Pancreatoduodenectomy mankhwala ndi mavuto

Pakali pano, khansa pancreatic ndi mtundu wamba khansa. Nthawi zambiri, Mapa ndi zotsatira wokongola zoipa. Pamene anali kumupima, madokotala azindikire pamaso pa metastases sekondale, amene kuukira minofu wathanzi ziwalo zina.

The drawback chachikulu cha matenda ndi kuti mwaonapo zizindikiro zilizonse zizindikiro matenda. Pankhaniyi, maselo a khansa kuyamba kukula ndi mphamvu kwambiri. Pa kudziwika ambiri odwala metastases ntchito mpheto opaleshoni.

pancreatoduodenectomy Technology

Kuti resection pancreatoduodenal akhoza wodwala? Opaleshoni akusonyeza okhawo odwala amene zotupa ndi kutanthauzira osiyana mu kapamba. opaleshoni Izi amachita ngati ndondomeko achire.

Pamaso opaleshoni dokotala achititsa matenda womveka wa limba anakhudzidwa. Ndiyamika mayeso ultrasound ndi kusanthula zosiyanasiyana chitsanzo matenda limasonyeza mtundu wa opaleshoni.

Ngati khansayo ili mu mutu wa kapamba kapena pafupi ndi kutsegula kwa ritsa pancreatic, madokotala madokotala Whipple. Pamaso pa ndondomeko zilonda m'dera la thupi kapena mchira wa madokotala kapamba kuchita pancreatectomy.

Opaleshoni (pancreatoduodenal resection kapena opaleshoni Whipple) anali woyamba kuchitikira oyambirira 1930. Alan dokotala Whipple. Cha m'ma 60 ntchentche wa kusokonezedwa imfa amenewa anali mkulu ziwerengero zokwanira.

Chibwenzi pancreatoduodenal resection imatengedwa kukhala otetezeka kotheratu. kungachititse imfa anakana mlingo wa 5%. Zotsatira zake zomalizira za phukusi la mwachindunji amadalira zinachitikira akatswiri a dokotala wa.

ndondomeko Kodi

Tiyeni tione mmene kubala pancreatoduodenal resection. Magawo a ntchito pansipa. M'kupita kwa ntchito ngati woleza ntchito kuchotsa pancreatic mutu dera. Mu matenda aakulu anagwira tsankho kuchotsa ya ndulu ritsa ndi duodenum. Ngati khansayo isanafalikire m'mimba, izo anachita kufufutidwa tsankho.

Pambuyo pancreatoduodenectomy madokotala kulumikiza otsala zigawo pancreatic. Ya ndulu ritsa mwachindunji olumikizidwa kwa intestine lapansi. Nthawi opareshoni ichi ndi 8 maola. Pambuyo opaleshoni ya mtima ndi outpatient chithandizo, zimafunika za 3 masabata.

Laparoscopy Whipple

Njira imeneyi mankhwala ikuchitika kuti kuwerengetsa malo a khansa. Laparoscopy Whipple kwambiri amachepetsa nthawi konzanso wodwalayo. Mtundu wa opaleshoni ikuchitika pamaso pa odwala ampullary khansa.

Laparoscopic opaleshoni imagwiridwa kudzera amacheka yaing'ono pamimba. Linapangidwa madokotala odziwa ndi zipangizo zina zapadera zachipatala. Ntchito yachibadwa Whipple imachitika amacheka m'mimba kukula chidwi.

Pamene laparoscopic opaleshoni, madokotala kunena zoona magazi imfa pa njira opaleshoni. Amaonanso chiopsezo osachepera kulowa mitundu yosiyanasiyana ya matenda.

Pamene ntchito zofunika Whipple

Pali zingapo magawo umene ntchito amatha kukonza kwathunthu alili. Njirazi ndi monga:

• zotupa khansa ya mutu wa dipatimenti ya kapamba (unachitikira pancreatoduodenal pancreatectomy).
• Chotupa chija m'dera la duodenum ndi.
• Cholangiocarcinoma. Pankhaniyi chotupa amakhudza maselo thanzi la ndime chiwindi ya ndulu.
• Ampullar khansa. Apa khansa lili ritsa pancreatic zimafunika ya ndulu mu duodenum ndi.

Opaleshoni wa mtundu uwu amagwiritsidwa ntchito pa matenda a zotupa chosaopsa. Zikuphatikizapo matenda monga kapamba aakulu.

Pafupifupi 30% odwala kukumana mtundu uwu wa mankhwala. Iwo ama chotupa malo mwa kapamba. Chifukwa chosowa zizindikiro bwinobwino ambiri a milandu zimachitika odwala metastasis ziwalo zina. Kugwira ntchito mu imeneyo ya matenda sizimatanthauza.

Pancreatoduodenectomy Chimayambitsa matenda molondola m'madipatimenti anakhudzidwa limba. Kulola nkhani zogwirizana adzakusonyezani chithunzi cha matenda.

Kukula yaing'ono ya kansa yotupa kulola njira laparoscopic. Chifukwa cha zimenezi, madokotala sangakhoze kwathunthu kuchotsa zinkakhala m'dera, motero popanda kuwononga ziwalo zina za zinthu zonse m'mimba.

Zotsatira za mankhwala

odwala ambiri kufunsa funso lomwelo: zotsatira pankreatoduodnalnoy resection? Pa zaka zapitazi 10, wodwalayo amafa amagwa 4%. choona kuti zabwino zimatheka pamaso pa zimene zinachitikira lalikulu la dokotala kuchita opaleshoni.

Pamene pancreatic adenocarcinoma Whipple ntchito amalola Kupulumutsa moyo za odwala 50%. Mu anasiya zotupa mu dongosolo lymphatic, kukhwimitsa kuonjezera kupulumuka odwala kangapo.

Pambuyo ntchito wodwala ulipo pa njira ya radiotherapy ndi mankhwala amphamvu. Izi ndi zofunika kuti kuwononga maselo a khansa kufalikira ku ziwalo zina.

chithandizo Ndiponso pambuyo opaleshoni ali contraindicated odwala ndi pamaso pa mtima wabwino chotupa, komanso ndi limasinthira neuroendocrine.

Pancreatoduodenectomy: Njira opaleshoni

Pa ndondomeko opaleshoni amachotsa ambiri a thupi, amene ali ndi udindo kwa katulutsidwe wa insulin. Poyankha, zimathandiza kuchepetsa mlingo wa shuga mu dongosolo magazi. Tsankho resection kwambiri kuchepetsa kupanga insulin. Chifukwa cha zimenezi, ambiri odwala kwambiri kumaonjezera ngozi ya kudwala matenda monga matenda a shuga.

Odwala misinkhu shuga magazi ambiri atengeke mtundu wa matenda. misinkhu Normal shuga mu mtima ndi aakulu kapamba pakalibe kwambiri amachepetsa chitukuko cha matenda a shuga.

Kumapeto kwa ndondomekoyi konzanso ndi dokotala kupezeka akuonetsa zakudya. Kuchokera zakudya Tisawasale kwambiri mafuta ndi zakudya mchere. Nthawi zambiri, pambuyo aziloŵerera, odwala ambiri anali tsankho zakudya zotsekemera. Pankhaniyi, ntchito yake contraindicated.

Zovuta opaleshoni Whipple

Mtundu wa chithandizo ali pangozi mokwanira mkulu matendawo. Kapezekedwe ka zinachitikira akatswiri a dokotala a kwambiri amachepetsa zosayembekezereka ya vuto lirilonse. mavuto ambiri monga:

• Maonekedwe a fistula pancreatic. Pa opaleshoni ya dokotalayo zikugwirizana ndi England ku dipatimenti matumbo. Zofewa minofu thupi msoko pancreatic kuteteza machiritso mofulumira. Nthawi imeneyi, pali imfa ya madzi pancreatic.
• Tsankho ziwalo za mmimba. Pambuyo opaleshoni ya mtima akapatsidwa jekeseni kudzera njira IV. Izi ndi zofunika kuti abwezeretse ntchito yachibadwa m'mimba.

Chakudya pambuyo pancreatoduodenectomy ayenera kukhala zolondola, zizolowezi zoipa zonse muyenera kuthetsa. Kugwilizana ndi malangizo onse a munthuyo pang'onopang'ono ndi moyo wabwinobwino.