Gallstones

Gallstones yog cov tso nyiaj nyuaj uas tsim nyob rau hauv lub zais khoom. Cov no tuaj yeem me me li pob zeb hauv cov xuab zeb lossis loj npaum li lub pob golf.

Qhov ua rau ntawm lub qog ua mob txawv txav. Muaj ob hom kab mob pob zeb:

• Lub pob zeb ua los ntawm cov roj (cholesterol) - Qhov no yog hom ntau. Cov roj (cholesterol) hauv lub cev tsis muaj feem ntsig txog cov roj (cholesterol) hauv cov ntshav. Feem ntau, lawv tsis pom ntawm CT scans.
• Cov pob zeb ua los ntawm bilirubin - Cov no yog hu ua cov xim pob zeb. Lawv tshwm sim thaum cov qe ntshav liab raug puas tsuaj thiab ntau bilirubin nyob hauv cov kua tsib.

Gallstones muaj ntau yam nyob hauv:

• Poj niam zij poj niam
• Cov Neeg Qhab Asmeskas thiab cov neeg ntawm haiv neeg Hispanic
• Cov neeg muaj hnub nyoog tshaj 40 xyoo
• Cov neeg uas rog dhau
• Cov neeg muaj keeb kwm ntawm tsev neeg muaj mob gallstones

Cov hauv qab no yam tseem ua rau koj muaj feem ntau txhim kho qog qes:

• Mob pob txha los yog hloov khoom nruab nrog cev
• Mob ntshav qab zib
• Ua tsis tiav ntawm lub zais zis mus rau cov kua tsib hauv kom raug (qhov no feem ntau tshwm sim thaum cev xeeb tub)
• Mob siab ua mob rau daim siab thiab mob rau cov leeg (cov pob zeb ua pob)
• Cov xwm txheej kho mob uas ua rau cov ntshav liab ntau heev ua kom puas tsuaj
• Ceev ceev kom yuag los ntawm kev noj zaub mov kom yuag ntau, lossis tom qab phais qhov ceeb thawj
• Tau txais khoom noj khoom haus los ntawm cov leeg ntshav rau lub sijhawm ntev (kev pub leeg plab)
• Noj tshuaj txwv

Ntau tus neeg muaj mob qog muaj cov tsos mob tsis muaj tsos mob. Cov no feem ntau pom thaum xoo hluav taws xob xoo, phais plab, lossis lwm yam txheej txheem kho mob.

Txawm li cas los xij, yog lub pob zeb loj loj ua kom lub raj lossis qhov tso dej tawm rau lub qhov ncauj tawm, koj tuaj yeem mob mob hauv nruab nrab mus rau sab xis lub plab mog. Qhov no yog hu ua biliary colic. Qhov mob yuav ploj mus yog tias lub pob zeb dhau mus rau thawj ntu ntawm txoj hnyuv.

Cov tsos mob uas yuav tshwm sim suav nrog:

• Mob ntawm sab xis sab hauv lossis nruab nrab sab sauv sab hauv tsawg kawg 30 feeb. Qhov mob yuav yog tas li lossis mob ntswj. Nws tuaj yeem xav tias ntse lossis npub.
• Ua npaws.
• Kev daj daj ntawm daim tawv thiab ntsiab muag ntawm lub qhov muag (daj ntseg daj).

Lwm cov tsos mob tuaj yeem suav nrog:

• Av ntawm cov quav tawv nqaij
• Xeev siab thiab ntuav

Kev ntsuam xyuas uas siv los kuaj tus mob gallstones lossis gallbladder muaj xws li:

• Ultrasound, plab
• CT scan, plab mog
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Gallbladder radionuclide scan
• Endoscopic ultrasound
• Sib nqus resonance cholangiopancreatography (MRCP)
• Kev Hloov Pauv Nruab Nrab cholangiogram (PTCA)

Koj tus kws kho mob yuav yuam kom kuaj ntshav li nram no:

• Bilirubin
• Kev kuaj mob siab ua haujlwm
• Ua kom tiav cov ntshav suav
• Pancreatic enzyme

NTU

Feem ntau, phais yog tsis xav tau tshwj tsis yog cov tsos mob pib. Txawm li cas los xij, tib neeg npaj yuav ua rau lub cev poob phaus tuaj yeem yuav tsum tau muaj gallstones tshem tawm ua ntej kev kho mob. Feem ntau, cov neeg uas muaj cov tsos mob yuav xav tau kev phais sai sai lossis tau sai tom qab tau pom lub pob zeb.

• Cov txheej txheem hu ua laparoscopic cholecystectomy feem ntau siv. Cov txheej txheem no siv kev phais me me, uas tso cai rau kom rov zoo dua. Tus neeg mob feem ntau tuaj yeem mus tsev tom tsev kho mob tsis pub dhau 1 hnub ntawm kev phais mob.
• Sij hawm dhau los, qhib cholecystectomy (tshem tawm txoj hnyuv) feem ntau ua tiav. Txawm li cas los xij, cov txheej txheem no tsis tshua muaj tshwm sim tam sim no.

Endoscopic retrograde cholangiopancreatography (ERCP) thiab cov txheej txheem hu ua sphincterotomy yuav ua kom pom los yog kho tus mob gallstones nyob rau hauv cov leeg kab ke.

COV TSHUAJ KHO MOB

Tshuaj noj tuaj yeem muab tso rau hauv cov ntsiav tshuaj kom yaj cov roj cholesterol ua ke. Txawm li cas los xij, cov tshuaj no yuav siv li 2 xyoos lossis ntev dua ua haujlwm, thiab cov pob zeb yuav rov tuaj tom qab kev kho mob tas.

Tsis tshua muaj, tshuaj lom neeg dhau mus rau hauv lub zais khoom los ntawm txoj raj. Cov tshuaj lom neeg sai sai rau cov roj (cholesterol) pob zeb. Qhov kev kho no yog qhov nyuaj ua, yog li nws tsis ua tiav ntau zaus. Cov tshuaj siv tshuaj tuaj yeem ua kom lom, thiab lub gallstones tuaj yeem rov qab.

KEV HLUB

Shock wave lithotripsy (ESWL) ntawm lub zais zis kuj tseem tau siv rau cov neeg uas tsis tuaj yeem hlais tawm. Qhov kev kho no tsis tau siv tas li uas nws ib zaug yog vim tias mob gallstones feem ntau rov qab los.

Koj yuav tsum noj cov zaub mov ua kua lossis ua lwm txoj hau kev los so koj lub plab zom mov tom qab koj kho. Koj tus kws khomob yuav qhia rau koj thaum koj tawm hauv lub tsev khomob mus.

Txoj kev pheej hmoo ntawm cov tsos mob lossis teeb meem los ntawm kev phais tus mob gallstones yog tsawg. Yuav luag txhua tus neeg uas muaj kev phais mob gallbladder tsis muaj lawv cov tsos mob tshwm sim.

Kev txhaws ntawm lub pob zeb ua pob yuav ua rau o lossis mob rau hauv:

• Gallbladder (cholecystitis)
• Cov raj uas nqa cov kua tsib los ntawm nplooj siab mus rau lub zais plab thiab txoj hnyuv (cholangitis)
• Mob caj pas (pancreatitis)

Hu rau koj tus kws khomob yog koj muaj:

• Hnov mob rau sab saud hauv koj lub plab
• Daj ntawm daim tawv nqaij lossis ntsiab muag dawb

Coob leej neeg, tiv thaiv tsis tau tus mob qog (gallstones). Hauv cov neeg uas rog dhau hwv, zam kev poob phaus nrawm nrawm nrawm yuav pab tiv thaiv tus mob gallstones.

Cholelithiasis; Gallbladder nres; Biliary colic; Gallstone nres; Biliary laij laij: gallstones chenodeoxycholic acids (CDCA); Ursodeoxycholic acid (UDCA, ursodiol); Endoscopic retrograde cholangiopancreatography (ERCP) - mob qog

• Gallbladder tshem tawm - laparoscopic - paug
• Gallbladder tshem tawm - qhib - tso tawm
• Gallstones - paug

• Lub plab zom mov
• Lub raum cyst nrog gallstones - CT scan
• Gallstones, cholangiogram
• Tus mob cholecystolithiasis
• Cholelithiasis
• Gallbladder
• Gallbladder tshem tawm - Series

Cov Fogel EL, Sherman S. Cov kab mob ntawm lub gallbladder thiab kua tsib lub raj. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 155.

Jackson PG, Evans SRT. Biliary system. Hauv: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Phau Ntawv Txog Kev Kho MobCov. 20 tus ed. Philadelphia, PA: Elsevier; 2017: chap 54.

Wang D Q-H, Afdhal NH. Cov kab mob Gallstone. Hauv: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger thiab Fordtran's Gastrointestinal thiab Kab Mob Qog: Kab Mob Rau Ib Tus Mob / Tshuaj Ntsuam Xyuas / TswjCov. 10 tus ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 65.