ERCP bụ teknụzụ dị mkpa maka nchọpụta na ọgwụgwọ nke ọrịa biliary na pancreatic. Ozugbo ọ pụtara, o nyela ọtụtụ echiche ọhụrụ maka ọgwụgwọ nke ọrịa biliary na pancreatic. Ọ bụghị naanị na "radiography". Ọ gbanweela site na teknụzụ nchọpụta mbụ gaa na ụdị ọhụrụ. Usoro ọgwụgwọ gụnyere sphincterotomy, mwepụ nkume bile duct, drainage bile na ụzọ ndị ọzọ iji gwọọ ọrịa bile na pancreas.
Ọkwa ịga nke ọma nke ntinye aka na ERCP maka ERCP nwere ike iru ihe karịrị 90%, mana enwere ụfọdụ ọnọdụ ebe ohere ịnweta biliary siri ike na-akpata ọdịda ntinye aka na duct bile. Dịka nkwenye kachasị ọhụrụ gbasara nchọpụta na ọgwụgwọ nke ERCP si dị, enwere ike ịkọwa ntinye aka siri ike dị ka: oge ntinye aka na duct bile nke isi ara nke ERCP nkịtị karịrị nkeji 10 ma ọ bụ ọnụọgụ nke mgbalị ntinye aka karịrị ugboro 5. Mgbe ị na-eme ERCP, ọ bụrụ na ntinye aka na duct bile siri ike n'ọnọdụ ụfọdụ, a ga-ahọrọ atụmatụ dị irè n'oge iji melite ọnụego ịga nke ọma nke ntinye aka na duct bile. Isiokwu a na-eme nyocha usoro nke ọtụtụ usoro ntinye aka eji edozi ntinye aka na duct bile siri ike, iji nye ntọala echiche maka ndị na-ahụ maka endoscopists ụlọ ọgwụ ịhọrọ atụmatụ nzaghachi mgbe ha chere ihu na ntinye aka na duct bile siri ike maka ERCP.
I. Usoro waya otu, SGT
Usoro SGT bụ iji ihe na-eme ka ọ dị mma iji ihe na-eme ka ọ dị mma iji ihe na-eme ka ọ dị mma iji ihe na-eme ka ọ dị mma mgbe waya nduzi banyere n'ime ọkpọkọ pancreas. N'oge mbụ nke mmepe nke teknụzụ ERCP, SGT bụ ụzọ a na-ejikarị eme ihe maka intubation siri ike nke biliary. Uru ya bụ na ọ dị mfe ịrụ ọrụ, na-edozi ara ara, ma nwee ike ịnọ n'ọnụ ụzọ ọkpọkọ pancreas, na-eme ka ọ dị mfe ịchọta oghere nke ọkpọkọ bile.
E nwere akụkọ n'akwụkwọ ndị na-egosi na mgbe intubation nkịtị dara, ịhọrọ intubation enyere aka na SGT nwere ike imecha intubation bile duct nke ọma n'ihe dị ka 70%-80% nke ikpe. Akụkọ ahụ kwukwara na n'ọnọdụ SGT dara, ọbụna mgbanwe na itinye nke abụọ n'ọrụ.waya nduziteknụzụ emeghị ka ọnụego ọganihu nke intubation bile duct dịkwuo mma ma belataghị ihe ize ndụ nke pancreatitis mgbe ERCP gasịrị (PEP).
Ụfọdụ nnyocha egosikwala na ọnụego ihe ịga nke ọma nke intubation SGT dị ala karịa nke okpukpu abụọwaya nduziteknụzụ na teknụzụ transpancreatic papillary sphincterotomy. Ma e jiri ya tụnyere mgbalị ugboro ugboro nke SGT, mmejuputa mbụ nke okpukpu abụọwaya nduziteknụzụ ma ọ bụ teknụzụ tupu mbepụ nwere ike nweta nsonaazụ ka mma.
Kemgbe e mepụtara ERCP, e mepụtala ọtụtụ teknụzụ ọhụrụ maka intubation siri ike. Ma e jiri ya tụnyere otu intubation.waya nduziteknụzụ, uru ya doro anya karịa, ọnụego ihe ịga nke ọma dịkwa elu. Ya mere, otuwaya nduziA naghị eji teknụzụ eme ihe ugbu a n'ụlọọgwụ.
II.Double-guide waya usoro,DGT
A pụrụ ịkpọ DGT usoro nduzi waya nke pancreas, nke bụ ịhapụ waya nduzi ka ọ banye na pancreas iji chọpụta ma biri na ya, wee tinye waya nduzi nke abụọ n'elu waya nduzi pancreas. Ntinye aka nke bile duct nhọrọ.
Uru nke ụzọ a bụ:
(1) Site n'enyemaka nkewaya nduzi, oghere nke ọkpọ bile dị mfe ịchọta, na-eme ka ntinye nke ọkpọ bile dị nro;
(2) Waya nduzi nwere ike idozi ara;
(3) N'okpuru nduzi nke ọkpọkọ pancreaswaya nduzi, enwere ike izere ịhụ anya ugboro ugboro nke ọkpọkọ pancreas, si otú a belata mkpali nke ọkpọkọ pancreas nke sitere na intubation ugboro ugboro.
Dumonceau na ndị otu ya chọpụtara na enwere ike itinye waya nduzi na catheter dị iche iche n'ime oghere biopsy n'otu oge, wee kọọ akụkọ ihe mere eme nke usoro ndu nke pancreas, wee kwubie nawaya nduziIji usoro pancreas mee ihe na-aga nke ọma maka intubation nke bile duct. Ọnụego ya nwere mmetụta dị mma.
Nnyocha e mere na DGT nke Liu Deren na ndị otu ya chọpụtara na mgbe e mechara DGT nye ndị ọrịa nwere nsogbu ERCP bile duct intubation, ọnụego mmeri intubation ruru 95.65%, nke dị elu karịa nke 59.09% nke ihe ịga nke ọma nke intubation nkịtị.
Nnyocha e mere n'oge Wang Fuquan na ndị otu ya gosiri na mgbe e tinyere DGT n'ahụ ndị ọrịa nwere nsogbu ERCP bile duct intubation n'ime otu nnwale ahụ, ọnụego mmeri intubation ahụ ruru 96.0%.
Ọmụmụ ihe ndị a dị n'elu na-egosi na itinye DGT n'ahụ ndị ọrịa nwere nsogbu intubation nke bile duct maka ERCP nwere ike ime ka ọnụego ọganihu nke intubation bile duct dị mma.
Ihe ndị na-adịghị mma nke DGT gụnyere isi ihe abụọ ndị a:
(1) Ọrịa pancreaswaya nduziikekwe furu efu n'oge intubation nke bile duct, ma ọ bụ nke abụọwaya nduzinwere ike ịbanye n'ime ọkpọkọ pancreas ọzọ;
(2) Usoro a adabaghị maka ikpe dịka kansa isi pancreas, nsogbu nke pancreas duct tortuosity, na pancreatic fission.
Site n'echiche nke ihe gbasara PEP, ọnụọgụgụ PEP nke DGT dị ala karịa nke ọnụọgụgụ bile duct intubation nkịtị. Nnyocha e mere n'ọdịnihu gosiri na ọnụọgụgụ PEP mgbe DGT gasịrị bụ naanị 2.38% na ndị ọrịa ERCP nwere nsogbu intubation bile duct. Ụfọdụ akwụkwọ na-egosi na ọ bụ ezie na DGT nwere ọkwa dị elu nke intubation bile duct, ọnụọgụgụ nke pancreatitis mgbe DGT gasịrị ka dị elu ma e jiri ya tụnyere usoro ọgwụgwọ ndị ọzọ, n'ihi na ọrụ DGT nwere ike imebi ọwara pancreas na oghere ya. N'agbanyeghị nke a, nkwenye n'ụlọ na mba ofesi ka na-egosi na n'ọnọdụ nke intubation bile duct siri ike, mgbe intubation siri ike ma na-aghọ aghụghọ ugboro ugboro na pancreatic duct, DGT bụ nhọrọ mbụ n'ihi na teknụzụ DGT enweghị ihe isi ike n'ọrụ, ọ dịkwa mfe ijikwa. A na-ejikarị ya eme ihe n'ọtụtụ ebe na intubation siri ike.
III. Nduzi waya cannulation-pan-creatic stent, WGC-P5
A pụkwara ịkpọ WGC-PS usoro ọrụ stent nke pancreas duct. Usoro a bụ itinye stent nke pancreas duct nawaya nduzinke na-abanye n'ime ọkpọkọ pancreas na-amaghị ama, wee dọpụta yawaya nduzima mee ka ọkpọkọ bile dị n'elu stent ahụ.
Nnyocha nke Hakuta na ndị otu ya mere gosiri na na mgbakwunye na imeziwanye ọnụego ọganihu nke intubation site n'ịduzi intubation, WGC-PS nwekwara ike ichebe oghere nke pancreas ma belata ihe PEP pụtara nke ukwuu.
Nnyocha e mere na WGC-PS nke Zou Chuanxin na ndị otu ya mere gosiri na ọnụọgụgụ ihe ịga nke ọma nke intubation siri ike site na iji usoro ọrụ stent nke pancreas ruo nwa oge ruru 97.67%, a belatakwara ọnụọgụgụ PEP nke ukwuu.
Otu nnyocha chọpụtara na mgbe e tinyere stent nke ọkpọkọ pancreas nke ọma, ohere nke nnukwu pancreatitis mgbe a wachara ahụ n'ọnọdụ siri ike nke intubation na-ebelata nke ukwuu.
Usoro a ka nwere ụfọdụ adịghị ike. Dịka ọmụmaatụ, stent duct pancreatic nke etinyere n'oge ọrụ ERCP nwere ike ịkwaga; ọ bụrụ na ọ dị mkpa ka etinye stent ahụ ruo ogologo oge mgbe ERCP gasịrị, enwere ohere dị elu nke mkpọchi stent na mgbochi duct. Mmerụ ahụ na nsogbu ndị ọzọ na-eduga na mmụba nke PEP. Ugbua, ụlọ ọrụ amalitela ịmụ banyere stent duct pancreatic nwa oge nke nwere ike ịpụ na duct pancreatic. Ebumnuche ya bụ iji stent duct pancreatic iji gbochie PEP. Na mgbakwunye na ibelata nke ukwuu ihe mberede PEP, stent ndị dị otú ahụ nwekwara ike izere ọrụ ndị ọzọ iji wepụ stent ahụ ma belata ibu dị n'ahụ ndị ọrịa. Ọ bụ ezie na ọmụmụ ihe egosila na stents duct pancreatic nwa oge nwere mmetụta dị mma n'ibelata PEP, ojiji ha n'ụlọ ọgwụ ka nwere nnukwu oke. Dịka ọmụmaatụ, na ndị ọrịa nwere duct pancreatic dị gịrịgịrị na ọtụtụ alaka, ọ na-esiri ike itinye stent duct pancreatic. Ihe isi ike ga-abawanye nke ukwuu, ọrụ a chọrọ ọkwa ọkachamara dị elu nke ndị ọkachamara endoscopist. Ọ dịkwa mkpa ịmara na stent nke pancreas duct stent etinye ekwesịghị ịdị ogologo n'ime duodenal lumen. Stent dị ogologo gabiga ókè nwere ike ibute mgbawa duodenal. Ya mere, a ka kwesịrị ịkpachara anya maka nhọrọ nke usoro ijide stent nke pancreas duct.
IV. Trans-pancreatocsphincterotomy,TPS
A na-ejikarị teknụzụ TPS eme ihe mgbe waya nduzi banyere n'ime ọkpọkọ pancreas n'amaghị ama. A na-egbutu septum dị n'etiti ọkpọkọ pancreas n'akụkụ waya nduzi ọkpọkọ pancreas site na elekere iri na otu ruo elekere iri na abụọ, wee tinye ọkpọkọ ahụ n'akụkụ ọkpọkọ bile ruo mgbe waya nduzi ahụ banyere na ọkpọkọ bile.
Nnyocha nke Dai Xin na ndị otu ya mere tụnyere TPS na teknụzụ intubation enyemaka abụọ ndị ọzọ. A pụrụ ịhụ na ọnụego ihe ịga nke ọma nke teknụzụ TPS dị elu nke ukwuu, na-eru 96.74%, mana ọ naghị egosi nsonaazụ pụrụ iche ma e jiri ya tụnyere teknụzụ intubation enyemaka abụọ ndị ọzọ. Uru ya.
Akọpụtala na njirimara nke teknụzụ TPS gụnyere ihe ndị a:
(1) Mbepụ ahụ dị obere maka septum nke pancreas;
(2) Oke nsogbu ndị a na-enwe mgbe a wachara ahụ dị obere;
(3) Nhọrọ nke ụzọ ịkpụ ihe dị mfe ijikwa;
(4) A pụrụ iji usoro a mee ihe maka ndị ọrịa nwere intubation ugboro ugboro nke pancreas duct ma ọ bụ ara n'ime diverticulum.
Ọtụtụ nnyocha egosila na TPS enweghị ike imeziwanye ọnụego ọganihu nke intubation siri ike nke bile duct, kamakwa ọ naghị eme ka nsogbu dịkwuo elu mgbe ERCP gasịrị. Ụfọdụ ndị ọkà mmụta na-atụ aro na ọ bụrụ na intubation nke pancreas duct ma ọ bụ obere papilla duodenal emee ugboro ugboro, a ga-ebu ụzọ tụlee TPS. Agbanyeghị, mgbe ị na-etinye TPS, a ga-eleba anya na ohere nke stenosis nke pancreas duct na nlọghachi nke pancreatitis, nke bụ ihe egwu ogologo oge nke TPS.
V. Precut Sphincterotomy, PST
Usoro PST na-eji eriri papillary arcuate dị ka oke elu nke tupu mbepụ ahụ na ntụziaka elekere 1-2 dị ka ókè iji mepee duodenal papilla sphincter iji chọta oghere nke bile na pancreas duct. N'ebe a, PST na-ezo aka kpọmkwem na usoro pre-incision sphincter nipple sphincter ọkọlọtọ site na iji mma arcuate. Dịka atụmatụ iji lụso intubation siri ike maka ERCP ọgụ, a na-ewere teknụzụ PST dị ka nhọrọ mbụ maka intubation siri ike. Endoscopic nipple sphincter pre-incision na-ezo aka na endoscopic incision nke papilla surface mucosa na obere obere akwara sphincter site na mma mbepụ iji chọta oghere nke bile duct, wee jiriwaya nduzima ọ bụ catheter iji tinye aka na ọkpọkọ bile.
Nnyocha e mere n'ụlọ gosiri na ọnụego ihe ịga nke ọma nke PST ruru 89.66%, nke na-adịghị iche na DGT na TPS nke ukwuu. Agbanyeghị, ọnụọgụ PEP na PST dị elu karịa nke DGT na TPS.
Ugbu a, mkpebi iji teknụzụ a dabere n'ọtụtụ ihe. Dịka ọmụmaatụ, otu akụkọ kwuru na PST kacha mma maka ndị nwere nsogbu ma ọ bụ gbagọrọ agbagọ, dịka stenosis duodenal ma ọ bụ kansa.
Tinyere nke a, ma e jiri ya tụnyere ụzọ ndị ọzọ e si alụso ọrịa ọgụ, PST nwere nsogbu dị elu dịka PEP, ihe achọrọ maka ịwa ahụ dịkwa elu, yabụ ọ kacha mma ka ndị ọkachamara n'ihe gbasara endoscopy rụọ ọrụ a.
VI. Papillotomy,NKP, agịga mma
NKP bụ usoro intubation nke ejiri mma agịga enyere aka. Ọ bụrụ na intubation siri ike, enwere ike iji mma agịga gbutuo akụkụ nke papilla ma ọ bụ sphincter site na oghere nke duodenal papilla n'akụkụ elekere 11-12, wee jiriwaya nduzima ọ bụ catheter gaa na ntinye nhọrọ n'ime ọkpọkọ bile nkịtị. Dịka atụmatụ ịnagide intubation siri ike nke ọkpọkọ bile siri ike, NKP nwere ike imeziwanye ọnụego ọganihu nke intubation siri ike nke ọkpọkọ bile n'afọ ndị na-adịbeghị anya. N'oge gara aga, a kwenyere na NKP ga-eme ka ọnụọgụ PEP dịkwuo elu n'afọ ndị na-adịbeghị anya. N'afọ ndị na-adịbeghị anya, ọtụtụ akụkọ nyocha azụ azụ egosila na NKP anaghị eme ka ihe egwu nke nsogbu mgbe ịwachara ahụ dịkwuo elu. Ọ dị mkpa ịmara na ọ bụrụ na emee NKP n'oge mmalite nke intubation siri ike, ọ ga-enyere aka nke ukwuu iji melite ọnụego ịga nke ọma nke intubation. Agbanyeghị, ugbu a enweghị nkwekọrịta na mgbe a ga-etinye NKP iji nweta nsonaazụ kacha mma. Otu nnyocha kọrọ na a na-etinye ọnụego intubation nke NKP n'ogeERCPihe na-erughị nkeji iri abụọ dị elu nke ukwuu karịa nke NKP etinyere mgbe nkeji iri abụọ gachara.
Ndị ọrịa nwere nsogbu nke ikpuchi ọkpọ bile ga-erite uru kachasị na usoro a ma ọ bụrụ na ha nwere mmụba ara ma ọ bụ mgbasa nke ọkpọ bile dị ukwuu. Na mgbakwunye, e nwere akụkọ na mgbe ha na-ezute ikpe intubation siri ike, ojiji TPS na NKP jikọtara ọnụ na-enwe ọganihu dị elu karịa itinye naanị ya. Ihe na-adịghị mma bụ na ọtụtụ usoro mbepụ etinyere na ara ga-eme ka nsogbu dịkwuo elu. Ya mere, a chọrọ nnyocha karịa iji gosi ma ị ga-ahọrọ tupu mbepụ iji belata ihe isi ike ma ọ bụ ijikọta ọtụtụ usoro ọgwụgwọ iji melite ọnụego ịga nke ọma nke intubation siri ike.
VII.Needle-knife Fistulotomy,NKE
Usoro NKF na-ezo aka n'iji mma agịga dụpuo mucosa ihe dị ka 5mm n'elu ara, jiri ike ngwakọta kpụọ oyi akwa n'otu oyi akwa n'akụkụ elekere iri na otu ruo mgbe a hụrụ nhazi dị ka oghere ma ọ bụ mmiri mmiri, wee jiri waya nduzi chọpụta ọpụpụ nke bile na mbepụ nke anụ ahụ. Emere ntinye aka na tubing nke bile na ebe jaundice dị. Awa ahụ NKF na-ebelata n'elu oghere ara. N'ihi na imi bile duct dị, ọ na-ebelata mmebi okpomọkụ na mmebi igwe na oghere nke pancreas duct, nke nwere ike ibelata ohere nke PEP.
Nnyocha nke Jin na ndị otu ya mere gosiri na ọnụego ọganihu nke intubation tube NK nwere ike iru 96.3%, ọ dịghịkwa PEP mgbe a wachara ahụ. Na mgbakwunye, ọnụego mmeri nke NKF na mwepụ nkume dị elu ruo 92.7%. Ya mere, ọmụmụ ihe a na-akwado NKF dị ka nhọrọ mbụ maka iwepụ nkume bile duct nkịtị. . Ma e jiri ya tụnyere papillomyotomy nkịtị, ihe egwu ọrụ NKF ka dị elu, ọ na-enwekarị nsogbu dịka oghere na ọbara ọgbụgba, ọ chọkwara ọkwa ọrụ dị elu nke ndị na-ahụ maka endoscopist. Ebe mmeghe windo ziri ezi, omimi kwesịrị ekwesị, na usoro ziri ezi niile kwesịrị ka a mụta nke ọma.
Ma e jiri ya tụnyere ụzọ ndị ọzọ e si ewepụ ihe n'ahụ, NKF bụ ụzọ dị mfe karị, ọ na-emekwa nke ọma karịa. Agbanyeghị, usoro a chọrọ ka onye ọrụ ahụ na-eme ihe ruo ogologo oge, ọ na-agbakọtakwa ihe niile n'ụzọ kwesịrị ekwesị iji ruo eru, yabụ usoro a adabaghị maka ndị mbido.
VIII.Megharịa-ERCP
Dịka ekwuru n'elu, e nwere ọtụtụ ụzọ isi merie nsogbu intubation siri ike. Agbanyeghị, enweghị nkwa na ọ ga-aga nke ọma 100%. Akwụkwọ ndị dị mkpa egosila na mgbe intubation duct bile siri ike n'ọnọdụ ụfọdụ, intubation ogologo oge na ọtụtụ intubation ma ọ bụ mmetụta okpomọkụ nke pre-cut nwere ike ibute ọnya papilla duodenal. Ọ bụrụ na ịwa ahụ agaa n'ihu, intubation duct bile agaghị aga nke ọma, kamakwa ohere nke nsogbu ga-abawanye. Ọ bụrụ na ọnọdụ dị n'elu emee, ị nwere ike ịtụle ịkwụsị ugbu aERCPMee ọrụ mbụ wee mee ERCP nke abụọ n'oge achọrọ. Mgbe papilloedema ahụ kwụsịrị, ọrụ ERCP ga-adị mfe inweta intubation nke ọma.
Donnellan na ndị otu ya mere nke abụọERCPịwa ahụ n'ahụ ndị ọrịa iri ise na otu ERCP ha dara ada mgbe e gbuchara ha n'ime akpa agịga, ikpe iri atọ na ise gara nke ọma, nsogbu ndị ahụ amụbaghịkwa.
Kim na ndị otu ya mere ịwa ahụ ERCP nke abụọ n'ahụ ndị ọrịa 69 dara ada.ERCPMgbe e mechara mma agịga tupu e bepụ ya, ikpe 53 gara nke ọma, na ọnụego ihe ịga nke ọma nke 76.8%. Ndị ikpe ndị ọzọ na-enweghị ihe ịga nke ọma mechara ọrụ ERCP nke atọ, na ọnụego ihe ịga nke ọma nke 79.7%., ọtụtụ ịwa ahụ emeghị ka nsogbu ndị a dịkwuo elu.
Yu Li na ndị otu ya mere ihe omume nke abụọ n'ọkwa nhọrọERCPna ndị ọrịa 70 dara ERCP mgbe a gbuchara ha tupu e jiri agịga mee ihe, na ikpe 50 gara nke ọma. Ọnụọgụgụ ihe ịga nke ọma zuru oke (ERCP mbụ + ERCP nke abụọ) mụbara ruo 90.6%, ihe isi ike ndị a amụbaghị nke ukwuu. . Ọ bụ ezie na akụkọ egosila na ERCP nke abụọ dị irè, oge dị n'etiti ọrụ ERCP abụọ ekwesịghị ịdị ogologo oge, na n'ọnọdụ ụfọdụ pụrụ iche, igbu oge mmiri biliary nwere ike ime ka ọnọdụ ahụ ka njọ.
IX. Endoscopicultrasound duziri site na drainage biliary, EUS-BD
EUS-BD bụ usoro ịwa ahụ nke na-eji agịga apịpụta eriri afọ site na afọ ma ọ bụ duodenum lumen n'okpuru nduzi ultrasound, banye na duodenum site na duodenal papilla, wee mee biliary intubation. Usoro a gụnyere ma intrahepatic na extrahepatic.
Nnyocha e mere n'oge gara aga gosiri na ọnụego ihe ịga nke ọma nke EUS-BD ruru 82%, na ọnụọgụ nke nsogbu mgbe ịwa ahụ gasịrị bụ naanị 13%. N'ọmụmụ ihe atụnyere, EUS-BD ma e jiri ya tụnyere teknụzụ tupu ịwa ahụ, ọnụego ihe ịga nke ọma ya na intubation dị elu, ruo 98.3%, nke dị elu karịa 90.3% nke tupu ịwa ahụ. Agbanyeghị, ruo ugbu a, ma e jiri ya tụnyere teknụzụ ndị ọzọ, ka nwere obere nnyocha gbasara ojiji nke EUS maka ihe siri ike.ERCPintubation. Enweghị data zuru oke iji gosi na teknụzụ mgbapụta bile nke EUS na-eduzi dị irè maka nsogbu siri ikeERCPintubation. Ụfọdụ nnyocha egosila na ọ belatala Ọrụ nke PEP mgbe a wachara ahụ adịghị mma.
X. Ọwa mmiri nke na-eme ka imeju dị n'ime akpụkpọ ahụ, PTCD
PTCD bụ usoro nyocha mwakpo ọzọ enwere ike iji ya na njikọta ya.ERCPmaka nsogbu siri ike nke ntinye bile duct, ọkachasị n'ọnọdụ ihe mgbochi biliary dị njọ. Usoro a na-eji agịga apịpụta iji banye n'ime bile duct n'ime ahụ, dọpụta bile duct site na papilla, wee tinye bile duct azụ site na nke edobere.waya nduziOtu nnyocha nyochachara ndị ọrịa 47 nwere nsogbu intubation nke bile duct intubation bụ ndị e mere usoro PTCD, ọnụego ihe ịga nke ọma ruru 94%.
Nnyocha nke Yang na ndị otu ya mere gosiri na ojiji nke EUS-BD nwere oke oke ma a bịa n'ihe gbasara stenosis hilar na mkpa ọ dị ịpịa ọkpọkọ bile dị n'ime imeju aka nri, ebe PTCD nwere uru nke ime ka ọ dabara na ọkpọkọ bile dị ma na-agbanwe agbanwe na ngwaọrụ nduzi. A ga-eji intubation bile duct mee ihe n'ime ndị ọrịa dị otú ahụ.
PTCD bụ ọrụ siri ike nke chọrọ ọzụzụ usoro ogologo oge na imecha ọnụọgụgụ zuru oke nke ikpe. Ọ na-esiri ndị mbido ike imecha ọrụ a. Ọ bụghị naanị na PTCD siri ike ịrụ ọrụ, kamakwa ọ na-esiri ike ịrụ ọrụ, kamakwa ọ na-esiri ike ịrụ ọrụ.waya nduzinwekwara ike imebi ọkpọkọ bile n'oge ọganihu.
Ọ bụ ezie na ụzọ ndị a dị n'elu nwere ike ime ka ọnụego ọganihu nke intubation siri ike nke bile duct dịkwuo mma nke ukwuu, ọ dị mkpa ka a tụlee nhọrọ ahụ nke ọma.ERCP, A pụrụ ịtụle SGT, DGT, WGC-PS na usoro ndị ọzọ; ọ bụrụ na usoro ndị a dị n'elu ada, ndị ọkachamara endoscopist agadi na ndị nwere ahụmahụ nwere ike ime usoro tupu mbepụ, dị ka TPS, NKP, NKF, wdg.; ọ bụrụ na ọ ka dị. Ọ bụrụ na enweghị ike imecha ntinye bile duct nhọrọ, nke abụọERCPenwere ike ịhọrọ; ọ bụrụ na ọ dịghị nke ọ bụla n'ime usoro ndị a dị n'elu nwere ike idozi nsogbu nke intubation siri ike, enwere ike ịnwale ịwa ahụ mwakpo dịka EUS-BD na PTCD iji dozie nsogbu ahụ, enwere ike ịhọrọ ọgwụgwọ ịwa ahụ ma ọ bụrụ na ọ dị mkpa.
Anyị, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., bụ ụlọ ọrụ mmepụta ihe na China nke ọkachamara n'ihe ndị a na-eji eme ihe na endoscopic, dịka biopsy forceps, hemoclip, polyp snare, sclerotherapy agịga, catheter spray, na cytology brushes,waya nduzi, nkata mwepụta nkume, katita drainage biliary imiwdg. nke a na-ejikarị eme ihe na EMR, ESD,ERCPNgwaahịa anyị nwere asambodo CE, ebe osisi anyị nwere asambodo ISO. Ebupụla ngwa ahịa anyị na Yuropu, North America, Middle East na akụkụ Eshia, ma na-eme ka ndị ahịa nweta otuto na otuto nke ukwuu!
Oge ozi: Jenụwarị-31-2024