Uthintelo lweeBiliary Duct

Umxholo

• Iindidi zemibhobho yenyongo
• Yintoni ebangela isithintelo se-biliary?
• Ziziphi izinto ezinobungozi?
• Ziintoni iimpawu zokuthintelwa kwe-biliary?
• Kufunyaniswa njani isithintelo se-biliary?
• Uvavanyo lwegazi
• Ultrasonography
• I-Bion radionuclide scan (i-HIDA scan)
• Cholangiography
• Ukuskena iMRI
• Imagnetic resonance cholangiopancreatography (MRCP)
• I-Endoscopic retrograde cholangiopancreatography (ERCP)
• Yintoni unyango lokuthintelwa kwe-biliary?
• Iingxaki zokuthintela i-biliary duct
• Ngaba ukuthintelwa kwe-biliary kungathintelwa?

Yintoni uthintelo lwebiliary?

Isithintelo se-biliary sisithintelo semibhobho yenyongo. Imijelo yenyongo ithwala inyongo isuka kwisibindi kunye nenyongo epancreas iye kwi-duodenum, eyinxalenye yamathumbu amancinci. IBile ngumbala oluhlaza-mnyama okanye tyheli-bumdaka ulwelo olufihlwe sisibindi ukwetyisa amafutha. Emva kokutya, i-gallbladder ikhupha i-bile ukunceda ekucoleni ukutya kunye nasekufunxeni amafutha. IBile ikwanceda ukucoca isibindi seemveliso zenkunkuma.

Ukuthintelwa kwayo nayiphi na kwezi mibhobho yenyongo kubhekiswa kuyo njengokuthintelwa kwe-biliary. Uninzi lweemeko ezinxulumene nezithintelo ze-biliary zinokunyangwa ngempumelelo. Nangona kunjalo, ukuba ukuvalelwa kuhlala kunganyangwa ixesha elide, kunokukhokelela kwizifo ezisongela ubomi besibindi.

Iindidi zemibhobho yenyongo

Uneentlobo ezininzi zemibhobho yenyongo. Ezi ndidi zimbini zemibhobho yenyongo esibindini ziyi-intrahepatic kunye ne-extrahepatic ducts.

• Imibhobho Intrahepatic: Imibhobho ye-Intrahepatic yinkqubo yeetyhubhu ezincinci ngaphakathi kwesibindi eziqokelela kwaye zihambise i-bile ukuya kwimibhobho ye-extrahepatic.
• Imibhobho Extrahepatic: Imijelo ye-extrahepatic iqala njengezahlulo ezibini, elinye lingasekunene kwesibindi elinye lingasekhohlo. Njengoko behla esibindini, bayamanyana ukwenza i-hepatic duct. Oku kugijimela ngqo emathunjini amancinci.

I-biliary duct, okanye i-duct evela kwi-gallbladder, ikwavula kwi-hepatic duct. I-bile duct ukusukela kweli nqanaba yaziwa njenge-bile duct okanye i-choledochus. Ngaphambi kokukhuphela emathunjini amancinci, umgudu oqhelekileyo we-bile udlula kwi-pancreas.

Yintoni ebangela isithintelo se-biliary?

Ukuthintelwa kwe-biliyali kunokubangelwa zizinto ezininzi ezibandakanya:

• imibhobho yenyongo
• isibindi
• inyongo
• injeke
• Ndibonise uthando

Ezi zilandelayo zezinye zezizathu eziqhelekileyo zokuthintela i-biliary:

• ngamatye enyongo, angoyena nobangela uqhelekileyo
• ukudumba kwemibhobho yenyongo
• umothuko
• ungqinisiso lwe-biliary, olucutha ngokungaqhelekanga kwendlela
• umqala
• ukwandisa ii-lymph node
• ukudumba komzimba
• ukwenzakala okunxulumene nenyongo okanye uqhaqho lwesibindi
• amathumba afikelele kwisibindi, i-gallbladder, i-pancreas, okanye i-bile ducts
• usulelo, kubandakanya i-hepatitis
• izifunxi-gazi
• i-cirrhosis, okanye isikhumba esibindayo
• umonakalo omkhulu wesibindi
• i-choledochal cyst (ekhoyo kwiintsana ekuzalweni)

Ziziphi izinto ezinobungozi?

Imiba yomngcipheko kuthintelo lwe-biliary ihlala ixhomekeke kwisizathu sokuthintelwa. Uninzi lwamatyala ziziphumo zenyongo. Oku kwenza ukuba abasetyhini babe sesichengeni sokuphuhliswa kwesithintelo se-biliary. Ezinye izinto ezinobungozi zibandakanya:

• Imbali yeenyongo
• pancreatitis ezingapheliyo
• umhlaza wepancreatic
• ukwenzakala kwinxalenye elungileyo yesisu
• ukutyeba kakhulu
• ukunciphisa umzimba ngokukhawuleza
• iimeko ezinxulumene nokonakala kweeseli ezibomvu zegazi, ezinjengearheng cell anemia

Ziintoni iimpawu zokuthintelwa kwe-biliary?

Iimpawu zokuthintela i-biliary zixhomekeke kwisizathu sokuthintelwa. Abantu abane-biliary obstruction bahlala bene:

• izitulo ezikhanyayo
• umchamo omnyama
• i-jaundice (amehlo atyheli okanye ulusu)
• ukurhawuzelela
• iintlungu kwicala elingasekunene lesisu
• isicaphucaphu
• ukugabha
• ukuhla ukusinda
• ifiva

Kufunyaniswa njani isithintelo se-biliary?

Iimvavanyo ezahlukeneyo ziyafumaneka kubantu abanokuba nesithintelo se-biliary. Ngokusekwe kwisizathu sokuthintelwa, ugqirha wakho unokucebisa olunye okanye nangaphezulu kwezi mvavanyo zilandelayo.

Uvavanyo lwegazi

Uvavanyo lwegazi lubandakanya inani elipheleleyo legazi (CBC) kunye novavanyo lomsebenzi wesibindi. Uvavanyo lwegazi luhlala luchaza iimeko ezithile, ezinje:

• cholecystitis, kukudumba kwenyongo
• I-cholangitis, kukudumba kwendlela eqhelekileyo ye-bile
• Inqanaba elonyukayo le-bilirubin edibeneyo, eyimveliso yenkunkuma yesibindi
• Inqanaba elonyukayo le-enzymes yesibindi
• inqanaba elonyukayo le-alkaline phosphatase

Nayiphi na kwezi inokubonisa ukulahleka kokuphuma kwenyongo.

Ultrasonography

I-Ultrasonography ihlala iluvavanyo lokuqala olwenziwe nakubani na okrokrelwa kuthintelo lwe-biliary. Ivumela ugqirha wakho ukuba abone inyongo ngokulula.

I-Bion radionuclide scan (i-HIDA scan)

Ukuskena i-hepatobiliary iminodiacetic acid scan, okanye ukuskena kwe-HIDA, kukwabizwa ngokuba yi-bion radionuclide scan. Isebenzisa izinto ezinemitha ye-radio ukubonelela ngolwazi oluxabisekileyo malunga nenyongo kunye naluphi na uthintelo olunokubakho.

Cholangiography

I-cholangiography yi-X-ray yemibhobho ye-bile.

Ukuskena iMRI

Uvavanyo lweMRI lubonelela ngemifanekiso eneenkcukacha zesibindi, i-gallbladder, i-pancreas, kunye ne-bile ducts.

Imagnetic resonance cholangiopancreatography (MRCP)

Imagnetic resonance cholangiopancreatography (MRCP) isetyenziselwa ukufumanisa isifo kuthintelo lwe-biliary kunye nesifo sepancreatic.

I-Endoscopic retrograde cholangiopancreatography (ERCP)

I-endoscopic retrograde cholangiopancreatography (ERCP) ibandakanya ukusetyenziswa kwe-endoscope kunye ne-X-ray. Zombini sisixhobo sokuqonda isifo kunye nonyango. Ivumela ugqirha wakho wotyando ukuba abone imibhobho yenyongo kwaye ikwasetyenziswa kunyango. Esi sixhobo siluncedo ngakumbi kuba ugqirha wakho angasisebenzisa ukususa amatye kwaye uthathe iisampulu zebhayopsy xa kukho imfuneko.

Yintoni unyango lokuthintelwa kwe-biliary?

Unyango lujolise ekulungiseni oyena nobangela. Eyona njongo iphambili yonyango okanye unyango kukunciphisa ukucinywa. Ezinye zeendlela zonyango zibandakanya i-cholecystectomy kunye ne-ERCP.

I-cholecystectomy kukususwa kwe-gallbladder ukuba kukho i-gallstones. I-ERCP inokwanela ukususa amatye amancinci kwi-bile duct okanye ukubeka i-stent ngaphakathi kwendlela yokubuyisela ukuhamba kwe-bile. Oku kuhlala kusetyenziswa kwimeko apho isithintelo sibangelwa lithumba.

Iingxaki zokuthintela i-biliary duct

Ngaphandle konyango, ukuthintelwa kwe-biliary duct kungasongela ubomi. Iingxaki ezinokubakho ngaphandle konyango zibandakanya:

• ukwakhiwa okuyingozi kwe-bilirubin
• usulelo
• ispsis
• isifo sesibindi esinganyangekiyo
• ukuqina kwesibindi

Nxibelelana nogqirha wakho ukuba uphuhlisa i-jaundice okanye uqaphele utshintsho kumbala wesitulo sakho okanye umchamo.

Ngaba ukuthintelwa kwe-biliary kungathintelwa?

Nazi iinguqu ezimbalwa onokuzenza ukunciphisa amathuba akho okuphuhlisa isithintelo se-biliary:

• Yandisa inani lefayibha ekutyeni kwakho.
• Nciphisa inani leswekile kunye namafutha awaneleyo kwisidlo sakho. Ezi zombini zinokubangela i-gallstones.
• Ukuba utyebe kakhulu, ngokuthe ngcembe ufumane ubunzima bakho kuluhlu olusempilweni ngesini sakho, ubudala, kunye nokuphakama.