Ugqirha lomhlaza wepancreatic

Utyando lwepancreatic lwenziwe ukunyanga umhlaza wepancreas gland.

Ipancreas ibekwe ngasemva kwesisu, phakathi kwe-duodenum (inxalenye yokuqala yamathumbu amancinci) kunye ne-spleen, naphambi komqolo. Inceda ekutyeni ukutya. Ipancreas inamalungu amathathu abizwa ngokuba yintloko (ububanzi obude), phakathi, kunye nomsila. Yonke okanye inxenye yepancreas iyasuswa ngokuxhomekeke kwindawo yethumba lomhlaza.

Nokuba le nkqubo yenziwa nge-laparoscopically (kusetyenziswa ikhamera encinci yevidiyo) okanye ukusebenzisa utyando lweerobhothi kuxhomekeke:

• Ubungakanani botyando
• Amava kunye nenani lotyando olwenziwe ngugqirha wakho
• Amava kunye nenani lotyando olwenziwe esibhedlele oza kulisebenzisa

Utyando lwenziwa esibhedlele nge-anesthesia ngokubanzi ke ngoku ulele kwaye awunazintlungu. Ezi ndidi zilandelayo zotyando zisetyenziswa kunyango lotyando lomhlaza wepancreatic.

Inkqubo yeWhipple - Olu lolona qhaqho luqhelekileyo kumhlaza wepancreatic.

• Kusikiwe esiswini sakho kwaye intloko yepancreas iyasuswa.
• I-gallbladder, i-bile duct, kunye nenxalenye ye-duodenum (inxalenye yokuqala yamathumbu amancinci) nayo iyathathwa. Ngamanye amaxesha, inxalenye yesisu iyasuswa.

Ipancreatectomy ekude kunye ne-splenectomy- Olu tyando lusetyenziswa rhoqo kwizidumba embindini kunye nomsila wepancreas.

• Phakathi kunye nomsila wepancreas uyasuswa.
• I-spleen nayo ingasuswa.

Ipancreatectomy iyonke - Olu tyando alwenziwa rhoqo. Akukho sibonelelo sincinci sokukhupha iipancreas xa umhlaza unganyangwa ngokususa kuphela incindi.

• Kusikiwe kwenziwa esiswini sakho kwaye yonke ipancreas iyasuswa.
• I-gallbladder, i-spleen, inxalenye ye-duodenum, kunye ne-lymph nodes ezikufutshane nazo zisuswe. Ngamanye amaxesha, inxalenye yesisu iyasuswa.

Ugqirha wakho unokucebisa ngenkqubo yotyando ukunyanga umhlaza wepancreas. Utyando lunokumisa ukusasazeka komhlaza ukuba ithumba alikhulanga ngaphandle kwepancreas.

Umngcipheko wotyando kunye neanesthesia ngokubanzi zezi:

• Ukunyanga kwamayeza kunyango
• Iingxaki zokuphefumla
• Iingxaki zentliziyo
• Ukopha
• Usulelo
• Amahlwili egazi emilenzeni okanye emiphungeni

Iingozi zolu tyando zezi:

• Ukuvuza kwamanzi kwi-pancreas, i-bile duct, isisu, okanye amathumbu
• Iingxaki ngokukhupha isisu
• Isifo seswekile, ukuba umzimba awukwazi ukwenza i-insulin eyaneleyo
• Ukuhla ukusinda

Dibana nogqirha wakho ukuze uqiniseke ukuba iingxaki zesifo seswekile, uxinzelelo lwegazi oluphezulu, kunye neengxaki zentliziyo okanye zemiphunga zilawulwa kakuhle.

Ugqirha wakho unokukucela ukuba wenze olu vavanyo lonyango ngaphambi kokuba utyandwe:

• Uvavanyo lwegazi (ukubala okupheleleyo kwegazi, ii-electrolyte, uvavanyo lwesibindi kunye nezintso)
• I-x-ray yesifuba okanye i-electrocardiogram (ECG), yabanye abantu
• I-Endoscopic retrograde cholangiopancreatography (ERCP) yokuvavanya i-bile kunye ne-pancreatic ducts
• Ukuskena i-CT
• I-Ultrasound

Ngexesha leentsuku ngaphambi kotyando:

• Unokucelwa ukuba uyeke okwethutyana ukuthoba igazi njenge-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• Buza ugqirha wakho ukuba zeziphi iziyobisi omele uzithathe ngosuku lotyando lwakho.
• Ukuba uyatshaya, zama ukuyeka. Ukutshaya kunokuthoba ukunyanga. Buza umboneleli wakho wezempilo ngoncedo lokuyeka.
• Yazisa umboneleli wakho malunga nako nakuphi na ukubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye esinye isigulo onokuba naso ngaphambi kotyando lwakho. Ukuba uyagula, utyando lwakho lunokufuna ukuba limiswe elinye ixesha.

Ngomhla wotyando:

• Uya kucelwa ukuba ungaseli okanye ungatyi nantoni na iiyure ezininzi ngaphambi kotyando.
• Thatha nawaphi na amachiza ugqirha wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Landela imiyalelo ukuba ufike nini esibhedlele. Qiniseka ukuba ufika ngexesha.

Uninzi lwabantu luhlala esibhedlele iiveki ezi-1 ukuya kwezi-2 emva kotyando.

• Ekuqaleni, uya kuba kwindawo yotyando okanye ukhathalelo olunzulu apho unokujongwa khona ngokusondeleyo.
• Uyakufumana ulwelo kunye namayeza ngekheyetha yegazi efakwa ngaphakathi (IV) engalweni. Uya kuba nombhobho empumlweni yakho.
• Uya kuba neentlungu esiswini sakho emva kotyando. Uya kufumana amayeza eentlungu nge-IV.
• Unokuba ne-drain esiswini sakho ukukhusela igazi kunye nolunye ulwelo ekwakhiweni. Iityhubhu kunye nemisele iya kususwa xa uphilisa.

Emva kokuba uye ekhaya:

• Landela nayiphi na imiyalelo yokukhutshwa kunye neyokuzinyamekela oyinikiweyo.
• Uya kuba notyelelo olulandelayo kunye nogqirha wakho kwiiveki ezi-1 ukuya kwezi-2 emva kokuba uphumile esibhedlele. Qiniseka ukuba uyaligcina eli dinga.

Unokufuna olunye unyango emva kokuba uphinde wachacha. Buza ugqirha wakho malunga nemeko yakho.

Utyando lwepancreatic lunokuba yingozi. Ukuba utyando lwenziwe, kufuneka lwenziwe esibhedlele apho uninzi lwezi nkqubo lwenziwa khona.

IPancreaticoduodenectomy; Inkqubo yokubetha; I-distal pancreatectomy evulekileyo kunye ne-splenectomy; I-Laparoscopic distal pancreatectomy; Ipancreaticogastrostomy

UYesu-Acosta AD, uNarang A, uMauro L, uHerman J, uJaffee EM, uLaheru DA. I-Carcinoma yepancreas. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahl. 78.

UPucci MJ, uKennedy EP, uYo CJ. Umhlaza wepancreatic: imiba yezonyango, uvavanyo kunye nolawulo. Ku: Jarnagin WR, ed. Utyando lukaBlumgart lweSibindi, iTeknoloji yeBiliary, kunye neePancreas. Umhla wesi-6. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 62.

IShires GT, iWilfong LS. Umhlaza wepancreatic, cystic pancreatic neoplasms, kunye nezinye izidumbu zepancreatic ezingezizo ezendalo. 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 60.