ERCP bụ teknụzụ dị mkpa maka nyocha na ọgwụgwọ ọrịa biliary na pancreatic.Ozugbo ọ pụtara, o nyela ọtụtụ echiche ọhụrụ maka ọgwụgwọ ọrịa biliary na pancreatic.Ọ bụghị nanị na "radiografi".Ọ gbanweela site na teknụzụ nyocha izizi gaa n'ụdị ọhụrụ.Usoro ọgwụgwọ gụnyere sphincterotomy, iwepụ nkume bile duct, mmiri mmiri bile na ụzọ ndị ọzọ iji gwọọ ọrịa bile na pancreatic.
Ọnụọgụ ihe ịga nke ọma nke intubation bile duct maka ERCP nwere ike iru karịa 90%, mana a ka nwere ụfọdụ ebe ohere biliary siri ike na-ebute ọdịda intubation bile duct nhọrọ.Dika nkwekorita ohuru na nchoputa na ọgwụgwọ ERCP siri di, enwere ike akowa intubation siri ike dika: oge maka intubation bile duct nke isi onu ara nke ERCP bu ihe kariri nkeji iri ma obu onu ogugu nke intubation kariri ugboro ise.Mgbe ị na-arụ ọrụ ERCP, ọ bụrụ na intubation bile duct siri ike n'ọnọdụ ụfọdụ, a ga-ahọrọ usoro dị irè n'oge iji kwalite ọnụego ihe ịga nke ọma nke intubation bile duct.Edemede a na-eduzi nyocha nhazi nke ọtụtụ usoro intubation inyeaka nke a na-eji na-edozi intubation bile duct siri ike, n'ebumnuche inye usoro ihe ọmụmụ maka ndị endoscopy na-ahụ maka ụlọ ọgwụ ịhọrọ usoro nzaghachi mgbe ọ na-eche ihu mgbagwoju anya maka ERCP.
Usoro I.Singleguidewire,SGT
Usoro SGT bụ iji ihe dị iche iche na-aga n'ihu na-agbalị ịbanye bile duct mgbe waya nduzi batara n'ime pancreatic duct.N'oge mmalite nke mmepe teknụzụ ERCP, SGT bụ usoro a na-ahụkarị maka intubation biliary siri ike.Uru ya bụ na ọ dị mfe ịrụ ọrụ, na-edozi ọnụ ọnụ ara, ma nwee ike ịbanye na oghere nke pancreatic duct, na-eme ka ọ dịkwuo mfe ịchọta oghere nke bile duct.
Enwere akụkọ na akwụkwọ akụkọ na mgbe intubation nke ọdịnala na-ada, ịhọrọ intubation na-enyere aka SGT nwere ike mezue intubation bile duct nke ọma n'ihe dịka 70%-80% nke ikpe.Akụkọ ahụ gosikwara na n'ọnọdụ nke ọdịda SGT, ọbụna mgbanwe na ngwa nke okpukpu abụọndumoduTeknụzụ emeghị ka ọ̀tụ̀tụ̀ ịga nke ọma nke intubation bile duct adịghị ebelata ọ̀tụ̀tụ̀ nke post-ERCP pancreatitis (PEP).
Ụfọdụ nnyocha egosiwokwa na ọnụ ọgụgụ ịga nke ọma nke intubation SGT dị ala karịa nke okpukpu abụọndumoduteknụzụ na teknụzụ transpancreatic papillary sphincterotomy.Tụnyere na mgbalị ugboro ugboro nke SGT, mmalite mmejuputa iwu nke okpukpu abụọndumoduteknụzụ ma ọ bụ teknụzụ tupu mbepụ nwere ike nweta nsonaazụ kacha mma.
Kemgbe mmepe nke ERCP, e mepụtala teknụzụ ọhụrụ dị iche iche maka intubation siri ike.Tụnyere otundumodunkà na ụzụ, uru ndị ọzọ doro anya na ihe ịga nke ọma ọnụego dị elu.Ya mere, otundumoduA naghị eji teknụzụ eme ihe ugbu a n'ụlọ ọgwụ.
II.Double-guide waya usoro,DGT
DGT nwere ike ịkpọ pancreatic duct guide wire occupation method, nke bụ ịhapụ waya ndu na-abanye n'ime duct pancreatic ka ọ chọpụta ma nọrọ ya, mgbe ahụ, enwere ike itinye waya nduzi nke abụọ n'elu waya ndu pancreatic.Nhọrọ intubation bile duct.
Uru nke usoro a bụ:
(1) Site n'enyemaka nke andumodu, oghere oghere bile dị mfe ịchọta, na-eme ka intubation bile duct dị nro;
(2) waya ndu nwere ike idozi ọnụ ara;
(3) N'okpuru nduzi nke duct pancreaticndumodu, enwere ike izere ịhụ ụzọ ugboro ugboro nke ọwa pancreatic, si otú ahụ belata mkpali nke ọwa pancreatic kpatara site na ntinye ugboro ugboro.
Dumonceau et al.chọpụtara na enwere ike ịtinye catheter guidewire anda contrast n'ime oghere biopsy n'otu oge ahụ, wee kọwapụta ihe ịga nke ọma nke usoro ndu ndu pancreatic duct, wee kwubie nandumoduibido usoro ọwa pancreatic na-aga nke ọma maka intubation bile duct.ọnụego nwere mmetụta dị mma.
Ọmụmụ na DGT nke Liu Deren et al.chọpụtara na ka emechara DGT na ndị ọrịa nwere ERCP bile duct intubation siri ike, ọnụ ọgụgụ ịga nke ọma nke intubation ruru 95.65%, nke dị elu nke ukwuu karịa 59.09% ọganiihu nke intubation oge ochie.
Ọmụmụ ihe na-atụ anya nke Wang Fuquan et al.rụtụrụ aka na mgbe etinyere DGT na ndị ọrịa nwere ERCP bile duct intubation siri ike n'ime otu nnwale, ọnụ ọgụgụ ịga nke ọma intubation ruru 96.0%.
Ọmụmụ ihe ndị a dị n'elu na-egosi na itinye DGT n'ọrụ na ndị ọrịa nwere nsogbu intubation bile duct maka ERCP nwere ike imeziwanye ọganihu nke ntanye bile duct nke ọma.
Mmejọ nke DGT gụnyere isi ihe abụọ ndị a:
(1) Ọrịa pancreaticndumodunwere ike furu efu n'oge intubation bile duct, ma ọ bụ nke abụọndumodunwere ike ịbanye ọzọ na duct pancreatic;
(2) Usoro a adabaghị maka ikpe ndị dị ka ọrịa kansa isi pancreatic, nhụsianya duct pancreatic, na fission pancreatic.
Site n'echiche nke omume PEP, ihe omume PEP nke DGT dị ala karịa nke intubation bile duct.Nnyocha e mere na-atụ anya na-egosi na ihe omume PEP na-esote DGT bụ nanị 2.38% na ndị ọrịa ERCP nwere nrịbama bile duct siri ike.Ụfọdụ akwụkwọ na-egosi na ọ bụ ezie na DGT nwere ọganihu dị elu nke ntanye bile duct, ọnụ ọgụgụ nke ọrịa pancreatitis na-esote DGT ka dị elu ma e jiri ya tụnyere usoro ọgwụgwọ ndị ọzọ, n'ihi na ọrụ DGT nwere ike imebi duct pancreatic na oghere ya.N'agbanyeghị nke a, nkwenye n'ụlọ na ná mba ọzọ ka na-arụtụ aka na n'ọnọdụ nke siri ike bile duct intubation, mgbe intubation siri ike na pancreatic duct na-ezighị ezi ugboro ugboro, DGT bụ nke mbụ nhọrọ n'ihi na DGT technology nwere dịtụ obere ihe isi ike na-arụ ọrụ, na dịtụ mfe. iji chịkwaa.A na-ejikarị ya eme ihe na nhọrọ siri ike intubation.
III.Wire ndu cannulation-pan-creatic stent,WGC-P5
A pụkwara ịkpọ WGC-PS usoro ọrụ stent nke pancreatic.Usoro a bụ iji tinye stent nke pancreaticndumodunke na-ezighi ezi na-abanye n'ime eriri afọ pancreatic, wee wepụ yandumoduma mee cannulation bile duct n'elu stent.
Ọmụmụ Hakuta et al.gosiri na gbakwunyere na-emeziwanye ọnụego ihe ịga nke ọma n'ozuzu intubation site n'ịduzi intubation, WGC-PS nwekwara ike ichekwa oghere nke eriri afọ pancreatic ma belata ihe omume PEP nke ukwuu.
Ọmụmụ na WGC-PS nke Zou Chuanxin et al.rụtụrụ aka na ọnụ ọgụgụ ịga nke ọma nke intubation siri ike site na iji usoro ọrụ stent nke pancreatic na-adịru nwa oge ruru 97.67%, na mbelata nke PEP na-ebelata nke ukwuu.
Otu nnyocha chọpụtara na mgbe etinyere stent nke pancreatic nke ọma, ohere nke nnukwu ọrịa pancreatitis gachara n'ọnọdụ intubation siri ike na-ebelata nke ukwuu.
Usoro a ka nwere ụfọdụ adịghị ike.Dịka ọmụmaatụ, stent pancreatic nke etinyere n'oge ọrụ ERCP nwere ike ịwepụ;Ọ bụrụ na ọ dị mkpa ka etinye stent ahụ ogologo oge mgbe ERCP gasịrị, a ga-enwe ohere dị elu nke nkwụsị nke stent na mgbochi duct.Mmerụ ahụ na nsogbu ndị ọzọ na-eduga na mmụba nke PEP.Ugbua, ụlọ ọrụ amalitela ịmụ stent nke pancreatic ducts nke nwere ike ịpụ na ọwa pancreatic ozugbo.Ebumnuche bụ iji stent duct pancreatic iji gbochie PEP.Na mgbakwunye na ibelata nke ukwuu nke ihe mberede PEP, stent dị otú ahụ nwekwara ike izere ọrụ ndị ọzọ iji wepụ stent ma belata ibu na ndị ọrịa.Ọ bụ ezie na ọmụmụ egosila na stent pancreatic na-adịru nwa oge nwere mmetụta dị mma n'ibelata PEP, ngwa ụlọ ọgwụ ha ka nwere oke oke.Dịka ọmụmaatụ, na ndị ọrịa nwere eriri pancreatic dị mkpa na ọtụtụ alaka, ọ na-esiri ike itinye stent pancreatic.Ihe isi ike ahụ ga-abawanye nke ukwuu, ọrụ a na-achọkwa ọkwa endoscopy ọkachamara dị elu.Ọ dịkwa mma ịmara na stent nke pancreatic a na-etinye ekwesịghị ịdị ogologo na duodenal lumen.Ogologo stent dị ogologo nwere ike ịkpata perforation duodenal.Ya mere, nhọrọ nke usoro ọrụ stent nke pancreatic ka kwesịrị ka kpachara anya.
IV.Trans-pancreatocsphincterotomy,TPS
A na-ejikarị teknụzụ TPS eme ihe mgbe waya ntuziaka batara n'ime ụzọ pancreatic n'amaghị ama.A na-agbanye septum dị n'etiti eriri pancreatic n'akụkụ ntụziaka nke eriri ndu pancreatic site na elekere 11 ruo elekere 12, mgbe ahụ, a na-etinye tube na ntụziaka nke bile duct ruo mgbe waya nduzi abanye n'ime bile. duct.
Ọmụmụ nke Dai Xin et al.tụnyere TPS na abụọ ọzọ intubation teknụzụ inyeaka.Enwere ike ịhụ na ọganihu nke teknụzụ TPS dị oke elu, na-eru 96.74%, mana ọ naghị egosi nsonaazụ pụtara ìhè ma e jiri ya tụnyere teknụzụ intubation abụọ ndị ọzọ.Uru.
A kọwapụtara na njirimara teknụzụ TPS gụnyere isi ihe ndị a:
(1) Mberibe ahụ dị ntakịrị maka septum pancreaticobiliary;
(2) Mmetụta nke nsogbu ndị na-esochi arụ ọrụ dị ala;
(3) Nhọrọ nke ntụziaka ịkpụ dị mfe ịchịkwa;
(4) Enwere ike iji usoro a maka ndị ọrịa nwere intubation duct pancreatic ugboro ugboro ma ọ bụ ara ara n'ime diverticulum.
Ọtụtụ nnyocha egosiwo na TPS nwere ike ọ bụghị nanị na-emeziwanye ọganihu ọganihu nke intubation bile duct siri ike, ma ọ dịghịkwa amụba nsogbu nke nsogbu mgbe ERCP gasịrị.Ụfọdụ ndị ọkà mmụta na-atụ aro na ọ bụrụ na intubation duct pancreatic ma ọ bụ obere duodenal papilla na-eme ugboro ugboro, a ga-ebu ụzọ tụlee TPS.Agbanyeghị, mgbe ị na-etinye TPS, ekwesịrị ị attentiona ntị na ohere nke stenosis duct pancreatic na nlọghachi nke pancreatitis, nke nwere ike ibute TPS ogologo oge.
V.Precut Sphincterotomy,PST
Usoro PST na-eji papillary arcuate band dị ka oke elu nke tupu mbepụ na ntụziaka elekere 1-2 dị ka oke iji mepee sphincter duodenal papilla iji chọta oghere nke bile na pancreatic duct.N'ebe a PST na-ezo aka kpọmkwem na usoro sphincter tupu mbepụ ọnụ ara ara na-eji mma arcuate.Dị ka atumatu iji nagide intubation bile duct siri ike maka ERCP, teknụzụ PST ka a na-ahụta n'ọtụtụ ebe dị ka nhọrọ mbụ maka intubation siri ike.Endoscopic nipple sphincter tupu mbepụ ya na-ezo aka na mbepụ endoscopic nke papilla elu mucosa na obere akwara sphincter site na mma mbepụ iji chọta oghere nke bile duct, wee jiri ya mee ihe.ndumoduma ọ bụ catheter iji tinye bile duct.
Nnyocha e mere n'ụlọ gosiri na ọganihu nke PST dị elu dị ka 89.66%, nke na-adịghị iche na DGT na TPS.Agbanyeghị, ọnọdụ PEP na PST dị elu nke ukwuu karịa nke DGT na TPS.
Ugbu a, mkpebi iji teknụzụ a dabere n'ụdị dị iche iche.Dịka ọmụmaatụ, otu akụkọ kwuru na a na-eji PST kacha mma n'ọnọdụ ebe papilla duodenal dị njọ ma ọ bụ gbagọọ agbagọ, dị ka duodenal stenosis ma ọ bụ malignancy.
Tụkwasị na nke ahụ, e jiri ya tụnyere usoro ọgwụgwọ ndị ọzọ, PST nwere nsogbu dị elu nke mgbagwoju anya dị ka PEP, na ọrụ chọrọ dị elu, n'ihi ya, ndị endoscopy nwere ahụmahụ na-arụ ọrụ a kacha mma.
VI.Needle-knife Papillotomy,NKP
NKP bụ usoro ntinye aka na-enyere aka agịga.Mgbe intubation siri ike, enwere ike iji mma agịga mee ka akụkụ nke papilla ma ọ bụ sphincter si na oghere nke duodenal papilla na ntụziaka nke elekere 11-12, wee jiri ya mee ihe.ndumoduma ọ bụ catheter na ntinye nhọrọ n'ime duct bile nkịtị.Dị ka atụmatụ anagide maka intubation bile duct siri ike, NKP nwere ike imeziwanye ọnụ ọgụgụ ịga nke ọma nke ntinye eriri bile duct siri ike.N'oge gara aga, a na-ekwenyekarị na NKP ga-abawanye mmụba nke PEP n'afọ ndị na-adịbeghị anya.N'ime afọ ndị na-adịbeghị anya, ọtụtụ akụkọ nyocha na-atụgharị uche na-egosi na NKP adịghị eme ka ihe ize ndụ nke nsogbu ndị na-esote gasịrị.Ọ dị mma ịmara na ọ bụrụ na a na-eme NKP n'oge mmalite nke intubation siri ike, ọ ga-enye aka dị ukwuu iji meziwanye ọganihu nke intubation.Agbanyeghị, enweghị nkwekọrịta ugbu a maka oge itinye NKP iji nweta nsonaazụ kacha mma.Otu nnyocha kwuru na ọnụego intubation nke NKP etinyere n'ogeERCPIhe na-erughị nkeji iri abụọ dị elu nke ukwuu karịa nke NKP etinyere ma emechaa ka nkeji iri abụọ gachara.
Ndị na-arịa ọrịa na-arịa ọrịa ike nke bile duct ga-erite uru kachasị na usoro a ma ọ bụrụ na ha nwere nhịhịa ọnụ ara ma ọ bụ nnukwu dilation bile duct.Tụkwasị na nke a, enwere akụkọ na mgbe ị na-ezute ikpe intubation siri ike, ijikọta ọnụ nke TPS na NKP nwere ọganihu dị elu karịa itinye naanị ya.Ihe ọghọm dị na ya bụ na ọtụtụ usoro mbepụ nke etinyere n'ọnụ ara ga-eme ka ọnọdụ nsogbu dịkwuo elu.Ya mere, a chọkwuru nyocha iji gosi ma ọ bụrụ na a ga-ahọrọ mmalite mmalite iji belata ọnọdụ nke nsogbu ma ọ bụ ijikọta ọtụtụ usoro mmezi iji meziwanye ọnụego ọganihu nke intubation siri ike.
VII.Needle-knife Fistulotomy,NKE
Usoro NKF na-ezo aka n'iji mma agịga dụpuo mucosa ihe dịka 5mm n'elu ọnụ ọnụ ara, na-eji oge a gwakọtara agwakọta iji gbanye oyi akwa site n'elekere 11 ruo mgbe a chọtara ihe owuwu dị ka orifice ma ọ bụ bile tojuru, wee jiri ya. waya nduzi iji chọpụta mpụta ọpụpụ bile na mbepụ anụ ahụ.A na-eme ntinye ntinye nke bile duct na saịtị jaundice.Ịwa NKF na-ebipụ n'elu oghere ọnụ ara.N'ihi ịdị adị nke bile duct sinus, ọ na-ebelata nke ukwuu mmebi okpomọkụ na mebie mebere na oghere nke pancreatic duct, nke nwere ike ibelata ihe omume PEP.
Ọmụmụ nke Jin et al.rụtụrụ aka na ọnụego ihe ịga nke ọma nke NK tube intubation nwere ike iru 96.3%, ọ nweghịkwa PEP na-aga n'ihu.Tụkwasị na nke ahụ, ọganihu nke NKF na mwepụ nkume dị elu dị ka 92.7%.Ya mere, ọmụmụ ihe a na-akwado NKF dị ka nhọrọ mbụ maka iwepụ nkume bile duct nkịtị..E jiri ya tụnyere papillomyotomy a na-emekarị, ihe ize ndụ ọrụ NKF ka dị elu, ọ na-enwekwa ike ịnweta nsogbu dị ka perforation na ọbara ọgbụgba, ọ na-achọkwa ọkwa dị elu nke endoscopy.Ebe mmeghe windo ziri ezi, omimi kwesịrị ekwesị, na usoro ziri ezi niile kwesịrị ka ejiri nwayọ mụọ.nna ukwu.
Tụnyere ụzọ ndị ọzọ tupu mbepụ, NKF bụ usoro dabara adaba yana ọnụego ọganiihu dị elu.Otú ọ dị, usoro a chọrọ omume ogologo oge na nchịkọta na-aga n'ihu site n'aka onye na-arụ ọrụ ka ọ bụrụ onye ruru eru, ya mere usoro a adịghị adabara ndị mbido.
VIII. Tinyegharịa-ERCP
Dị ka e kwuru n'elu, e nwere ọtụtụ ụzọ isi nagide intubation siri ike.Otú ọ dị, ọ dịghị nkwa nke 100% ịga nke ọma.Akwụkwọ ndị dị mkpa egosila na ọ bụrụ na intubation bile duct siri ike n'ọnọdụ ụfọdụ, ogologo oge na otutu intubation ma ọ bụ mmetụta ntinye okpomọkụ nke tupu ịkpụ nwere ike iduga duodenal papilla edema.Ọ bụrụ na ịwa ahụ na-aga n'ihu, ọ bụghị naanị na intubation bile duct agaghị aga nke ọma, mana ohere nke nsogbu ga-abawanye.Ọ bụrụ na ọnọdụ dị n'elu mere, ị nwere ike ịtụle ịkwụsị ugbu aERCPrụọ ọrụ mbụ ma mee ERCP nke abụọ n'oge nhọrọ.Mgbe papilloedema ga-apụ n'anya, ọrụ ERCP ga-adị mfe iji nweta ntinye nke ọma.
Donnellan et al.rụrụ nke abụọERCPArụ ọrụ na ndị ọrịa 51 bụ ndị ERCP dara mgbe ọ gachara nke ọma agịga-mma, na ikpe 35 gara nke ọma, na nsogbu nke nsogbu abawanyeghị.
Kim et al.rụrụ ọrụ ERCP nke abụọ na ndị ọrịa 69 dara adaERCPmgbe agịchara mma agịga, na ikpe 53 gara nke ọma, yana ọnụ ọgụgụ ịga nke ọma nke 76.8%.Okwu ikpe ndị fọdụrụ na-enwekwaghị ihe ịga nke ọma mekwara ọrụ ERCP nke atọ, yana ọnụ ọgụgụ ịga nke ọma nke 79.7%., na ọtụtụ arụmọrụ emeghị ka ọnọdụ nke mgbagwoju anya dịkwuo elu.
Yu Li et al.rụrụ elective secondaryERCPna ndị ọrịa 70 bụ ndị dara ERCP mgbe agịga mma agịga, na ikpe 50 gara nke ọma.Ọnụ ọgụgụ ihe ịga nke ọma n'ozuzu ya (nke mbụ ERCP + ERCP nke abụọ) mụbara ruo 90.6%, na nsogbu nke nsogbu amụbaghị nke ọma..Ọ bụ ezie na akụkọ egosila ịdị irè nke ERCP nke abụọ, oge dị n'etiti ọrụ ERCP abụọ ekwesịghị ịdị ogologo oge, na n'ọnọdụ ụfọdụ pụrụ iche, nkwụsị biliary na-egbu oge nwere ike ime ka ọnọdụ ahụ ka njọ.
IX.Endoscopicultrasound-eduzi biliary drainage,EUS-BD
EUS-BD bụ usoro mkpasu iwe nke na-eji agịga puncture kụpu gallbladder site na afọ ma ọ bụ duodenum lumen n'okpuru nduzi ultrasound, banye duodenum site na duodenal papilla, wee mee intubation biliary.Usoro a gụnyere ma ụzọ intrahepatic na extrahepatic.
Nnyocha e mere nlegharị anya kọrọ na ọnụ ọgụgụ ihe ịga nke ọma nke EUS-BD ruru 82%, na nsogbu nke nsogbu ndị na-eme n'ịwa ahụ bụ nanị 13%.N'ime ọmụmụ ihe atụnyere, EUS-BD ma e jiri ya tụnyere nkà na ụzụ tupu mbepụ, ọnụ ọgụgụ ọganihu nke intubation ya dị elu, na-erute 98.3%, nke dị elu karịa 90.3% nke tupu mbepụ.Otú ọ dị, ka ọ dị ugbu a, ma e jiri ya tụnyere nkà na ụzụ ndị ọzọ, a ka nwere ụkọ nyocha na ngwa nke EUS maka ihe siri ikeERCPintubation.Enweghị data ezughi oke iji gosi ịdị irè nke teknụzụ nsị bile duct nke EUS na-eduzi maka ihe siri ikeERCPintubation.Ụfọdụ nnyocha egosiwo na ọ belatara ọrụ nke PEP na-aga n'ihu adịghị ekweta.
X.Percutaneous transhepatic cholangial drainage,PTCD
PTCD bụ usoro nyocha ọzọ na-akpa ike nke enwere ike ijikọ ya na yaERCPmaka intubation bile duct siri ike, ọkachasị n'ọnọdụ mgbochi biliary dị njọ.Usoro a na-eji agịga puncture na-abanye n'ime bile duct nke ọma, gbanye bile duct site na papilla, wee gbanye bile duct nke ọma site na nke edobere.ndumodu.Otu nnyocha nyochara ndị ọrịa 47 nwere intubation bile duct siri ike bụ ndị mere usoro PTCD, ọnụ ọgụgụ ọganihu ahụ ruru 94%.
Ọmụmụ Yang et al.rụtụrụ aka na ngwa nke EUS-BD doro anya na ọ bụ oke ma a bịa n'ihe gbasara hilar stenosis na mkpa ọ dị ịkụnye eriri afọ intrahepatic ziri ezi, ebe PTCD nwere uru nke ime ihe kwekọrọ na axis bile duct na ịdị na-agbanwe agbanwe na ngwaọrụ na-eduzi.Ekwesịrị iji ntinye mmiri bile duct maka ndị ọrịa dị otú ahụ.
PTCD bụ ọrụ siri ike nke chọrọ ọzụzụ nhazi ogologo oge yana imecha ọnụọgụ ikpe zuru oke.Ọ na-esiri ndị novice ike imecha ọrụ a.PTCD abụghị naanị ike iji rụọ ọrụ, mana nke ahụndumodunwekwara ike imebi bile duct n'oge ọganihu.
Ọ bụ ezie na ụzọ ndị a dị n'elu nwere ike imeziwanye ọnụ ọgụgụ ihe ịga nke ọma nke intubation bile duct siri ike, nhọrọ ahụ kwesịrị ịtụle nke ọma.Mgbe ị na-eme iheERCP, SGT, DGT, WGC-PS na ndị ọzọ usoro nwere ike tụlee;Ọ bụrụ na usoro ndị a dị n'elu daa, ndị agadi na ndị endoscopy nwere ahụmahụ nwere ike ịrụ usoro tupu mbepụ, dị ka TPS, NKP, NKF, wdg;ma ọ bụrụ ka Ọ bụrụ na enweghị ike ịmecha intubation bile duct, nke abụọ ahọpụtaraERCPnwere ike họrọ;Ọ bụrụ na ọ nweghị usoro ndị a dị n'elu nwere ike dozie nsogbu nke intubation siri ike, a pụrụ ịnwale ọrụ mmegide dị ka EUS-BD na PTCD iji dozie nsogbu ahụ, a pụkwara ịhọrọ ọgwụgwọ ịwa ahụ ma ọ bụrụ na ọ dị mkpa.
Anyị, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., bụ emeputa na China ọkachamara na endoscopic consumables, dị ka biopsy forceps, hemoclip, polyp ọnyà, sclerotherapy agịga, ịgba catheter, cytology brushes,ndumodu, nkata eweghachite okwute, imi biliary drainage catheterwdg nke a na-ejikarị eme ihe na EMR, ESD,ERCP.Ngwaahịa anyị bụ CE asambodo, na osisi anyị bụ ISO asambodo.Ebupụla ngwongwo anyị na Europe, North America, Middle East na akụkụ nke Eshia, na-enwetakwa ndị ahịa nke nnabata na otuto!
Oge nzipu: Jan-31-2024