Kev Hla Ib Cheeb Tsam cholangiogram

Kev txiav txim siab kab mob sib hloov pauv (PTC) yog xoo hluav taws xob ntawm cov kua tsib. Cov no yog cov hlab uas coj cov kua tsib los ntawm nplooj siab mus rau lub plab thiab lub plab hnyuv.

Qhov kev ntsuam xyuas no tau ua nyob hauv chav ntsuas hluav taws xob los ntawm kev ntsuas hluav taws xob.

Yuav kom koj mus pw ntawm koj sab nraum qab ntawm lub rooj xoo hluav taws xob. Tus kws kho mob yuav muab ntxuav sab saud sab xis thiab nruab nrab thaj tsam ntawm koj lub plab thiab tom qab ntawv thov cov tshuaj loog.

Xoo hluav taws xob thiab ultrasound raug siv los pab rau tus neeg saib xyuas kev noj qab haus huv nrhiav koj daim siab thiab daim siab. Qhov ntev, nyias, yoog yooj yim yog tom qab ntawd tso los ntawm daim tawv nqaij ua rau daim siab. Tus kws kho mob txhaj cov xim tso xim, hu ua qhov sib thooj nruab nrab, mus rau hauv cov kua tsib. Lub teeb xim sib txawv pab qhia qee qhov chaw kom lawv pom. Yuav siv cov duab xoo hluav taws xob ntau dua raws li cov xim ntws los ntawm cov kua tsib mus rau txoj hnyuv. Qhov no tuaj yeem pom ntawm cov duab saib ze ze.

Koj yuav muab tshuaj rau kom koj nyob ntsiag to (ua kom tsaug zog) rau txoj kev ua no.

Qhia rau koj tus kws kho mob yog tias koj cev xeeb tub los yog los ntshav tsis zoo.

Koj yuav muab lub tsho tshaj sab hauv tsev kho mob rau koj hnav thiab koj yuav tau kom tshem tag nrho cov hniav nyiaj hniav kub.

Yuav kom koj tsis txhob noj lossis haus dab tsi rau 6 teev ua ntej kev kuaj mob.

Qhia rau koj tus kws kho mob yog tias koj noj cov tshuaj ntshav ib ce xws li Warfarin (coumadin), Plavix (clopidogrel), Pradaxa, lossis Xarelto.

Yuav muaj kev plev li kev ua kom loog. Koj yuav muaj qee qhov tsis xis nyob vim tias koob tau nce mus rau hauv lub siab. Koj yuav muaj kev ua kom tsaug zog rau txoj kev ua no.

Qhov kev kuaj ntshav no tuaj yeem pab txheeb xyuas qhov ua kom muaj bile txhaws txhaws.

Bile yog kua tawm los ntawm lub siab tawm. Nws muaj cov roj (cholesterol), kua tsib ntsev, thiab cov khoom pov tseg. Kua tsib ntsev pab koj lub cev zom (zom) yam rog. Qhov thaiv ntawm cov kua tsib lub raum tuaj yeem ua rau lub ntsej muag daj (daj daj ua kom tawv nqaij), ua pob khaus ntawm daim tawv nqaij, lossis kis ua mob rau daim siab, lub plab zais lossis cov txiav.

Thaum nws ua yeeb yam, PTC feem ntau yog thawj feem ntawm kev ua ob-kauj ruam los daws lossis kho qhov blockage.

• Lub PTC ua ib "daim ntawv qhia kev" ntawm lub bile ducts, uas tuaj yeem siv los npaj kho qhov mob.
• Tom qab txoj kev ntawm txoj kev ntawm txoj kev ua tiav, qhov thaiv yuav tuaj yeem kho los ntawm kev muab lub kav los yog txoj hlab nyias hu ua lub qhov dej.
• Cov dej ntws lossis tso quav yuav pab kom lub cev tshem tau cov kua tsib tawm hauv lub cev. Tus txheej txheem ntawd hu ua Percutaneous Biliary Drainage (PTBD).

Bile ducts yog ib txwm muaj qhov loj me thiab ua kom pom cov neeg uas muaj hnub nyoog.

Cov txiaj ntsig tshwm sim tuaj yeem qhia tau hais tias cov ducts yog loj dua. Qhov no txhais tau tias cov ducts yog sim. Qhov blockage tuaj yeem tshwm sim los ntawm pob caws pliav lossis pob zeb. Tej zaum nws yuav qhia tus kabmob kheesxaws hauv cov kua tsib lub plab, nplooj siab, tus txiav ua pa, lossis thaj chaw ntawm lub zais zis.

Muaj feem me me ntawm kev tsis haum ntawm lub cev tsis sib xws (iodine). Kuj tseem muaj kev pheej hmoo me me rau:

• Puas tsuaj rau cov kabmob uas nyob ze
• Kev puas tsuaj rau daim siab
• Kev noj ntshav ntau dhau
• Ntshav lom (sepsis)
• Kev mob ntawm cov bile ducts
• Kab mob

Feem ntau, qhov kev ntsuas no tau ua tom qab kev kuaj mob endrogcopic cholangiopancreatography (ERCP) tau sim ua ntej. PTC tuaj yeem ua tau yog tias kev ntsuas ERCP tsis tuaj yeem ua lossis ua tsis tiav los tshem tawm qhov thaiv.

Lub zog nqus rov qab kho dua tshiab cholangiopancreatography (MRCP) yog cov qauv tshiab dua, tsis ua kom pom cov xim, raws li cov hlau nplaum rov ua kom zoo dua (MRI). Nws tseem muab cov views ntawm lub bile ducts, tab sis nws tsis yog ib txwm ua tau los ua qhov kev kuaj mob no. Tsis tas li, MRCP tsis tuaj yeem siv los kho qhov blockage.

PTC; Cholangiogram - PTC; PTC; PBD - Percutaneous biliary tso dej ntws; Percutaneous transhepatic cholangiography

• Gallbladder anatomy
• Bile taug txoj kev

Chockalingam A, Georgiades C, Hong K. Transhepatic kev cuam tshuam rau kev muaj nqaij tawv nqaij txhaws. Hauv: Cameron JL, Cameron AM, eds. Kev Kho Mob Tam Sim NoCov. 12th ed. Philadelphia, PA: Elsevier; 2017: 475-483.

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.

Lidofsky SD. Qhov muag daj. Hauv: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger thiab Fordtran's Gastrointestinal thiab Kab Mob SiabCov. 10 tus ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 21.

Stockland AH, Baron TH. Endoscopic thiab radiologic kev kho mob ntawm tus kab mob biliary. Hauv: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger thiab Fordtran's Gastrointestinal thiab Kab Mob SiabCov. 10 tus ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 70.