Klatskin isimila: Izimpawu kanye Ukwelashwa

Klatskin isimila - a umdlavuza proximal Bile imbobo. Kumiswa zokuzikhukhumeza lolu hlobo is engxenyeni engenhla yaleli pheshana biliary, lapho bahlukene phakathi iyizingxenye isibindi. Klatskin isimila kungase elasungulwa kokubili Amapayipi, noma omunye wabo, kanye okukhipha kusukela kwesibindi. Nge isifo isimila ungasakazekela izitsha isibindi igazi.

ulwazi olujwayelekile mayelana isifo

Naphezu kweqiniso lokuthi kwezokwelapha zanamuhla iye yazuza eziningi amathuluzi awusizo lapho ungakwazi ukuthola futhi ngokushesha ukuhlola isifo, umdlavuza pancreas ziye kancane wafunda. Ikakhulukazi, lesi simo siphathelene ingxenye vnepechennogo wokugaya ukudla. Lesi sifo siphatha kakhulu ukuba isimila Klatskin amaqembu ingozi ethile. Okokuqala - izingane ezingaphansi kweminyaka engu-5 ubudala musa uhlushwa kwezinso yokusetshenziswa pheshana emathunjini. Esesibili - abantu abaye wangenela engu-60 mlando, sibhekene abalulekile biliary ipheshana ukusebenza kahle.

Umdlavuza ezingavela ngenxa yezizathu ezihlukahlukene, kodwa kwezokwelapha zanamuhla ichaza lokhu okulandelayo: kwemfucumfucu enobuthi adedelwa emkhathini obuningi; ukucindezeleka nezinye izifo sezinzwa; ukungcoliswa kwemvelo; imikhuba emibi. Ngaphezu kwalokho, isizathu kumiswa Klatskin izimila ongakhonza nokudla okungafanele:

• ukusetshenziswa kwemikhiqizo ukudla okushintshwe izakhi;
• basebenzisa kabi utshwala;
• izingilazi esiningi nezivimbelakuvunda futhi izithasiselo zokudla.

Lesi sifo livela ngenxa izinkinga eziyinkimbinkimbi ukuthi zisenza sibe zempilo. Bona ekugcineni yakha izimila ezihlukahlukene. Uma ungenalo sinake izimpawu bese uqala lesi sifo, iqhubeka ngokushesha futhi abahambisele ukungakhululeki abalulekile.

izimila Ukwahlukanisa biliary

1. Benign: papillomas, lipomas, adenomas.
2. Ebulalayo: cholangiocellular umdlavuza, nenyongo umdlavuza wesinye, umdlavuza Bile mapayipi.
3. Klatskin lwesimila.

Ukwahlukanisa emkhakheni kwasendaweni

• Ethinta Amapayipi Bile nge ekuphambukeni hepatic.
• Hlula omunye mapayipi.
• Ukunqotshwa kwe-Amapayipi ezimbili.

izikhalazo isiguli

Lesi sifo sitholakale odokotela kakhulu kuyaqabukela. yokwelashwa okuphumelelayo kuxhomeke ezicini eziningi, kodwa abalulekile kakhulu - kulokhu, ukwelapha isiguli udokotela. Uma ubuzwa lo mbuzo onguchwepheshe isikhathi, ukwelashwa ezimweni eziningi kuphumelela, futhi uma isifo iyasebenza, imiPhumela yokuFunda kumiphumela yokuhlaziya yimpumelelo kunamathuba amaningi okuthi kufanele kulindeleke. Ngokuvamile, Klatskin isimila kutholakala ukuthi uphethwe yini ngesikhathi luhlolo ngenxa nezinye izifo oyingozi noma ezingamahlalakhona of ipheshana wokugaya ukudla.

Kwezinye izimo, iziguli uze gastroenterologist nodokotela usizo ngale nkinga. Izikhalazo ezivamile iziguli kulokhu:

• ukuzimuka ohlangothini lwakhe;
• ubuthakathaka jikelele zomzimba kanye ukukhathala;
• esingachaziwe ukunambitheka kabi mouthfeel;
• umkhuhlane.

I Oncology kakhulu efanayo sitholakale ngisho simple. Iqiniso lokuthi Klatskin isimila - jaundice, njengoba ibizwa - inezimpawu ezifanayo ezifweni ezihlukahlukene, njenge isibindi parenchyma futhi ipheshana biliary.

izimpawu

Ngokuya izimpawu, lesi sifo has izici ezilandelayo:

• ukuncipha eziphawulekayo isisindo isikhathi esifushane;
• umchamo uba sezinyawo umthunzi mnyama ukuxegiselwa;
• esisebenzayo ukuqhubekela phambili kwesifo livela isikhumba silume, ukuqubuka kwesikhumba;
• isimila ezikhulayo kubangela emizweni ubuhlungu ezindaweni ezihlukahlukene lapho esiswini, abonakala emazingeni kamuva lesi sifo.

izici Etiological sokuthuthukisa uhlobo olubulalayo ezemfundo extrahepatic Bile Amapayipi cishe engaziwa. Kodwa njengoba ungalokothi uphuze ekuthuthukiseni lesi sifo zingelashwa kanje:

• Ngokuvamile abantu kuphakama amadala angu-60 Klatskin isimila ngokuhlanganyela cholelithiasis;
• Kubaluleke kakhulu kanye nezici ezithile zofuzo, ikakhulukazi abantu abavuthiwe, kodwa hhayi sokuguga;
• phakathi izifo sikakhokho angabhekwa sclerosing eyinhloko cholangitis ;
• Bebubuncani isifo kulethe ongakhonza ukusha kwesibindi kohlobo B no-C amagciwane

Njengoba kwembulwe khona isifo

izindlela eziningana ingasetshenziswa ukukhomba isimila Klatskin:

1. Transcutaneous transhepatic cholangiography - nale nqubo, odokotela ukuthola ngokugcwele X-ray of the imbobo Bile. Ukuze inqubo, isiguli akuvunyelwe amahora 6 kokuba siqale ukuba badle futhi baphuze ngesikhathi esifanayo wanikwa sedatives. Inqubo iqala ngesingeniso endaweni kwesokudla esiswini a izinzwa lendawo, bese ngokusebenzisa isikhumba ku ipheshana biliary eyenziwa inaliti mncane okuyothi udayi is injected. Khona-ke, i-X-ray, elibonisa ukuthi zikhona yini ezinye semfene esiqeshini biliary. Inqubo ephelele ekubhekeni ukunemba okuhamba inaliti kusetshenziswa umshini ultrasound. Ngaphambi nangemva transhepatic percutaneous cholangiography iziguli ebekiwe imithi elwa namagciwane ukuze avimbele kungenzeka ukutheleleka.
2. Angiography. Leli fomu ukuxilongwa inikezwa uma imbobo iseduze izitsha ezinkulu igazi kwesibindi. Nge angiography kunqunywa ukuthi washaya egeleza izitsha lwesimila. It uyabulawa kanje: in the Umthambo imbilapho eyethula tube mncane okuyothi udayi ubanjwe izinjongo ezikhethekile, okuyinto ke ludlulele ngaphakathi emithanjeni yegazi.
3. Percutaneous cholangiography transhepatic liyasetshenziswa uma kwenzeka umdlavuza, kuyasiza e isimila isimiso. It wenziwa ukucacisa kahle isikhathi of percolation izinqubo sokugembula ngemva percutaneous cholangiography transhepatic.
4. Magnetic resonance yokwelapha - eyodwa yezindlela ezingcono kakhulu uphenyo yesimila. It ikuvumela ukuba kutholakale indawo esiqondile futhi Ziveza isakhiwo izitsha isibindi.
5. Biopsy - indlela ephumelela kakhulu. kuphela ikuvumela ukunquma ngokunembile khona kuwuphawu lwesimila, isimo sawo futhi ubunjalo nezicubu. Ngokwezinhloso zalesi sigaba kuthathwe wokubhoboza ezilimele, okuyinto ke liphenywa ukuhlaziywa microbiological. Le nqubo wenziwa ngokuhlanganyela percutaneous transhepatic cholangiography.

ekwelapheni lesi sifo

Njengoba sekushiwo, kunzima kakhulu ukuba aqaphele isimila Klatskin. ukwelashwa cholangitis - kuyinto ukuqaliswa ngeqoqo lezinyathelo ukuqeda lesi sifo. Uma isikhathi kungaqali ukwelashwa, isiguli befa nakanjani phakathi kwezinyanga 4-6. Umdlavuza - a kunzima ukuyelapha isifo izici ezifanayo kanye isimila Klatskin. Ukwelashwa yalesi sifo ngokuvamile kuhilela ukususwa izicubu abathintekayo. Kulokhu, kufanele kube ngokuphelele, ukuthi, izicubu abathintekayo isuswe isilonda ngendwangu ehlanzekile. Lokhu kwenziwa ukuze endaweni ethintekile ishiywa amaseli abulalayo, ngezinye izikhathi isuswe komunye Lobe kwesibindi. Uma isimila Klatskin, okuyinto ingathiyeki kakhulu ekuthuthukiseni isibikezelo ayikwazi ukususwa ngenxa kokunqotshwa isimiso sokujikeleza kwegazi yokukhula komzimba wonke isetshenziswa ngemisebe nangamakhemikhali, kodwa ngokuvamile, kuba ayizwakali.

Lapho ukubheka poomosch

Naphezu kweqiniso lokuthi lesi sifo okukhulunywa Sekuyisikhathi eside kwaziwa, futhi kukhona izindlela zokunqanda ngokusebenzisa ukususwa izicubu, kusekhona kungekho indlela evame udaba sendlela yokuphatha abanye isimila Klatskin. Ukwelashwa nokuvikelwa cholangitis suppurative wathwala ngempumelelo ngaphandle kwa-Israyeli emitholampilo ezikhethekile ukuze athole ukwelashwa Oncology. Sekuyisikhathi eside kwadingeka Kukhona konke okudingekayo ukuze aphathe lesion lokhu isibindi nemvelo. Kuyinto imfihlo ukuthi i-Israel - indawo lokuhlushwa ochwepheshe esiqine ngokweqile kwezokwelapha, ngakho kuyaqondakala ukuthi kungani abantu lapho ziphathwa ngempumelelo futhi isimila Klatskin. Izibuyekezo iziguli iphathwa khona, abonisa ukuthi isevisi Israeli imitholampilo Oncology kuyinto ezingeni eliphezulu kakhulu.