lweBiliary: iinyongo ze-chenodeoxycholic acid (CDCA); Ursodeoxycholic acid (UDCA, ursodiol); I-Endoscopic retrograde cholangiopancreatography (ERCP) -inyongo

• Ukususwa kwe-gallbladder-laparoscopic-discharge
• Ukususwa kwenyongo - ukuvulwa okuvulekileyo
• Gallstones - ukukhutshwa

• Inkqubo yokwetyisa
• Izintso zezintso ezinama-gallstones - i-CT scan
• Amatye egall, cholangiogram
• ICholecystolithiasis
• Cholelithiasis
• Inyongo
• Ukususwa kwerbbladder-Uthotho

UFogel EL, uSherman S. Izifo ze-gallbladder kunye ne-bile ducts. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Umhla wama-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 155.

UJackson PG, uEvans SRT. Inkqubo yeBiliary. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 54.

UWang D QH, Afdhal NH. Isifo seGallstone. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Amathumbu kunye nezifo zesibindi: iPathophysiology / Diagnosis / Management. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 65.