Choledocholithiasis

Choledocholithiasis yog muaj tsawg kawg ib gallstone nyob rau hauv cov kua tsib uas nquag. Lub pob zeb yuav ua tau cov kua roj nplua mias lossis calcium thiab roj ntsev.

Li 1 ntawm 7 leej neeg muaj mob gallstones yuav ua pob zeb rau cov kua tsib lub ntsaws. Qhov no yog lub raj me me uas nqa cov kua tsib los ntawm lub plab mus rau txoj hnyuv.

Cov yam phom sij muaj xws li keeb kwm ntawm lub qog Txawm li cas los xij, choledocholithiasis tuaj yeem tshwm sim hauv cov neeg uas tau tshem tawm lawv lub tsib lub plab.

Feem ntau, tsis muaj cov tsos mob tshwj tsis yog tias lub pob zeb thaiv cov kev nqaj npaum li cas. Cov tsos mob tuaj yeem suav nrog:

• Mob ntawm sab xis sab hauv lossis nruab nrab sab sauv sab hauv tsawg kawg 30 feeb. Qhov mob yuav tsis tu ncua thiab mob siab rau. Nws tuaj yeem yog mob me lossis hnyav.
• Ua npaws.
• Kev daj daj ntawm daim tawv thiab ntsiab muag ntawm lub qhov muag (daj ntseg daj).
• Tsis qab los noj mov.
• Xeev siab thiab ntuav.
• Av ntawm cov quav tawv nqaij.

Kev ntsuam xyuas uas qhia qhov chaw nyob ntawm pob zeb hauv cov kua tsib lub raj muaj xws li cov hauv qab no:

• Mob plab hauv TV
• Mob plab hauv ultrasound
• Endoscopic retrograde cholangiography (ERCP)
• 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
• Ua kom tiav cov ntshav suav (CBC)
• Kev kuaj mob siab ua haujlwm
• Pancreatic enzymes

Lub hom phiaj ntawm kev kho mob yog los daws txoj kev txhaws.

Kev kho mob yuav suav nrog:

• Kev phais kom tshem tawm lub gallbladder thiab pob zeb
• ERCP thiab cov txheej txheem hu ua sphincterotomy, uas ua rau kev phais mob txiav rau hauv cov leeg nqaij ntawm cov kua tsib uas nquag ua kom pob zeb hla lossis tshem tawm

Qhov thaiv thiab kis tus kab mob tshwm sim los ntawm cov pob zeb hauv lub biliary tuaj yeem ua rau tuag taus. Feem ntau, cov txiaj ntsig tau zoo yog tias qhov teeb meem raug kuaj thiab kho thaum ntxov.

Teeb meem yuav suav nrog:

• Biliary mob plawv
• Cholangitis
• Kev mob caj dab

Hu rau koj tus kws khomob yog:

• Koj pib mob plab, nrog lossis tsis kub, thiab tsis paub tias yog vim li cas
• Koj tsim daj
• Koj muaj lwm cov tsos mob ntawm choledocholithiasis

Gallstone hauv cov kua tsib; Bile txhaws pob zeb

• Lub plab zom mov
• Lub raum cyst nrog gallstones - CT scan
• Choledocholithiasis
• Gallbladder
• Gallbladder
• Bile taug txoj kev

Almeida R, Zenlea T. Choledocholithiasis. Hauv: Ferri FF, ed. Ferri Tus Kws Pab Tswv Yim Rau Xyoo 2019Cov. Philadelphia, PA: Elsevier; 2019: 317-318.

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 Mob. 20 tus ed. Philadelphia, PA: Elsevier; 2017: chap 54.