Ho buoa bakeng sa mofetše oa pancreatic

Ho etsoa opereishene ea pancreatic ho phekola mofets'e oa tšoelesa ea manyeme.

Manyeme a teng kamora mpa, lipakeng tsa duodenum (karolo ea pele ea mala a manyane) le spleen, le ka pele ho mokokotlo. E thusa tšilong ea lijo. Manyeme a na le likarolo tse tharo tse bitsoang hlooho (bophara bo pharalletseng), bohareng le mohatla. Karolo eohle kapa karolo ea manyeme e tlosoa ho latela sebaka sa hlahala ea mofetše.

Hore na ts'ebetso e etsoa laparoscopically (ho sebelisa kh'amera e nyane ea video) kapa ho sebelisa opereishene ea roboto ho latela:

• Boholo ba ho buuoa
• Phihlelo le palo ea ho buuoa ke ngaka e buoang eo u e entseng
• Phihlelo le palo ea ho buuoa e etsoang sepetlele seo u tla se sebelisa

Ho buuoa ho etsoa sepetlele ka anesthesia e akaretsang ka hona u robetse ebile ha u na bohloko. Mefuta e latelang ea ho buoa e sebelisoa kalafong ea kalafo ea mofetše oa pancreatic.

Tsamaiso ea Whipple - Ena ke opereishene e atileng haholo bakeng sa mofetše oa pancreatic.

• Ho na le sehiloeng ka mpeng ea hau 'me hlooho ea manyeme ea tlosoa.
• The gallbladder, bile duct, le karolo ea duodenum (karolo ea pele ea mala a manyane) le tsona lia ntšoa. Ka linako tse ling, karolo ea mpa ea tlosoa.

Pancreatectomy e fapaneng le splenectomy - Ts'ebetso ena e sebelisoa hangata bakeng sa lihlahala tse bohareng le mohatla oa manyeme.

• Bohareng le mohatla oa manyeme lia tlosoa.
• Spleen le eona e ka tlosoa.

Kakaretso ea pancreatectomy - Ts'ebetso ena ha e etsoe khafetsa. Ha ho na molemo oa letho oa ho ntša manyeme kaofela haeba mofetše o ka phekoloa ka ho tlosa karolo e le 'ngoe feela ea tšoelesa.

• Ho sehiloe ka mpeng ea hau mme manyeme kaofela a ntšoa.
• The gallbladder, spleen, karolo ea duodenum, le lymph node tse haufi le tsona lia tlosoa. Ka linako tse ling, karolo ea mpa ea tlosoa.

Ngaka ea hau e ka khothaletsa ts'ebetso ea ho buoa ho alafa mofetše oa manyeme. Ho buoa ho ka emisa ho ata ha mofets'e haeba hlahala e sa hola kantle ho manyeme.

Likotsi tsa ho buuoa le ho thethebatsoa ka kakaretso ke:

• Matšoao a alejiki meriana
• Mathata a phefumolohang
• Mathata a pelo
• Ho tsoa mali
• Tšoaetso
• Mali a koala maoto le matšoafo

Likotsi tsa ts'ebetso ena ke:

• Ho dutla ha maro a tsoang manyeme, methapo ea bile, mpa kapa mala
• Mathata ka ho qeta mpa
• Lefu la tsoekere, haeba 'mele o sitoa ho etsa insulin e lekaneng
• Ho fokotsa boima ba 'mele

Kopana le ngaka ea hau ho etsa bonnete ba hore mathata a bongaka a kang lefu la tsoekere, khatello e phahameng ea mali le mathata a pelo kapa a matšoafo a laoloa hantle.

Ngaka ea hau e ka u kopa hore u etsoe liteko tsena tsa bongaka pele u etsoa opereishene.

• Liteko tsa mali (palo e felletseng ea mali, li-electrolyte, liteko tsa sebete le liphio)
• X-ray sefubeng kapa electrocardiogram (ECG), bakeng sa batho ba bang
• Endoscopic retrograde cholangiopancreatography (ERCP) ho hlahloba methapo ea bile le pancreatic
• CT scan
• Ultrasound

Nakong ea matsatsi a pele ho ts'ebetso:

• U ka kopuoa ho emisa ho noa mali nakoana joalo ka aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• Botsa ngaka ea hau hore na ke lithethefatsi life tseo u lokelang ho li noa ka letsatsi la ts'ebetso ea hau.
• Haeba u tsuba, leka ho emisa. Ho tsuba ho ka lieha ho fola. Botsa mofani oa tlhokomelo ea bophelo hore au thuse ho tlohela.
• Lumella mofani oa hau hore a tsebe ka serame, feberu, feberu, ho tsoa ha herpes kapa bokuli bo bong boo u ka bang le bona pele u etsoa opereishene. Haeba u kula, ho ka hlokahala hore opereishene ea hao e chechisoe.

Letsatsing la ho buuoa:

• Mohlomong u tla botsoa hore u se ke ua noa kapa ua ja letho ka lihora tse 'maloa pele u buuoa.
• Nka lithethefatsi leha e le life tseo ngaka ea hao e u boleletseng hore u li noe ka ho noa metsi hanyane.
• Latela litaelo tsa hore na u fihle sepetlele neng. Etsa bonnete ba hore o fihla ka nako.

Batho ba bangata ba lula sepetlele libeke tse 1 ho isa ho tse 2 kamora ho buuoa.

• Qalong, u tla ba sebakeng sa ho buuoa kapa sebakeng sa tlhokomelo e matla moo u ka shebelloang haufi-ufi.
• U tla fumana maro le meriana ka catheter ea methapo (IV) letsohong la hau. O tla ba le phaephe nko.
• U tla ba le bohloko ka mpeng kamora ho buuoa. U tla fumana meriana ea bohloko ka IV.
• U kanna oa ba le li-drain ka mpeng ho thibela mali le mokelikeli o mong ho aha. Li-tubes le drains li tla tlosoa ha u ntse u fola.

Ka mor'a hore u ee hae:

• Latela litaelo leha e le life tsa ho tsoa le ho itlhokomela tseo u li fuoang.
• U tla ba le ketelo e latelang le ngaka ea hau libeke tse 1 ho isa ho tse 2 kamora hore u tsoe sepetlele. Etsa bonnete ba hore u boloka kopano ena.

U kanna ua hloka kalafo e ngoe kamora hore u fole ho tsoa opereisheneng. Botsa ngaka ea hau ka boemo ba hau.

Ho buuoa ka pancreatic ho ka ba kotsi. Haeba ho etsoa opereishene, e lokela ho etsahala sepetlele moo mekhoa ena e mengata e etsoang teng.

Pancreaticoduodenectomy; Tsamaiso ea whipple; Open distal pancreatectomy le splenectomy; Laparoscopic distal pancreatectomy; Pancreaticogastrostomy

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Pucci MJ, Kennedy EP, Yeo CJ. Kankere ea Pancreatic: likarolo tsa bongaka, tlhahlobo le tsamaiso. Ka: Jarnagin WR, e hlophisitsoeng. Opereishene ea Blumgart ea Sebete, Pampiri ea Biliary, le Manyeme. La 6th. Philadelphia, PA: Elsevier; 2017: khaolo ea 62.

Litlhare GT, Wilfong LS. Kankere ea pancreatic, cystic pancreatic neoplasms, le lihlahala tse ling tsa pancreatic tse sa sebetseng. Ka: Feldman M, Friedman LS, Brandt LJ, bahlophisi. Sleisenger le Fordtran's Mafu a ka Mpeng le a Sebete: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 60.