Unyango Pancreatoduodenectomy kanye nobunzima

Ukuza kuthi ga ngoku, umhlaza pancreatic uhlobo obanga umhlaza. Kwiimeko ezininzi, uqikelelo kuba nemiphumo amahle embi. Ngethuba loviwo, oogqirha ukubona ubukho metastases zasesekondari, ezithi zihlasele ephilile zeminye imibutho.

Eyona ethile iphambili yale sifo kukuba akukho liyasetyenziswa naziphi na iimpawu zesifo sifo. Kulo mzekelo, iiseli umhlaza ziqala ukukhula ngamandla amakhulu. Xa efumanise inani elikhulu lezigulane kunye metastases ukuba enze okubi yotyando.

pancreatoduodenectomy Technology

Ukuze resection pancreatoduodenal nga recommended? Surgery iboniswe kuphela ezo izigulane zabo yamathumba kuba lizwe ecacileyo ngaphakathi pancreas. Olu tyando lisebenza njengenkqubo therapeutic.

Phambi kokuba umsebenzi ugqirha uqhuba kukho uxilongo olunzulu organ ochaphazelekayo. Ngenxa iimviwo ultrasound nokuhlalutya iintlobo ipateni sifo ibonisa uhlobo lotyando.

Ukuba umhlaza ise intloko zepancreas okanye kummandla yokuvulwa duct nepancreatic, oogqirha benza utyando Whipple. Xa kukho inkqubo amabi, kummandla umzimba okanye nomsila oogqirha nepancreas enze pancreatectomy.

Operation (resection pancreatoduodenal okanye uqhaqho Whipple) kwaqhutywa kuqala ekuqaleni 1930 Alan ugqirha Whipple. Ngasekupheleni-imi- 60 yokufa kuphazamiseka yaba manani aphezulu ngokwaneleyo.

Ukuza kuthi ga ngoku resection pancreatoduodenal kuthathwa ukuze akhuseleke ngokupheleleyo. walile Izinga lokusweleka ukuya kwinqanaba 5%. Isiphumo sokugqibela kongenelelo wayexhomekeke ngqo kwi amava nobungcali ngugqirha.

Yintoni inkqubo

Makhe siqwalasele ukuvelisa njani resection pancreatoduodenal. Amanqanaba of operation ezichazwe ngezantsi. Iikhosi imisebenzi enjalo isiguli isebenze ukususwa mmandla intloko pancreatic. Kwezifo ezinzima wayisa Ukususwa kwenxenye ye bile duct duodenum. Ukuba umhlaza yenzelwe esiswini, oko kwenziwa ucimo buso.

Emva oogqirha pancreatoduodenectomy ukudibanisa eseleyo amacandelo pancreatic. Bile duct elidityaniswe ngqo ukuya emathunjini. Ixesha lo msebenzi umalunga iiyure ezi-8. Emva kotyando isigulana unyango izigulana, nto leyo ethatha malunga 3 iiveki.

Laparoscopy Whipple

Le ndlela unyango kwenzelwa ukubala indawo somhlaza. Laparoscopy Whipple kakhulu kunciphisa ixesha kwimo umguli. Olu hlobo lotyando oluqhutywa phambi izigulane ampullary somhlaza.

utyando laparoscopy lwenziwa ngenxa ukusikwa ezincinane esiswini. Yenziwe ngu oogqirha abanamava kunye nezixhobo zonyango ezizodwa. Ukusebenza oqhelekileyo Whipple olwenziwe ukusikwa esiswini ubukhulu umxhelo.

Xa laparoscopy kotyando, oogqirha bathi igazi ilahleko ubuncinane ngexesha utyando. Kwakhona qaphela nengozi ubuncinane wokungena iintlobo ezahlukeneyo zamangenelela.

Xa operation kuyimfuneko Whipple

Kukho inani yemida phantsi apho umsebenzi uyakwazi ukulungisa ngokupheleleyo imeko yesigulane. Ezi ziquka:

• amanxeba umhlaza kwintloko yesebe zepancreas (kuqhutywa pancreatectomy pancreatoduodenal).
• Yobubi kule ndawo duodenum.
• Cholangiocarcinoma. Kulo mzekelo nethumba kuchaphazela iiseli onempilo zicatshulwa zesibindi inyongo.
• umhlaza Ampullar. Apha umhlaza ifumaneka kwi duct nepancreatic, nto leyo ethatha inyongo kungena duodenum.

Utyando elolu hlobo isetyenziselwa zezigulo yamathumba ebubonisayo. Ezi ziquka izifo ezifana pancreatitis ezigulo ezondeleyo.

Malunga nama-30% ezigulane bangenele olu hlobo lonyango. Ukuba ukuhlola indawo ithumba ngaphakathi pancreas. Ngenxa yokunqongophala iimpawu ngqo kwi uninzi kwamatyala kwenzeka izigulane Ukudlulela kwamanye amalungu. Ukwenza umsebenzi kwikhosi enjalo esi sifo akwenzi ngqiqo.

Pancreatoduodenectomy uqala ukuxilongwa bamasebe omzimba abachaphazelekayo. Uphelile wasiqwalasela echaphazelekayo iya kubonisa umfanekiso esi sifo.

Ubukhulu encinane wayenomhlaza ukuvumela iinkqubo laparoscopy. Ngenxa yoko, oogqirha ayikwazi ukususa ngokupheleleyo kummandla ochaphazelekayo, oko ngaphandle kokonakalisa namanye amalungu kwisisu.

Iziphumo zonyango

izigulane ezininzi ukubuza umbuzo ofanayo: yintoni imiphumo pankreatoduodnalnoy resection? Kule minyaka ili-10 idlulileyo, izinga lokusweleka isigulane lehla kwi-4%. Into yokuba iziphumo ezidibanisayo ifunyanwa phambi amava enkulu ugqirha ekwenzeni lo msebenzi.

Xa adenocarcinoma pancreatic Whipple ukusebenza ivumela ukusindisa ubomi malunga-50 izigulane%. Xa engekho epheleleyo yamathumba kule nkqubo emithanjeni, imilinganiselo efana ukwandisa ukusinda izigulane izihlandlo eziliqela.

Emva kotyando isigulane eyabelwe kwikhondo radiotherapy kunye nechemotherapy. Oku kuyimfuneko ukuze abatshabalalise iiseli zomhlaza yandele kwamanye amalungu.

unyango olunye emva kotyando contraindicated kwizigulane kunye kukho ithumba nabungozi, kwakunye ukulungiswa neuroendocrine.

Pancreatoduodenectomy: indlela kuhlinzwa

Ngexesha etyandwa kususa ezininzi umzimba, leyo inoxanduva secretion kwencindi. Kwelinye icala, oko kunceda ukulawula inqanaba eswekile kwinkqubo yegazi. resection Partial kunciphisa kakhulu imveliso insulin. Ngenxa yoko, uninzi lwezigulane kakhulu kwandisa ingozi yokuba izifo ezifana neswekile.

Izigulane amazinga eswekile yegazi aphezulu kakhulu kalula lo hlobo sifo. amanqanaba glucose eqhelekileyo xa isigulane chronic pancreatitis engekho wehlisa uphuhliso seswekile.

Ekupheleni kwinkqubo yokubuyisela kwisimo yi igqirha ngokuya lithethelela ukuba ukutya. Ukususela ukutya kufuneka ngaphandle kakhulu okunamafutha kunye nokutya enetyuwa. Amaxesha amaninzi, emva kokuba ungenelelo olo, izigulane ezininzi kwafuneka ukunyamezelana ukuya ukutya okumnandi. Kulo mzekelo, ukusetyenziswa kwaso contraindicated.

Iingxaki evela Whipple

Olu hlobo lonyango umntu emngciphekweni sezingeni eliphezulu yeengxaki. Ukufumaneka yamava nobungcali ugqirha kunciphisa kakhulu kukuvela nayiphi na ingxaki. iingxaki ezinokubakho ziquka:

• Imbonakalo fistula pancreatic. Ngexesha kotyando ugqirha kanga esinobubovu kwisebe emathunjini. Soft izitho komphetho umzimba pancreatic ukuthintela ukuphiliswa ngokukhawuleza. Ngeli xesha, kukho ilahleko yejusi pancreatic.
• ekukhubazekeni Partial esiswini. Emva kotyando isigulane yabelwe ngenaliti ngokusebenzisa ikhosi IV. Oku kuyimfuneko ukuze kubuyiselwe ukusebenza eqhelekileyo esiswini.

Zokutya emva pancreatoduodenectomy ekuyo kumele ibe yechanekileyo, yonke imikhwa emibi ufuna ukuphelisa. Ukungqinelana zonke izindululo umntu ngcembe abuyele ubomi obuqhelekileyo.