Bile iwo lile

Idoju iwo bile jẹ didin ajeji ti iwo bile ti o wọpọ. Eyi jẹ ọpọn ti o nyi bile lati ẹdọ si ifun kekere. Bile jẹ nkan ti o ṣe iranlọwọ pẹlu tito nkan lẹsẹsẹ.

Idoju iṣan bile jẹ igbagbogbo ti o fa nipasẹ ipalara si awọn iṣan bile nigba iṣẹ-abẹ. Fun apẹẹrẹ, o le waye lẹhin iṣẹ abẹ lati yọ gallbladder kuro.

Awọn idi miiran ti ipo yii pẹlu:

• Akàn ti iwo bile, ẹdọ tabi ti oronro
• Ibajẹ ati aleebu nitori okuta olomi kan ninu iwo bile
• Bibajẹ tabi aleebu lẹhin yiyọ gallbladder
• Pancreatitis
• Akọkọ sclerosing cholangitis

Awọn aami aisan pẹlu:

• Inu ikun ni apa ọtún oke ti ikun
• Biba
• Ibà
• Nyún
• Gbogbogbo rilara ti aibalẹ
• Isonu ti yanilenu
• Jaundice
• Ríru ati eebi
• Igba tabi awọn otita awọ-amọ

Awọn idanwo wọnyi le ṣe iranlọwọ iwadii ipo yii:

• Endoscopic retrograde cholangiopancreatography (ERCP)
• Percutaneous transhepatic cholangiogram (PTC) Iyipada
• Oju eeyan cholangiopancreatography (MRCP)
• Endoscopic olutirasandi (EUS)

Awọn idanwo ẹjẹ wọnyi le ṣe iranlọwọ lati ṣafihan iṣoro kan pẹlu eto biliary.

• Alkaline phosphatase (ALP) ga ju deede lọ.
• Ipele enzymu GGT ga ju deede lọ.
• Ipele Bilirubin ga ju deede lọ.

Ipo yii tun le paarọ awọn abajade ti awọn idanwo wọnyi:

• Ipele Amylase
• Ipele Lipase
• Ito bilirubin
• Akoko Prothrombin (PT)

Aṣeyọri ti itọju ni lati ṣatunṣe idinku. Eyi yoo gba laaye bile lati ṣan lati ẹdọ sinu ifun.

Eyi le ni:

• Isẹ abẹ
• Endoscopic tabi fifọ percutaneous tabi fi sii awọn stents nipasẹ ihamọ naa

Ti iṣẹ abẹ ba ti ṣe, a ti yọ ihamọ naa kuro. Ikun bile ti o wọpọ yoo pada wa pẹlu ifun kekere.

Ni diẹ ninu awọn ọrọ miiran, a fi irin kekere kan tabi tube apapo apapo (stent) kọja ikọlu ifun bile lati jẹ ki o ṣii.

Itọju jẹ aṣeyọri julọ julọ akoko naa. Aṣeyọri igba pipẹ da lori idi ti ihamọ naa.

Iredodo ati idinku ti iṣan biliary le pada si diẹ ninu awọn eniyan. Ewu wa fun ikolu loke agbegbe ti o dín. Awọn ihamọ ti o wa fun igba pipẹ le ja si ibajẹ ẹdọ (cirrhosis).

Pe olupese iṣẹ ilera rẹ ti awọn aami aisan ba tun waye lẹhin pancreatitis, cholecystectomy, tabi iṣẹ abẹ biliary miiran.

Bile iwo ti o muna; Iyatọ Biliary

• Bile ọna

Anstee QM, Jones DEJ. Ẹkọ aisan ara. Ni: Ralston SH, ID Penman, Strachan MWJ, Hobson RP, awọn eds. Awọn Ilana Davidson ati Iṣe Oogun. 23rd atunṣe. Philadelphia, PA: Elsevier; 2018: ori 22.

Fogel EL, Sherman S. Awọn arun ti gallbladder ati awọn iṣan bile. Ni: Goldman L, Schafer AI, awọn eds. Oogun Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: ori 146.

Ibrahim-zada I, Ahrendt SA. Isakoso ti awọn eefin biliary ti ko lewu. Ni: Cameron AM, Cameron JL, awọn eds. Itọju Iṣẹ-iṣe Lọwọlọwọ. 13th ed. Philadelphia, PA: Elsevier; 2020: ori 462-466.

Jackson PG, Evans SRT. Eto Biliary. Ni: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, awọn eds. Iwe-ẹkọ Sabiston ti Isẹ abẹ. 20th ed. Philadelphia, PA: Elsevier; 2017: ori 54.