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Incazelo yezigulane ezizokwenziwa uhlolo okuthwi yi-Endoscopic Retrograde Cholangio Pancreatography(ERCP)

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Ingabulazigcawu

Ugqirha wakho ucele ukukwenza oluhlolo kuthiwe yiERCP ye bile duct nepancreas ukwenzela azuqonda izigulo ezikhoyo kulamalungu omzimba. Oku kuzomncenda akwazi ukukunceda ngokungaphatheki kwakho kakuhle zezizifo. Longumgaqo oqhelekileyo othi asetyenziswe ekufumaneni nokuphilise izigulo zepancreas, bile duct ne gallbladder. Le yindlela efanayo nendlela ekuhlolwa ngayo isisu ngoba nayo lombhobho ufakwa imlonyeni ukwenzela kuzohlolwa ibile duct nepancreatic duct. Ngaphezu koko lendlele ikwasetyenziswa ekuphiliseni okanye ekukhangeleni amatye akwi common bile duct. iX-rays ziyathathwa ngexesha lokwenziwa kolhlolo kungoko kubalulekile okokube ubaxelele oogqirha xa ekhona amathuba okokuba ukhulelwe.

Amalungiselelo anyanzelisa okokuba isisu sesigulane singabinakutya. Into leyo ethetha okukuba isigulane asifuneki sitye kutya okanye sisele nasiphi na isiselo okanye nokuba yintoni na ifakwa emlonyeni kangangexesha eliziyure ezibalekayo (ngokomthetho isigulane kufuneka sigqibelise ebusuku ukutya phambi koluhlobo). Ukutya okuqinileyo kubalulekile okokuba kungatyiwa kangangexesha eliziyure ezintandathu, yona into eselwayo kangangexesha eliziyure ezine phambi koluhlobo.

Imikhombiso

Ukuhlola kwesigulane esiphethwe yijaundice enokubangelwa kukuvaleka kwebile duct. Ukuhlola ezinye izigulo zebile duct.
Ukuhlola kwezigulane ezirhaneleka kumhlaza wepancreas, recurrent pancreatitis or pancreatic cyst.
Ukuhlola ibile duct or pancreatic duct emva kokwenzakela. 
Ukuhlolisisa isimo sebile duct nepancreatic duct ngaphambi kokuhlinzwa.

Umgaqo

Ugqirha okanye umongikazi uzakucacisela indlela okwenziwa ngayo oluhlolo phambi kokuba lwenziwe. Ngezizathu zokoyika nokungaqhelani nalendlela yokuhlola, izigulane zidla ngokunikwa iyeza lokuthomalalisa ingqondo ( bona “conscious sedation”- what you need to know) “conscious sedation” le yincwadi enencukaca ngayo yonke imithomalalisi yengqondo. Izigulane sizinika igcuntswana leyeza ekuthiwa yiDormicum okanye omnye umthomalalisi ofanayo nalo. Okukuba likelakhona iyeza elalikelakuphatha kakubi ngaphambili kubalulekile okukuba umxelele ugqirha ngaphambi kokuba akunike naliphina iyeza. Umthomalalisi wentlungu uye anikwe ukwenzela ukuthambisa umva womqala nombhobho wokuhlola uzakungena lula emqaleni.

Kuyanyanzeleka okokuba akhutshwe amazinyo emboleko, contact lenses, spectacles kunye nobucwebe,lenquba yenzelwa phezu kwetafise yeX-ray. Umqala uzakufakwa iyeza lokuphelisa intlungu. Into yokukhusela umlomo izakufakwa phakathi kwamazinyo. Umbhobho uzakufakwa emlonyeni ayokutsho emphinjeni. Lo mbhobho wokuhlola awuzuphazamisa indlela ophefumla ngayo okanye ukuvise intlungu. Lomgaqo uthatha imizuzu engangesiqingatho uyakutsho kwiyure.

Omva kwalomgaqo kungabanzinyana ukuginya. Unyanzelekile okokuba ungatyi okanye usele isiselo kangangethuba eliyiyure emva kwayoyonke lento, kwaye awuvumelekanga ukuqhuba isithuthi ngoba umthomalalisi wengqondo ukwenza kubenzima oku.


Ubungozi nezinye izinto ezinokwenzakala kulomgaqo

Lomgaqo kumaxesha amaninzi uye angabinazingozi, kodwa kungakho ingozi ezifana ne
Pancreatitis(ukudumba kwepancreas)-(kwi 0.2%-9%) yalemigaqo)
Izigulo zebile duct (0.65%-0.8%) 
Ukugqabhuka nokopha kunqabile
Ezingozi zinokubangela okokuba kufuneke isigulane sibalekiselwe esibhedlela okanye siqhaqhwe.

IERCP iindlela zokuphilisa

Okokuba iX-rays ibonisa amatye okanye enye indlela ezivaleke ngayo ibile ducts, umlomo okanye ungxunya we bile duct wenziwamkhulu ngokuwuqhawule ngocingo lombane. Ukwenzela kuzokwazeka ukukhupha amatye ayivalileyo okanye umbhobho weplastic uyasetyenziswa ekuvuleni indawo evalekileyo ukwenzela inyongo izokwazi ukuhamba lula ukuya emathunjini.

Imibuzo nenxaki emva kwalomgaqo
Qhaqhamshelana nogqirha owenze lomgaqo okanye uqgirha othunyelwe nguye okanye ngamaxesha angxamisekileyo yiya kwisibhedlela esivula maxesha onke uzofumana uncedo.


Inkcazelo siyezigulane ezizokwenziwa uhlolo lwamathumbu amakhulu

Ugqirha wakho ucele okokuba umphakathi wamathumbu akho amakhulu ahlolwe ngokusebenzisa umbhobho omde ogobekayo ukwenzela azokuqonda isigulo esikhoyo kuwo okokubasikhona.

Amalungiselelo angqongqo abalulekileyo xa kuzokwenziwe oluhlolo. Amathumbu amakhulu kufuneke acoceke angabinakutya ukwenzela ugqirha azokwazi ukwenza uhlolo olwanelisekileyo. Amalungiselelo anyanzelisa okokuba isigulane sitye ukutya okungamanzi usuku lubelunye phambi koluhlolo. Oku kwenziwa ngokusebenzisa iyeza lokuhambisa isisu ekuthiwa yiGolytey iqhele ukusebenzisa kangangelitha ezine xa ucoca amathumbu amakhulu phambi koluhlobo, amanye amalungiselelo angenziwa ngugqirha wakho. Ngezizathu zokoyika nolothuka izigulane ezininzi zinikwa imithomalalisi ngqondo Idormicum nepethidine emthanjeni xa kusenziwa uhlolo, kwakhono ugqirha angasebenzisa elinye iyeza okanye awadibanise. Buza yena uzokucacisela. Lamayeza awazukulalisa koko azokwenza uthomalale kuzokuphela nokoyika. (Bona “conscious sedation”: Yonke into ofuna ukuyazi) Okokuba uke wangaphatheki kakuhle ngenxa yalamayeza ngaphambili xelela ugqirha phambi kokuba akunike wona.

Uluhlolo lwenziwa isigulane silele ngecala lasekhohlo kwitafile yokuhlola. Impundu ziye ziqatye iyeza lokuthambisa ukwenzela umbhobho wokuhlola uzokungena lulangasemva. Ibalulekile okokuba ugqirha avuthele umoya ukwenzela azokuhlolisisalula. Oku kungakwenza uzive isisu sigcwele okanye siqunjelwe. Okokuba uziva unyanzelekile okokuba lomoya uwukhuphe, kuvumelekile oko ngaphambi kokuba ugqirha akakuvumeli. Amathumbu angamajikojiko.Xa lombhobho udlula kwezinye indawo ezijikayo emathunjini ungenza imvakalelo yokuqhineka kwesisu.Okukuqhineka kwesisu kubangcono xa lombhobho udlulile kwindawo ezijikayo .Oluhlolo luthathat ixesha eliyimizuzu eliyishumi elinanhlanu ukuyotsho kwiyure.Okokuba iipolyps kunyanzelekile okokuba zikhutshwe ,oku kungathatha ixesha elide.(iipolyps zizikhulela ezingenabungozi kodwa ezinamathuba okuba ngumhlaza).Umongikazi uncedisana nogqirha ekujongeni imeko yesigulane. Xa uhlolo lugqityiwe, uzakucelwa uphumle ixesha eliyiyure okanye ezimbini kwigumbi lokuphumlela kude kuhle amandla eyeza obulinikiwe nomoya obufakwe ngemva ude uphume.

Iipolyps zisuswa ngokuqala uzifumane ngombhobho wokuhlola emveni koko uzibophelele ngecingo esikhondweni sazo.Umbane okwelicingo uye usetyenziswe ukuqhawula lepolyp esikhondweni .Lombane usetyenziswayo awuzukuvisa zintlungu.Lepolyp iye ikhutshwe ngokuyifunxa ngomtshini wokufunxa.Ipolyp nalomtshini ziyezikhutshwe zombini.Xa ngaba zikhona ezinye iipolyp kubalulekile okokuba umtshini wokufunxa uphinde ufakwe azokukhupha ezinye iipolyps.

Kukho ubungozi obuthile kulomgaqo

1. Kukho amathuba amancici okugqabhuka okanye kuvuleke iminxunya emathunjini. Okokuba oku kukekwenzeka uqhaqho luyanyanzeleka ukwenzela kuzokulungiswa lomonakalo.
   

2. Ukulandela ukukhutswa kwepolyp, kukho amathuba amancinci okopha. Oku kungaziphelela ngokwako, okanye kufuna ukuhlolwa kwekhona okanye ngamaxesha ambalwa kufuneke uqhaqho. Ukunikezelwa ngegazi kungafuneka.
   

3. IX-ray ingasetyenziswa xa kusenziwa oluhlolo koko kubalulekile okokuba ubaxelele ogqirha xa ekhona amathuba okuba ukhulelwe.
   

Kubalulekile okokuba udibane nogqirha xa kukho ukungaphatheki kakuhle emva kwalomgaqo. Ugqirha uzakufuna ukukubona ezakuhlola engaphazamisanga maseko ukuba kukho imibuzo onayo, uyacelwa okokuba ubuze ugqirha.

 

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