ʻO ka pancreatectomy - hoʻokahi ʻano hana o ka maʻi pancreatic

ʻO ka hana hoʻopiʻi ma ka pancreas he hana koʻikoʻi a paʻakikī hoʻi.

I ka lāʻau lapaʻau, ʻike ʻia ka pancreatectomy kekahi o nā mea nui e hōʻiliʻili ai i ka wā o ka wehe ʻana o nā mea āpau a i ʻole ʻāpana o ke pancreas.

Hoʻohana ʻia kēia ala o ka mālama radical i nā hihia ʻaʻole i hāʻawi ka lāʻau lapaʻau i kahi hopena maikaʻi.

Nui kekahi ʻano o ka pancreatectomy, me ka:

  • ʻreatlelo hana (pancippoduodenectomy)
  • pale kumu iʻa,
  • paukū pancreatometry,
  • pancreatometry aoao.

Hoʻohana ʻia kēia mau kaʻina hana ma muli o ka maʻi maʻi i hana ʻia i ka mea maʻi. Akā hoʻokahi ala a i kekahi, ua pili pū lākou me ka pancreas. ʻOi paha, ma hope o ke nānā ʻana i kahi mānoanoa o ka pancreas, a i ʻole ke kanesa o kēia ʻala.

I mea e pane pololei ai i ka nīnau e like me ke ʻano o ka pancreatectomy, he ʻano ke ʻano o ke ʻano a pehea hoʻi e mākaukau pono ai no ia, pono ʻoe e hoʻomaopopo i ke ʻano he kumu no kēia hana.

Aia kēia papa inoa:

  1. Hoʻokumu ʻia o ke kō.
  2. ʻO ka pancreatitis necrotizing.
  3. ʻO ka maʻi pancreatitis me ka ʻeha.
  4. ʻEhaʻeha
  5. ʻO nā Tumors
  6. Adenocarcinoma (85%).
  7. Cystadenoma (mucinous / serous).
  8. Cystadenocarcinoma.
  9. ʻO nā ʻōpū o nā sela islet (nā tumuna neuroendocrine).
  10. Nā neoplasms papillary papillary.
  11. Lymphoma
  12. ʻO nā tumors cell cell.
  13. ʻO ka maʻi hypoglycemia koʻikoʻi.

E like me nā mea āpau e loaʻa, ʻo ka loaʻa o nā papa kauoha no ke kaʻina hana i hoʻoholo ʻia e ke kauka akamai. No ka hana ʻana i kēia, ʻike ʻia kahi hoʻokolokolo piha a hoʻokumu i ka pono no ka hana.

Nā hiʻohiʻona o nā ʻano hana like ʻole

ʻO ke kaʻina hana maʻamau ʻoi loa e pili ana me ka wehe ʻana o kahi ʻāpana o ka pancreas i kapa ʻia ka pancreatoduodenectomy. ʻO ia ka lawe ʻana i kahi poloka o ka māhele mamao o ka ʻōpū, ka mua a me ka lua o ka māhele o ka duodenum, ke poʻo o ka pancreas, ka lolo a me ka pala.

Hiki ke hoʻohana pū ka ʻoli pancreatectomy. I waena o nā hopena maʻamau o ka pancreatectomy kūʻokoʻa a i ʻole holoʻokoʻa loa, loaʻa nā hemahema i ka hana endocrine a exocrine pancreatic e koi ana i ka hoʻololi o ka insulin a me ka hoʻoweliweli ʻana paha.

Ma hope o kēlā ʻano hana, hoʻomohala koke ka mea maʻi i ka maʻi diabetes type II, ma muli o ke ʻano o ka hoʻopiʻi ʻana o ka hōʻemi, ʻo ka pancreas kekahi ʻokoʻa a ʻokoʻa ʻole paha. Hiki ke mālama ʻia ka maʻi maʻamau i ka nānā ʻana me ka mālama kokoke ʻana i ka glucose o ke koko a me ka lāʻau maʻi insulin.

No ka mea ke kuleana ka pancreas no ka hana ʻana o nā nui o nā kinina digestive, pono e hana ʻia ka pancreatectomy i mea ʻē wale nō he hopena hope loa. ʻO ka hōʻailona ʻehā ka maʻi maʻi pancreatic koʻikoʻi ka mea e hoʻoweliweli nei, e like me ke kanesa o ka maʻi maʻi. He mea koʻikoʻi loa ia e hoʻomaopopo i ka wā ma hope o ka pancreatectomy, hoʻomau ka hōʻeha i ka hapa nui o nā mea maʻi.

ʻO ka pancreatectomy Distal ka laweʻana i ke kino a me kahi wī o ka pancreas.

He aha nā wānana i ʻike mua i nā kauka?

Ma hope o ka pancreatectomy maʻamau, ʻaʻole i hana hou ke kino i kāna mauʻu ponoʻī ma lalo o ka hana o ke pancreas a i ʻole insulin, no laila, ua hōʻike ʻia nā mea maʻi me ka hoʻomehana insulin a lawe i ka lako o nā enzyme. Loaʻa kahi kūlana like i ka wā e kū ai ka maʻi maʻi pancreatic necrosis.

Ua hōʻike ʻia kēia maʻi ma lalo o ka mana o kāna iho ponoʻī, ʻo ka hapa o nā pancreas e nalowale ana i nā hana a lilo i make. ʻOi ka pōʻino o nā mea a pau, a make ke kino a pau. Hoʻomaopopo kēia hōʻike i ka manawa o ke kanaka ke hana hou i ka nui o nā homoni, a me ka hoʻokele koke ʻana i nā inikini a me ka pono o nā ʻenehana.

ʻO kēlā mau mea ʻaʻole i maʻi maʻi maʻi, ma hope o ke ʻano o kahi maʻi maʻi, no laila, lilo ʻoe. No laila, ua koi ʻia lākou e hoʻololi i ko lākou ola a hahai i nā ʻōlelo hou o kā lākou kauka. ʻO ka mea mua, pono ʻoe e aʻo e ana i ke ana ʻana i ka kuhikuhi glycemic i loko o ke koko a nānā mau ia.

Maikaʻi kēlā ʻano hoʻokele e ʻoi aku ai i nā kānaka ʻōpio a olakino hoʻi. Akā inā ʻaʻole, hiki ke olakino i ke olakino. Eia kekahi, ma muli o nā pilikia o ka digestive, ka nele o ka insulin endogenous a me nā pancreatic enzymes, pono ka mea maʻi i nā ʻōkuhi maʻamau o ka like o ka lālani insulin. Hiki ke hōʻoia ʻia kēia paʻakikī ma muli o nā makahiki a me nā maʻi e pili ana. Akā i ka mea maʻamau, ka maikaʻi o ke ola o nā poʻe maʻi ma hope o ka pancreatectomy kūʻokoʻa i hoʻohālikelike ʻia i ka maikaʻi o ke ola i nā mea maʻi e loaʻa nei i kahi mālama o kahi ʻāpana.

Aia kahi kaʻina hana i kapa ʻia ʻo islet cell transplant, na mea e kōkua i ka hōʻemi o nā hopena o ka nalowale o ka hana endocrine ma hope o kahi pancreas maʻamau.

ʻOiaʻiʻo, i kēlā me kēia hihia, ʻokoʻa paha ka pono o ka prognosis a me ke ʻano. ʻO ia ke kumu, hiki i ke kauka ke kuhikuhi i nā ʻano like ʻole o ka lāʻau lapaʻau i kēlā me kēia maʻi.

ʻO ka hoʻomaʻamaʻaʻana o nā hana a me ka wā postoperative

E pili ana i ke ʻano o ka papa o nā hanana i ka mea maʻi i hana i kēia mea hana, pono e hoʻomaopopo ʻia ka alakaʻi ʻana i ka maʻi metabolic nui a me ka lawa ʻole exocrine. Ma ke hopena, pono e mālama pono i ka mālama maʻi a me ka mālama pono ʻana, a paʻakikī pinepine kēia hana.

Ke kūleʻa nei ke ola i loko o nā mea maʻi me nā maʻi ʻino. Akā, ʻike ka mea maʻamau. Ma muli o kēia ʻike i ka hoʻomaʻamaʻa mau ʻia o ka lāʻau lapaʻau o kēia wā, a no laila, ke holomua nei hoʻi ka ʻenehana o ka hōʻemi ʻana i ka maʻi hana.

ʻOiai ke kumukūʻai o kēia hana, pono e hoʻomaopopo ʻia he ʻano ka mea i kūlike i ka maʻi i hana ʻia i ka mea maʻi. Akā ma ka maʻamau e hoʻomaka ka kumukūʻai mai hoʻokahi kanahā mau rubles.

He mea nui hoʻi ke kaʻina no nā poʻe maʻi e loaʻa precancerous a me nā maʻi hōʻino, i ka mālama ʻana no ka maʻi pancreatic. Eia nō naʻe, alakaʻi ʻo TA i nā mahele nui o ka metabola e pono ai ka hoʻokele multidisciplinary e hoʻomaikaʻi i nā hopena. Hoʻopilikia ka mālama a me ka mālama ʻana i ka paona.

Ke koi aku nei ka maʻi diabetes a me nā mea aʻoaʻo e hoʻohui ai me ka insulin, ka pancreas exocrine, a me nā mea kanu huaʻai he mea nui ka hana postoperative. He mea nui ka heluhelu ʻana a me nā helu hoʻoluhi kaumaha a hōʻike i kēia mau mea maʻi e koi nui ana i ka hana lapaʻau a me ka mea hoʻolako keu hou i ke manawa lōʻihi.

ʻO ka make a me ka morbidity lōʻihi e pili ana i ka TA i hōʻemi iho i nā makahiki i hala aku nei, he mea e hōʻike ana i nā hopena e like me nā mea e hoʻokō ai i ka hoʻohālikelike ʻana, ʻo ia hoʻi nā mea maʻi me nā maʻi precancerous. Ma ka holoʻokoʻa, ma ke ʻano o ke ola i lalo o ke kaʻina lalo o ka maʻi o ka maʻi, a ʻaʻole ma ka hopena o ka hana.

Hiki i ka hewa ke hoʻopaʻi ʻia e loaʻa ai kēia hana hoʻokipa no ke kanaka ʻōpio a hoʻonaʻauao kahi maʻi maʻi maʻi o nā papa pancreas me ka maʻi maikaʻi ʻana a i ʻole ka maʻi maʻi pankre familial.

Pehea ke hana ʻana o ka papa pancreatic i wehewehe ʻia i ke wikiō ma kēia ʻatikala.

He aha ka pancreatectomy?

ʻO ka hua'ōlelo pancreatectomy ka lawe ʻana i ka pancreatic tissue (mahele ʻokoʻa a ʻokoʻa loa) i ka huehue maʻi me ka tissue necrosis a i ʻole ke kanesa o ke kino. Inā pili ka hopena o ke kanesa i nā ʻōnaehana kūlohelohe, a laila wehe ʻia kēia mau maʻi.

Hoʻomaopopo ʻia ka pancreatectomy i ka mālama pono loa no ka maʻi maʻi pancreatic. ʻO ka ʻaoʻao mākaha loa o ka ʻōpū i kapa ʻia ke poʻo a aia ma kahi o ka duodenum 12.

Ua kapa ʻia ka ʻaoʻao waena o ka pancreas o ke kino, a ʻo ka ʻoki a loae kahi o ka spleen i kapa ʻia ʻo ka ʻili.

  • ʻO ka manawa pinepine, ʻo nā hōʻailona no kēia hōʻino he mau maʻi paʻa kino i loko o nā kiko o ka aʻeha.
  • I kekahi manawa ke kū mai nei ka pono o kēlā hana ma ka hoʻopili ʻana i nā hana ʻoi ʻana ma ka pancreas.
  • Hoʻopili ʻia ka wehe hapa i ka wā i loaʻa ai nā pseudocysts, fistulas, a i ʻole ka trauma o nā mea i hala, a i ka wā e hoʻomaʻamaʻa nei i ka pancreatitis maʻi a me nā loli o ka hana ma nā ʻalā pancreatic.

No nā maʻi i ka pancreas, ua manaʻo ʻia ka hana ʻoi aku ka ala koho o ke ʻano maʻi, akā hiki nō ke 15% o nā maʻi me ka maʻi like ʻole, ʻoiai i ʻike ʻia ke ʻano o ke kuʻi ʻana.

ʻO ka maʻamau, hōʻike ʻia ka hana no nā maʻi hōʻiliʻili liʻiliʻi ma ka wahi poʻo i ʻole nā ​​hōʻailona o ka metastasis.

Hōʻalo i ke poʻo pancreatic

Wahi a nā heluʻepekema, kaʻina ʻaʻā o ke kaʻina i loko o ke aila o ka papa pancreas ma ke poʻo. Inā lawelawe ʻia ka ulu ʻana, a laila hana ʻia kahi ʻāpana o ke kūpaʻa a me nā ʻaoʻao kokoke.

A laila, hoʻihoʻi ʻia ka hua bile, nāʻiā a me nā puka wai. Ua kapa ʻia kēlā ʻano ʻano ʻano me ka pancreatoduodenectomy.

  1. Hoʻokomo ʻia ka mea maʻi me ka hana hoʻopili, ma o nā hōʻiliʻili liʻiliʻi, i ke komo ʻana i ka mea i hoʻokā ʻia e hana ʻia, me ke kōkua o nā mea laparoscopic, ʻo ke aʻo pono o ka wahi i manaʻo ʻia e hoʻopili ʻia ka hoʻopiʻi ʻana.
  2. Hoʻopau a wehe ʻia ka mea hoʻokūkū a wehe i nā kaila kūpono pono kahi e hānai ai i nā kumulā o nā ʻili.
  3. ʻO kekahi manawa hoʻi ia mea no ka hoʻokaʻawale ʻana i nā kūkulu kokoke e like me ka ʻāpana o ka duodenum, nā kelomi lymph kokoke loa a i ʻole he gallbladder organ.
  4. No ka hoʻihoʻi ʻana i ka ʻōnaehana digestive, hui pū ka mea puhaka i ke kino kūloko me ka lua o ka ʻōpū a me ke kikowaena o ka pūpū liʻiliʻi.

Hoʻomaka hoʻomaka

Ua kapa ʻia ka hana ʻo Beger me nā mea i hana ʻia, kahi e hoʻoneʻe ʻia ai ka hapa kokoke o ka pancreas, ʻoiai ka mālama ʻia ʻana o ka duodenum o ka ʻawa a ʻo ka pancreatojejunoanastomosis e hoʻohana ʻia.

Hoʻohana pinepine ʻia kēlā me kēia ʻano i ka mālama ʻana o ka pancreatitis maʻi, e hele ana i nā hana koʻikoʻi a paʻakikī i ka hypertension duct, ka hiki ʻana o nā calculi, nā calcization a me nā parenchyma cysts.

Wahi a ka hōʻike pilikino, pili ka hana a Beger i ke kikowaena o ka pancreas ma ka isthmus me kahi subtotal resection o ke poʻo poʻo a ke hoʻokumu ʻana i kahi anastomosis o nā pauku kelepa ākea a me ka proximal.

Me ka ʻenehana, he ʻano paʻakikī kēia hana ʻoi a pinepine pinepine i ke kahe koko kaumaha.

Haʻalele i ke ʻoki

ʻO ka hoʻopau ʻana o ka huelo pancreatic i pono no ka hōʻeha kino a i ʻole cyst, hoʻopiʻi o nā maʻi pancreatitis kūlohelohe, a no ka pankīniki pancreatic focal, suppuration o ke ʻano o ka huelo o nā mea, a me nā mea ʻē aʻe i kēlā mau kūlana, hana ʻia ka hana ma muli o ke ʻano o ka pancreatectomy distal.

  • Hoʻopilikia ʻia ka hoʻopili ʻana me ka hoʻohana ʻana i ka lehulehu.
  • Hana ka haukapila i ka autopsy o ka peritoneum, ka kaomi ʻana i ka pancreas a ka holoi ʻana i nā kiko āpau pili o ka ʻili pū, a, inā pono, ka spleen, etc.
  • Inā nā metastases hana i loko o ka ʻāpana o ka pua, a laila e neʻe ʻia.

Hoʻohālikelike ʻia kēia hana kolohe me ka ʻole o ka hoʻomohala ʻana i ka hopena o ka metabola me nā maʻi o ka maʻi a me ka maʻi diabetes, ʻoiai inā hiki ke hoʻopiʻi ka liʻiliʻi o ka hanu ʻana.

Pehea e lawe ʻia ai ka pancreas (pancreatectomy)

ʻO ka pancreatectomy ka hoʻopau ʻana o ka pancreas. ʻO ka pancreatectomy hiki ke hoʻopau piha loa, a ma ia hihia ua hana ʻia ke kino holoʻokoʻa, maʻamau me ka spleen, gall bladder, maʻamau cile duct a me nā ʻāpana o ka ʻōpū a me ka ʻōpū.

Hiki ke hoʻokaʻawale ʻia ke kaʻina hana, ʻo ia ka mea, ua hoʻoneʻe iki ʻia ka pancreas.

ʻO ka weheʻana o ka duodenum me ka hapa a i ʻole ʻāpana o ka pancreas i kapa ʻia ka pancreatoduodenectomy a hoʻohana pinepine ʻia i ka mālama ʻana i nā maʻi maʻi palupalu a me nā maʻi kūpono o ka pancreas. Ua komo pinepine kēia kaʻina hana i ka wehe ʻana o nā nū lymph.

He aha ka hana pancreatic i hoʻokō ʻia ai?

ʻO ka pancreatectomy ka hopena kūpono loa no ka maʻi maʻi pancreatic.

ʻO ka mea hope he ʻōpū o ka ʻōpū e hūnā ana i nā enzyme digestive, insulin a me nā hormone ʻē aʻe.

Aia ka wahi kiʻekiʻe loa o ka pancreas ma kahi kokoke i ka duodenum a kapa ʻia ʻo ia ke poʻo, ka ʻaoʻao waena i kapa ʻia ke kino, a me ke ʻāpana kikoʻī kokoke i ka pōpoki ʻo ia ka huelo.

ʻOiai ka lawe ʻana i ka maʻi ʻoi ma ka pancreas o ka lā i hoʻohana ʻia ka ʻimi ʻia ʻana, hiki wale nō ma ka 10-15% o nā maʻi i hōʻike ʻia i ka wā mua o ka maʻi.

Hana ʻia ka hana ma ka maʻi me nā mea liʻiliʻi e ʻoi aku ke poʻo o ka pancreas (kokoke i ka duodenum a i ʻole ka hapa mua o ka ʻōpū liʻiliʻi), me ka jaundice ke ʻano o ka hōʻailona mua a me ka ʻole o nā hōʻailona o ka maʻi metastatic (hoʻolaha ʻia i ke kanesa i nā mea ʻokoʻa a me nā ʻōpū).

ʻO ke ʻano o ke kano ka mea nui no ka pancreatomy, hiki ke hoʻopau piha a mamao.

ʻO ka mahele a me ka pancreatectomy piha

Hiki ke hōʻike ʻia ka pancreatectomy ʻāpana i ka nui o ka pohō o ka pancreas, ma mua hoʻi i ke kino a me ka huelo. ʻOiai ʻo ia ʻano hana e pili ana i ka wehe ʻana o ka kaila maʻamau, akā hiki i ka hopena lōʻihi o kēia kaʻina hana, a ʻaʻole i hoʻopilikia ka hana i ka hana o ka insulin, digestive enzymes a me nā hormone ʻē aʻe.

ʻO ka maʻi pancreatitis kahi ʻano ʻē aʻe kahi e hoʻoneʻe ʻia ai ka pancreas i kekahi manawa.

ʻO ka pancreatitis Chorn (ka hoʻomau ʻana o ka maʻi o ka pancreas), ka mea e alakaʻi i ka pōʻino mau loa i kēia ʻala, hiki ke hoʻomohala mai i nā manawa mau ka lōʻihi o ka maʻi o ka pancreatitis.

Ma muli o kēia ʻano ʻehaʻawa e hopena mai ka hōʻemi ʻana i ka waiʻona a i ʻole ka hele ʻana o nā gallstones. I ka hapa nui o nā poʻe maʻi me kēia maʻi, hiki ʻole ke hoʻoponopono ʻia me ka hōʻemi ʻana ma muli o ka waiʻona.

Ka mea e hana nei i ka papa inoa pancreatic

Hana ʻia kahi papa pancreatic e kahi mea lapaʻau gastroenterologist, ʻo ke anesthetist ke kuleana no ka mea hoʻohui, a lawe ʻia ka hana ma ka hale haukapila, a me ka mea maʻi oncologist ma kahi o ka maʻi pancreatic e hoʻoikaika i ke kaʻina hana.

Hiki ke hoʻokaʻawale ʻia nā pancreas me ka hoʻohana ʻana i ka wehe wehe, kahi i hana ʻia ai kahi incision nui, a i ʻole hiki ke hana laparoscopically, i loko o kēia hoʻouka ʻana, hana i ke kauka ʻehā mau liʻiliʻi e hoʻolauna i nā mea hana pono.

Hoʻopiha ʻia ka ʻōpū me ka hau, ʻo ka carbon dioxide, hiki i ka mea maʻi ke ʻike i ka ʻōpū o ka ʻōpū. Hoʻokomo ʻia ke kāmeʻa i kekahi o nā piʻi a hōʻike i nā kiʻi ma ke kāʻei o ka lumi hana. Hoʻokomo ʻia nā mea pono ma o nā ʻōpio he nui.

Ke hoʻokae ʻo Laparoscopic e hana ka mea maʻi ma loko o ka puʻuwai o ka mea maʻi me ke ʻano nui.

Inā hoʻokaʻawale ka pancreatectomy, hoʻopili ʻo ka mea puhaka a hōʻoki i nā kīʻaha koko, a ua hoʻoneʻe i ka pancreas a hemo. Inā pili ka maʻi i ka splenic artery a i ʻole vein, lawe ʻia hoʻi ka spleen. Inā maʻamau ka pancreatectomy, ua hoʻoneʻe ke kahuna maʻi i nā pancreas a me nā mea pili i pili iā ia.

I ka wā o ka hana papa hana pancreas, ua hoʻokomo ʻia nā kīkaha no ka mālama postoperative. I mea e pale ai i ka hōʻiliʻili ʻana o ka nui o nā meaka ma ka wahi hana, ua hoʻokomo ʻia kahi pāheu pōkole, a me kahi kaʻi g-ʻano e pale aku ai i ka hoʻomā a me ka luaʻi. Hiki ke hoʻohui ʻia kahi pākuhi ma loko o ka ʻōpū liʻiliʻi e like me ke ala no ka hoʻopili mau ʻia.

ʻO ka hoʻomākaukau ʻana no ka hoʻomaʻamaʻa ʻana

ʻO ka maʻi me nā maʻi o ka maʻi pankreatic e loaʻa i kahi ʻano o ka hoʻāʻo ma mua o ka noʻonoʻo ʻana i ka hana.

Hiki i nā noiʻi ke ʻano ultrasonography, x-ray, angiography, tomography i hoʻohālikelike ʻia a me endoscopic retrograde cholangiopancreatography, ka ʻike like ʻole.

Pono nā hoʻokolohua e hoʻokū ai i ka ʻike pololei ʻana i ka maʻi pancreatic a hoʻolālā i ka hana.

Mai ka mea nui a nā mea maʻi me ka maʻi pancreatic e ʻai liʻiliʻi, pono ke kākoʻo ponoʻī kūpono e pono ai ma mua o ka hoʻomaʻamaʻa ʻana, i kekahi manawa ma o ka hānai puna.

ʻO kekahi mau maʻi me ka maʻi maʻi pancreatic i hana i ka chemotherapy a me ka radiation therapy. Ke makemake nei kēia mālama maʻi e hōʻemi i ka ʻūpiki, kahi e hoʻomaikaʻi i nā manawa kūpono o ke kāpae ʻana i kūleʻa.

Hiki ke hoʻohana ʻia i ka lāʻau radiadi i ka wā o ka hoʻokele (ma ka pūnaewele) e hoʻomaikaʻi i ka manawa maʻi o ka mea maʻi.

Ua hōʻike kekahi mau noiʻi e hoʻonui i ke ola o ka radiation intraoperative e nā mahina he nui.

Hiki i ka poʻe maʻi ke hele nei i ka haʻalele ʻana o ka pancreatic distal, ka mea e wehe ai i ka spleen, hiki iā ia ke loaʻa ka hana preoperative e hōʻemi i ka hopena o ka maʻi maʻamau.

Nā kaʻina hana kūpono

He hana koʻikoʻi ka pancreatectomy. No laila, ʻo ka hoʻokipa hoʻomaha me kahi lumi hoʻomaha hoʻomaha maʻamau i ʻelua a ʻekolu mau pule ma hope o ka pono.

Hiki i kekahi mau mea maʻi me ka maʻi pancreatic ke loaʻa ka radiation hui a me ka chemotherapy ma hope o ke kūleʻa. Hoʻomau pinepine ka hoʻomaʻamaʻa hoʻomaʻamaʻa i ke ola.

Ma hope o ka hōʻemi ʻana, ʻike ka poʻe maʻi i ka ʻeha o ka ʻōpū a kuhikuhi ʻia i nā poʻe hōʻeha. Pono e nānā hou ai i ka hoʻihoʻi ʻana a me ka wehe ʻana i nā ʻili a implanted.

ʻO ka pancreatectomy ākea ke alakaʻi i kahi kūlana i kapa ʻia ka pancreatic insufficiency, no ka mea, ʻaʻole hiki ke ʻohi hou ka meaʻai i nā enzymes i hana ʻia e ka pancreas. ʻAʻole hiki ʻole ka ʻōlelo huna Insulin.

Ke koi nei kēia mau pilikia i ka hoʻololi papalena enzyme pancreatic a me nā inikini insulin.

I kekahi mau hihia, hiki i ka pale pancreatic wehe ke alakaʻi i ka hana ole o ke kino, ma muli o ke ola kino o ka mea maʻi ma mua o ka hoʻomaʻamaʻa ʻana a me ka hōʻailona o ka hōʻemi pancreatic.

Nā pilikia a me nā hoʻopiʻi

Aia kekahi hopena koʻikoʻi nui o nā hoʻopiʻi e pili ana i kekahi kaʻina ma luna o ka pancreas. ʻO nā hopena o nā ʻāpana like ʻole o ka 41% o nā hihia. ʻO ka mea pōʻino loa o kēia mau mea no ka huhū postoperative, ka mea e hoʻonui ai i ka make o ka make a hiki i ka 20-50%. Ma nā hihia o ka uʻi postoperative, hiki ke hana hou ʻia ka mea maʻi a i ʻole ʻia i nā ʻano hana ʻē aʻe.

ʻO kekahi o nā hoʻopiʻi maʻamau loa o ka pancreatoduodenectomy i hoʻokuʻu i ka waiho ʻana i ka gastric, kahi kūlana e hoʻomaʻū iki ʻia ai ka meaʻai a me nā wai. Hōʻike kēia hoʻonāuki i ka 19% o nā maʻi.

No ka hoʻopauʻana i kēia pilikia, hoʻohana kekahi mau kauka lāʻau i kahi mea hānai e hana ai i loko o ka hana hana kumu, ma o nā mea kanu e hiki ke hāʻawi pololei ʻia i nā ʻāpana o ka mea maʻi.

ʻO kēia kaʻina, i kapa ʻia nā mea kanu enteral, e kākoʻo i ka meaʻai inā hoʻoliu ka lohi i kāna hana maʻamau. Hiki i kekahi mau lāʻau lapaʻau ke kōkua i kēia hana kūwele.

Ma hope o ka hoʻopau pihaʻana o ka pancreas, lilo ka kino i ka hiki ke huna i ka insulin, nā enzyme a me nā mea ʻē aʻe.

Hoʻomaka hou nā mea maʻi i ka hana maʻamau i loko o hoʻokahi mahina. Ua noi ʻia lākou e pale aku i ka hoʻoikaika kino kino no ka ʻeono a ʻewalu mau pule ma hope o ka hoʻomaʻamaʻa ʻana a mai lawe ʻole i ka kaʻa a hiki ke lawe i ka lāʻau.

Ua emi ka nui o ka make nui no ka haʻalele ʻana o ka pancreatic i nā makahiki i hala iho nei i 5-10%, i ka ʻano o ke ʻano o ka hōʻemi ʻana o ka hoʻokō a me ka ʻike i ka mea maʻi. I kēiaʻano, ʻo ka maʻi maʻi pancreatic he ʻano make i ka umauma o ka gastrointestinal tract. Eia naʻe, hāʻawi ʻo ka pancreatectomy i ka manawa no ka mālama ʻana, ʻoiai inā hoʻokō ʻia ka hana e ka lāʻau lapaʻau ʻokoʻa.

Kuhi: ʻO ka ʻike i hōʻike ʻia ma kēia ʻatikala e pili ana i ka pancreatectomy i manaʻo ʻia e hōʻike wale aku i ka mea heluhelu. ʻAʻole hiki ke lilo i kahi mea kūkā no ka kūkā kūkā ʻana e nā mea lapaʻau olau.

Ka Hoʻolā Hou

Hoʻokomo ʻia e ka maʻi ma muli o ke ʻano o Frey i kahi wehe ʻana i kahi mahele o ke poʻo ʻo ka pancreatic me ke noi ʻana o ka pancreatojejunoanastomosis.

Hāʻawi ʻia kahi hana like no ka maʻi maʻi puhoi, ke kaumaha ʻana i ka maʻi hōʻeha a me ka paʻa ʻana o ka pankreatic panc, a me ka neʻe ʻana o nā loliuli intraductal a me nā loli cystic i ke poʻo glandular.

ʻO ka mea mua, ke hōʻole nei ke kauka i ka papa pancreatic a hoʻihoʻi i nā pōhaku mai ona, i meaʻole ʻole i nā hana i hoʻokumu ʻia. A laila hoʻokaʻawale kekahi mea lapaʻau i ke poʻo pancreatic. A laila kuhi ʻia kahi Ru loop ma ka jejunum, ua kau ʻia kahi pancreatojejunoanastomosis, e hoʻopili ana i ka pankī pancreatic, ka kuhi hewa i kuhi ʻia a haʻalele ka Ru loop.

ʻO ka hoʻokaʻa piha ʻana o ka pancreas he ʻokoʻa loa a ma mua o kekahi mau mea. ʻOiai i nā kūlana paʻakikī loa, makemake nui nā kauka e mālama i ke kino.

Pono ka hoʻohemo ʻana o ka pancreatic inā he organ necrosis, i ka wā e pono ai e hoʻopakele i ke ola o ka mea maʻi. ʻIke ʻia ka nui o ka huli ʻana ma ke ʻano he ʻoi loa e pili ana i kekahi mau ʻike.

Ma muli o ka lono o ka luahi aortic, koi aku ka hōʻemi ʻana i ka nui loa, a me ka kokoke o nā kino ʻē aʻe e like me ka ʻōpū a me ka duodenum, spleen a me ka bile, ʻāwī, paʻakikī i ka komo ʻana i ka pancreas. Hoʻololi kēia lono ma kahi o 6 mau hola.

kūkākūkā e pili ana i ka pau piha ʻana o ka pancreas.

Nā hopena

I waena o nā hoʻopiʻi pinepine ʻana o ia ʻano mimila, ʻike ka poʻe loea i ka maʻamau maʻamau:

  • ʻO nā maʻiʻai a me ke koko kaumaha paha,
  • ʻO ka komo ʻana o nā mea hoʻomaʻamaʻa pancreatic i loko o ka peritoneum,
  • Hōʻino i nā ʻōpū pūpoki a i ʻole ka hopena o ke kūpaʻa ʻana i ka lāʻau lapaʻau.

Ma hope o kaʻauʻau

He paʻakikī loa ka noho ʻana ma hope o ka pancreatectomy i nā mahina mua. Ma hope koke o ka hana, hoʻomāukiuki ʻia ka mea maʻi i ka ʻeha nui ma ka ʻāina suture, ʻaʻole hoʻomaha ka pōloli, no ka mea i papa ʻole ʻia ka ʻai ʻana i kekahi mau lā ma hope o ke komo ʻana. Ma hope aku, e pono ka mea maʻi e pili pono i nā koi o nā meaʻai no ke ola.

ʻO nā loina nui o ka papaʻai o ka papaʻai ma hope o ka lawe ʻana i ka pancreas ka nui a me ka palaki. Hiki iā ʻoe ke ʻai i ia mau huahana wale nō e ʻae ʻia ka papahana ʻoihanaʻai.

  • I ka papaʻai i loko o kahi nui e pono ke loaʻa nei ka protein i pili i ka hoʻihoʻi ʻana o nā membran cell me ka hoʻomaikaʻi ʻana i ka hoʻōla.
  • Pono ka palena o ka ʻai kākoholā, no ka mea ma ke kua ʻana o ka hooulu ʻana i ka insulin, ka hopena o ka endocrine pancreatic.
  • ʻAi ʻia kā ka momona.
  • Lāʻau ʻia, paʻakai, ʻala a ʻohi ʻia ka pāpā.

Nā Manaʻo ʻO ke Ola

ʻO ka noho ʻana me kahi aʻalolo kelepili pancreatic i hiki ke kūpono. ʻOiai ʻaʻohe mea hiki ke ʻoli ke hoʻololi iā ia, no laila, ma hope o ka haʻalele ʻana, e pohō ka maʻi o ka mea maʻi inā ʻaʻole ʻo ia e hahai i kā kaʻai koʻikoʻi, e hele pū me nā ʻōlelo a me nā kau a ka gastroenterologist.

Me ka hoʻoneʻe ʻāpana, ʻoi aku ka mea ʻoi aku ka maikaʻi o nā prognoses, no ka mea, ʻo nā koena o ke koena o ke kino i nā hana a pau o ka pancreas. Inā hoʻokaʻawale loa ka kelepona, a laila makemake ke ola hoʻonanea ola (e lawe i ka insulin, nā enzymes, ka hoʻoponopono ʻana i nā meaʻai, a me nā mea āpau).

ʻOmaʻomaʻi

Hōʻike nā ʻikepili iLive a nā poʻe loea lapaʻau e hōʻoia i ka ʻoi loa e hiki ke kūpono a kūlike me nā ʻike.

He kānāwai koʻikoʻi mākou e pili ana i ke koho ʻana o nā kumuwaiwai a ʻike wale mākou i nā pūnaewele kaulana, nā keʻena noiʻi hoʻonaʻauao a inā paha, inā hiki ke hōʻike ʻia ka noiʻi olakino. E hoʻomaopopo me ka helu ʻana i nā helu ma nā brackets (,,., A me nā mea a pau).

Inā ʻoe e manaʻo he pololei ʻole kekahi o kā mākou mea waiwai, outdated a i ʻole he nīnau'ē aʻe, e koho iā ia a kaomi Ctrl + Enter.

ʻO ka pancreatectomy - ke kāʻili ʻana o ka pancreas (ma loko āpau a ʻāpana paha o kahi mea ola) me kahi maʻi ʻeha a maʻi pancreatitis aʻeha paha (me ka tissue necrosis). A pili ka ʻōpala i nā ʻāpana pili kokoke (spleen, gall bladder, he ʻāpana o ka ʻōpū liʻiliʻi a i ʻole ka ʻōpū, nā lymph nodes), ʻoi aku ka palu i kēia mau wahi pili.

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Nā hōʻailona a me nā ala o ka pancreatectomy

I ka hapa nui, ua hoʻokaʻawale ʻia nā hana maʻi no nā ʻeha malignant ma luna o ka pancreas, i kekahi manawa ke koi ʻia ka hanana maʻi no ka pancreatitis waha (ka maʻi ʻaʻa o nā pancreas).

Ke hana ʻia kahi kuhi o kahi ʻōpū, e hoʻoneʻe loa ka mea maʻi o ke kino i ʻole a mahele ʻokoʻa paha, i ka hoʻohui ʻana i ka pancreas, inā ua loaʻa ka maʻi i nā mea kokoke i nā ʻaoʻao, hiki nō hoʻi ke wehe ʻia lākou. A laila paʻa a paʻa ʻia ka pūnaewele incision me nā pale kūikawā.

Inā pono, hoʻokomo ʻia nā pā wai i loko o ke ana o ka ʻōpū, ma laila ke kahe ʻana o nā wai, e hōʻuluʻulu i ka hale hana o ka mea maʻi. I kekahi manawa hoʻokaʻawale i kahi mea hoʻowalewale hou mai loko mai o ka ʻōpū no ka hana ʻana i ka ngongo.

Inā makemake ʻoe e kāpae wale i kahi ʻāpana o ka pancreas, hiki i ka mea lapaʻau ke hoʻohana i ke ʻano laparoscopy - ma o nā puka liʻiliʻi ua hoʻokomo nā mea kauka i kahi mea kūikawā me ka kāmele a me nā mea hoʻokani liʻiliʻi e hana ʻia ai ka haʻalele ʻana.

Ka hōʻailona o ka pancreatectomy

Me ka wehe ʻana o kahi ʻāpana, ʻoi aku ka maikaʻi o nā ʻike ke ʻoi aku ka maikaʻi ma mua o ka hoʻopau ʻana o ka pancreas, no ka mea, ʻo ka hapa o ke kōpana ka hana ma luna o nā hana a pau. Ke hoʻoneʻe nei i ka pancreas holoʻokoʻa i loko o ka papa hana kūwili, kū ʻia kahi hanana nui nui a mālama ʻia i ka hoʻokolohua hoʻololi hou ʻana i ka pono (nutritional, enzymes, insulin).

ʻO ka pancreatectomy i ka hapa nui i hāpai ʻia e mālama i ke ola kanaka. Me nā pīpī palaka, me nā hōʻeha koʻikoʻi, ʻo ka hoʻomaʻamaʻa wale nō ke ala e hoʻomaikaʻi ai i ke ola o ka mea maʻi.

ʻO nā hopena o ka pancreatectomy

Ma hope o ka wehe ʻana o ka pancreas, hiki mai kekahi mau hōʻeha - ka huhū, ka maʻi, ka hopena i ka anesthetics (haʻahaʻa i ke koko, hōʻalo, a me nā mea āpau).

Hoʻopilikia ka pilikia o nā ʻōpiopio me ka momona nui, ma ka ʻelemakule, me ka ʻai maikaʻi ʻole, ka maʻi ʻōpū a me nā ʻōpū.

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ʻO ka mālama pancreatectomy a me ka hoʻihoʻi

Ma hope o ka hana i loko o ka haukapila i kekahi mau lā, e nānā ke kauka i ke kūlana o ka mea maʻi, painkillers a me nā lāʻau maʻi nausea. Inā hoʻokomo ʻia nā lua wai, e lawe aku ke kauka iā lākou ma hope o ka hoʻomaka ʻana o ke kino.

Ma hope o ka hoʻokuʻu ʻana, pono ka mea maʻi e hahai i kahi kīʻai kūikawā, no ka mea, ʻaʻole i lawa ka hoʻomehana o ka pancreatic i ka ʻai ʻana i ka meaʻai. Eia nō hoʻi, ma muli o ka nui o ke kino i hoʻoneʻe ʻia, ka hoʻomākaukau ʻana o ka enzyme, ʻo ka insulin (e hoʻoponopono i ke kōʻai koko) hiki ke kuhikuhi.

Ma hope o ka hana ʻana, pono e nānā i ke ʻano hōʻoluʻolu, ʻaʻole e hoʻokiʻekiʻe i nā kaupaona, ʻaʻole e hoʻolōʻihi i ka palena (he awelika o 1.5 - 2 mau mahina).

Hoʻomaʻamaʻa ke kau hou i ke kau ʻana ma hope o kekahi mau mahina. Hoʻomaopopo ka hapanui o nā maʻi i nā pilikia i ka wā e hahai nei i ka ʻai hou a i ʻole ka lawe ʻana i nā lāʻau lapaʻau hou.

Paipai ʻia kekahi mau maʻi e komo i nā hui kākoʻo kūikawā e kōkua ana e hoʻomaikaʻi i ko lākou kūlana noʻonoʻo.

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Nā ʻano lāʻau lapaʻau Pancreatic

ʻO ka hana maʻi pancreatic kahi mea hōʻiliʻili o ka nui o ka paʻakikī, no ka mea, he mea koʻikoʻi ka hui a ʻaʻole i ʻike ʻia pehea e hana ai ma hope o ke kolo ʻana a i ka hemo ʻana o ka ʻūpī. Hōʻike ʻia nā hana ma ka hoʻonui ʻia o ka make a me ka ulu ʻana o nā pilikia olakino.

ʻO ka hana maʻi pancreatic kahi mea hōʻiliʻili o ka nui o ka paʻakikī, no ka mea, he mea koʻikoʻi ka hui a ʻaʻole i ʻike ʻia pehea e hana ai ma hope o ke kolo ʻana a i ka hemo ʻana o ka ʻūpī.

Nā hōʻailona no ka pale mamao aku i ka pancreatectomy

Hoʻohana ʻia kēia hana ma ke ʻano o ka hōʻino ʻana o nā maʻi maʻi resectable o ka gland, ʻo ia hoʻi, kahi ʻōpū o ke kanesa hiki ke neʻe.

Eia kekahi, hiki ke hoʻokaʻawale i nā pancreatectomy distal no ka maʻi pancreatitis, nā pancreatonecrosis focal, nā hōʻeha traumatic o nā kipi, nā cysts o ke kino a me ka lālani o ka pancreas, inā ʻaʻole mālama ʻia ka hana conservative.

Ke lūlū ʻia kahi ulu o ke kanesa i ka spleen, ʻōpū, nā kelepaʻi adrenal, diaphragm a i ʻole kope ʻia, nā ʻāpana o nā mea i hele mai ai i ke kaʻina o ke kanikau a pale ʻia a ʻoki loa

Haʻalele piha

ʻO ka hoʻokaʻa piha ʻana o ka pancreas he ʻokoʻa loa a ma mua o kekahi mau mea. ʻOiai i nā kūlana paʻakikī loa, makemake nui nā kauka e mālama i ke kino.

Pono ka hoʻohemo ʻana o ka pancreatic inā he organ necrosis, i ka wā e pono ai e hoʻopakele i ke ola o ka mea maʻi. ʻIke ʻia ka nui o ka huli ʻana ma ke ʻano he ʻoi loa e pili ana i kekahi mau ʻike.

Ma muli o ka lono o ka luahi aortic, koi aku ka hōʻemi ʻana i ka nui loa, a me ka kokoke o nā kino ʻē aʻe e like me ka ʻōpū a me ka duodenum, spleen a me ka bile, ʻāwī, paʻakikī i ka komo ʻana i ka pancreas. Hoʻololi kēia lono ma kahi o 6 mau hola.

Ke kau nei wikiō ma ka hoʻopau piha ʻana o ka pancreas.

Ma mua a ma hope o ka hoʻokō ʻana

I ma Elite Medical Clinic, ʻike ʻia nā mea maʻi me ka maʻi pancreatic me ka chemotherapy a me ka radiation radiation ma mua o ka pale aku ai i ka pancreatectomy, i mea e hōʻemi ai i ka maʻi maʻi maʻi.

Ma hope o ka hana ʻana, ke hoʻomanawanui nei ka poʻe maʻi i ka chemotherapy a me ka radiation radiation e pale ai i ka maʻi cancer.

Hoʻomaʻi ʻia nā ʻōmaʻomaʻo Pancreatic Cancer

Hōʻike pinepine nā hōʻike maʻi pancreatic a kokoke ʻole i ka ʻike. Hiki i kēia mau mea hōʻailona ke makaʻala:

  • ʻeha i ka ʻeha o luna o ke kāʻei a i ʻole ma ka kua,
  • lilo ka momona a me ka pohō nui.
  • ka ʻōmaʻomaʻo o ka ʻili a me nā membula,
  • indigestion i ke ʻano o ka constipation a i ʻole hoʻokuʻu ʻia,
  • nā maʻi dyspeptic i ke ʻano o ka paila a me ka luaʻi, ʻaʻole ia e hali.

POHOIA MAKAUOHA

ʻO nā hopena pōpilikia hoʻomaʻamaʻa pancreatic

Ke loaʻa nei kahi screening no ke kanā pancreatic i hiki ke hāʻawi i ka maʻi ma mua.

ʻO nā mea pilikia:

  • i a me ka uahi ulaula
  • ʻopi momona
  • he lau nui a me ka ai ole nā ​​meaʻai me nā hua a me nā mea kanu ʻai,
  • ʻopi momona
  • ka maʻi pancitisitis a me ka maʻi diabetes

Holoi predisposition e pili ana i ka maʻi pancreatic

No kekahi mau makahiki, ua ʻimi nei nā kauka Italia i ke kumuhana o kahi genis predisposition no ka maʻi pancreatic. I kekahi mau hihia, "nānā" famreial pancreatic cancer "(PCA) i ʻike ʻia (ma kahi o 3% mau hihia) inā aia nā ʻohana ma kahi o ka liʻiliʻi o ka maʻi maʻi pancreatic. ʻO kēia mau syndromes e pili ana: ka huaʻumi moʻomeheu me ka maha o ka maʻi neone i pili me ka melanoma (FAMMM), Peitz-Jägers syndrome (PJS), ka maʻi pancreatitis (huaʻōlelo), nā ona neʻi non-polypous colorectal (HNPCC), umauma umauma a me ka maʻi ovarian (HBOC) syndrome, cystic fibrosis (CF), polyposis familial adenomatous (FAP), Fanconi anemia

Hoʻomaka dietological o ka maʻi pancreatic *

Kahi iho i ka loiloi loiloi o nā hopena i loaʻa ma ke ʻano o ka noiʻi ʻepekema, ua hiki ke ʻike i nā ʻano pilikia o ka papaʻai a me nā mea e pale ai i nā ʻano maʻi maʻi ʻokoʻa. Ua heluhelu nā loiloi i nā hualoaʻa i ʻehā mau pae: "ʻoiaʻiʻo ke hōʻoiaʻiʻo", "hōʻike hōʻike", "hōʻike kūmole" a me ka pae hope loa, ka hoʻohui ʻana i kēlā mau hopena no ka mea ʻoi aku ka "maʻamau". Kūkulu ʻia nā ʻōlelo aʻoaʻo me nā hōʻike hōʻoia a maopopo ka hopena.

I nā hopena pilikia no ka pilikia o ka maʻi pancreatic:

  • kauaka a me ka momona (hōʻike hōʻike ikaika),
  • ʻōpū o ka pūpū ʻōpū o ka maʻi (hōʻike hōʻike).

Nā mea mālama huakaʻi o ke kano pancreatic:

ʻO nā meaʻai i nā momona waʻa folic: nā lau iʻa ʻāpala (spinach, chicory, endive, chard), broccoli, huaʻala palaoa (ʻokoʻa hōʻike hōʻoia). axial telangiectasia (AT) a me Fanconi anemia (FA).

ʻO ka hoʻomaʻemaʻe ʻana o ka maʻi pancreatic a me nā haʻawina haʻawina

ʻO ka hana maʻi maʻi pancreatic

I ka makahiki 2015, ua loaʻa kahi ʻike ma Italia e hoʻoikaika i ka hoʻomaʻamaʻa ʻana o ka holomua ʻana o ka maʻi pancreatic cancer. Ua hōʻike ʻia e nā kauka Italia he 4 mau ʻano o ka malignancies pancreatic e pane ʻokoʻa i kekahi mau lāʻau lapaʻau a me nā hōʻola ʻana. I kēia manawa, ke hoʻomaka nei kahi koho o nā lāʻau lapaʻau a me nā ala no ka mālama ʻana i nā ʻano kikoʻī o ka maʻi pancreatic cancer. ʻO kēia ka pōmaikaʻi kanalua o nā kauka Kepani, e kamaʻilio e pili ana i ka ʻike nui ʻana i ka mālama ʻana i nā maʻi o nā ʻano o kēia ʻano a me ka ʻoihana kiʻekiʻe.

Ma nā hana maʻamau, ʻo ke ʻano nui o ka mālama ʻana i ka maʻi maʻi pancreatic. I ka manawa e hōʻike ai i ke ʻano, akā, ʻo ka 5-20% wale nō o ka nui o ka maʻi pancreatic i hoʻohana ʻia. Ke koho nei i ke koho ma ke ʻano o ka nui a me kahi o ka ʻōpū. Nā hana mālama ola - ka mamao o ka pancreatectomy me ka splenectomy, duodenectomy me ka wehe ʻana o ke poʻo pancreatic. I nā pilikia nui, koi ʻia ka pancreatectomy. I ka hopena o kahi mea hiki ke loaʻa, pono ia e hoʻopili i kēlā mau keena o ke kanesa i hoʻoiho ʻia ka moperidity perioperative a me ka make ma ka liʻiliʻi. Hoʻokomo kēia i ka mea mua, ma luna o ka ʻike a me ka nui o nā hihia i hana ʻia a, ka lua, i ka ʻike pū kekahi a me nā ʻike kūikawā (oncologist surgeon, chemotherapist, radiologist, endoscopist-gastroenterologist, radiical interventional, pathologist, nutristist, endocrinologist). Aia kēia mau wahi āpau i Italia, a he mau loea loea e hoʻoikaika pū ana me kekahi me kekahi ke hiki ai i ke loiloi a ka lolo a me nā hoʻoponopono hoʻoponopono ʻana no kēia ʻanoʻano.

Hoʻolilo iki a hōʻemi iki ka hana ma ka lapaʻau o ka maʻi pancreatic

Ma muli o ka holomua o nā ʻenehana, nā mea hana a me nā ʻoihana o ka hōʻemi minimally invasive i lilo, ua hiki ke hoʻohana i ka hoʻohana ʻana laparoscopic minimally invasive i ka mālama ʻana i ka maʻi lapaʻau o pancreatic. Me ke kōkua o laparoscopy, ua hoʻoholo ʻia ke kahua a me ka pā o ka homa o ke ʻano, a hiki pū ke hana i ka pancreatectomy distal. A ʻoi aku ka maʻalahi o kēia ʻano hana a ʻoi aku ka maikaʻi a hāʻawi i ka waiwai nui ma mua o ka lāʻau radical i hana ʻia e ka laparotomy.

I ka wā postoperative, hiki ke loli i ka metabolism ma ke ʻano o ka mellitus o ka maʻi mellitus a i hoʻoponopono ʻia e nā endocrinologists a me nā mea hoʻouluulu.

Pila Kuhi ʻo ka Pankreatic

No ka pale ʻana i ka huli hou ʻana o ka lāʻau a me ka metastasis, hoʻohana ʻia nā lāʻau lapaʻau adjuvant. Hoʻokomo ka chemotherapy adjuvant i ka pale ʻana i ka puka hou ʻana o ka haki e hōʻike ana i kahi ala kūpono no ka mālama ʻana i nā maʻi maʻi e piʻi nui ana ka hōʻano hou ʻana, ʻoiai ka haʻalele. Ma ka hihia o kahi ʻōkuhi inoperable a me ka metastasis koʻikoʻi, he chemotherapy wale nō ka mea i makemake ʻia. Mahalo i nā hui hou o nā lāʻau lapaʻau i kēia mau makahiki i hala aku nei, hiki ke hiki ke mālama pono i ke mālama ʻana i ka maʻi maʻi i nā lā hope. ʻO ka gemcitabine chemotherapy i manaʻo ʻia he hana maʻamau wale nō o ka mālama ʻana i nā makahiki he mau makahiki;

ʻO ka endoprosthetics pīpī a hoʻoheheʻe paha

ʻO kahi koho hou aʻe i nā hana palliative e pili ana i ka jaundice ʻo ka hoʻokomo ʻana i kahi endoprosthesis biliary e ka endoscopy (endoscopic retrograde cholangiopancreatography, ERCP). ʻoi aku paha, ʻoi aku ka hopena o ke kūleʻa ʻana ma mua o 80%, ua emi ka lōʻihi o ka hoʻokipa ʻana a me ka hopena o ka maʻi kino. I ka poʻe maʻi me nā contraindications e hoʻopau i ka endoprosthetics, me ka poʻe i loaʻa i ka helu hou ʻana o ka ʻōpū, hiki i ka wai biliary ka ʻona.

ʻO nā haʻawina haukaʻi o ka maʻi maʻi pancreatic

Ke hana nei ka hoʻokololei haukapila i Italia e aʻo ai i ka hoʻomākaukau o ka chemotherapy neoadjuvant no ka maʻi ʻoi ʻana ke kano, a me nā mea ola hou e pili ana i ka mālamaʻana i nā metastases tumor. ʻO kahi ʻimi i kahi hana hou a ka poʻe loea e ʻimi ai i nā hōʻailona molekole ma nā ʻano o nā maʻi a me nā kūlana sporadic o nā maʻi.

Inā noʻonoʻo koʻikoʻi ʻoe i ka mālama ʻana ma Europa, a laila ʻo Italia ka koho maikaʻi. Ma Milan, ma kahi mamao o 15 mau kaʻa e ke kaʻa mai ke kikowaena o ke kūlanakauhale, ʻeono nā hale maʻi maʻi eono, piha ʻia me nā ʻenehana hou, me nā kauka he mākaukau kiʻekiʻe. Manaʻo mākou iā ʻoe ma kahi e ʻoi aku ka maikaʻi o ka hoʻoponopono ʻana i kahi hihia kikoʻī a kōkua e hoʻoponopono i nā kūlana āpau.

Nā Palapala Hoʻohui I KA ANO:

  • ʻO ka maʻi maʻi pancreatic i Italia - Hana Hou
  • Ke hoʻomohala nei ka poʻe Italia i kahi lapaʻau no ka maʻi maʻi pancreatic
  • Hoʻohana ʻia ka pancreatic i ʻEulopa
  • Nā kūlana hou no ka mālamaʻana i ka maʻi maʻi pancreatic

He aha nā hōʻailona maʻi o ka maʻi pancreatic?

I ka wā mua, ʻo ka maʻi maʻi pancreatic ka mea maʻamau asymptomatic. ʻO kēia mau hōʻailona me nā hōʻailonaʻehā he ʻano no ka maʻi maʻi maʻi pancreatic wale nō, akā no kekahi mau maʻi ʻē aʻe. E hana i kahi manawa me kāu kauka inā loaʻa iā ʻoe:

jaundice (ka melemele o ka ʻili a me ka protein o ka maka),

ka ʻeha ma ka ʻaoʻao o a i ʻole a i waena paha,

poʻomanaʻo ka mālama kaumaha

Oniʻi ʻia ka maʻi pancreatic ma ka ʻāina mua.

He mea paʻakikī ke pale maʻi pancreatic no ka ʻike ʻana i nā kumu aʻe:

I nā hoʻomaka mua o ka maʻi, ʻaʻole i ʻike nā maʻi i nā hōʻailona a hōʻailona paha o nā pathology.

ʻO nā hōʻailona maʻamau a me nā hōʻailona o ka maʻi maʻi pancreatic e like me nā maʻi ʻē aʻe he nui.

Hūnā ʻo ka pancreas ma hope o nā ʻokoʻa o ke kino, me ka ʻōpū, ka ʻili liʻiliʻi, ka ate, ka ʻūpū ʻana, ke kō a me nā kumu bile.

Ke ʻike i ke kanesa pancreatic, kuhikuhi nā kauka Israel i nā hoʻokolohua a me nā noi ʻana i nā maʻi i ka nānā ʻana i ke ʻano o ka pancreas.

Kanaka pancreatic: nā wānana

Ka poʻe prognosis a me ke koho i nā ʻano lāʻau lapaʻau no ka maʻi pancreatic oncology pili i kēia mau kūlana:

ka hiki o ka wehe ʻana i ka maʻi o ke kuhi, ka manawa o ka maʻi (ka nui o ka ʻōpū a me ka hele ʻana a i ʻole ke noho ʻana mai nā ʻōpū o ke kanesa ma waho o ka pancreas, ʻo ia hoʻi, i nā palaka pili, nā lymph nodes a i ʻole nā ​​wahi pilikino a me nā ʻōnaehana).

ola olakino o ka mea maʻi,

ʻo ka maʻi maʻamau a i ka hoʻoneʻe ʻana i ka maʻi maʻi (hou ka ulu ʻana o ka maʻi ma hope o ka mālama ʻana).

Hiki ke mālama ʻia ke maʻi pancreatic inā he ʻike ʻia ma mua o ka pālahalaha ʻana. Inā ua hana ka palaki i nā metastases, ua kuhikuhi ʻia ka mea maʻi i ka lāʻau palliative. Mālama ka lāʻau Palliative i ke ʻano o ka nohona olakino, e kōkua ana i ke kaua ʻana i nā hōʻailona a me nā hoʻopiʻi o ka maʻi.

ʻĀnohi ʻo Kaneka Kankīnohi ma loko o ka ʻIseraʻela

Kauka lapaʻau ʻoihana o ka keʻena oncology o ka Ichilov MC

Hoʻ pinepine pinepine, ʻo ka hoʻomohala ʻana o ka maʻi pancreatic i ka moʻolelo ʻohana no kēia maʻi. No laila, ua loaʻa ka poʻe nona nā ʻohana pili i ka maʻi pancreatic i ka hoʻomaʻamaʻa genetic i loko o ka ʻIseraʻela. Ma hope o ka hoʻomaopopo ʻana i ka pilikia genetic, ua koho hoʻokahi ka mea maʻi i kahi papahana noiʻi no ka hoʻomaka mua o ka maʻi maʻi.

ʻO nā ala nui i ka hōʻike ʻana i ke kano pancreatic:

endosonography - ka ultrasound, kahi i hoʻokomo ai ka sensor ma ka palena o ka endoscope a hoʻokomo i loko o ka digestive tract ma o ka esophagus.

Ke ʻae nei kēia mau kaʻina hana ʻaʻole e ʻike i kahi ʻōpiopio wale nō, akā e loiloi nō hoʻi i kāna hana. No ka loiloi i ka ulu ʻana o ke kaʻina, hiki ke kuhikuhi i ka PET-CT.

E ʻike i ke ʻano o kēia maʻi o ka maʻi ʻaʻai, hiki ke hoʻohana ʻia ka hoʻokolohua koko no ka māka paʻa ʻana i ka CA 19-9. Eia nō naʻe, pono e noʻonoʻo ʻia i kekahi mau ʻano o ka maʻi pancreatic, ʻo nā hua o kēia loiloi e noho maʻamau.

Pehea e mālama ʻia ai ka maʻi pancreatic ma ʻIseraʻela?

Ke poʻo o ke Komite Hui o ka ʻAmelika Hui Pū ʻIa o Surgeon Oncologists.

ʻO ke ala wale nō e hoʻokō ai i kahi lāʻau holoʻokoʻa no ka maʻi maʻi pancreatic:

piha pancratectomy, a hoʻopau piha paha i ka pancreas.

ʻO kahi koho maʻamau e koho ʻia no ka hoʻomaʻamaʻa ʻana ma kēia hihia ke hana wehe ʻia. ʻO nā interventions lole laparoscopic e hana i kekahi manawa, akā ʻaʻole kūpono ia no nā maʻi āpau. Eia kekahi, pono ka hoʻomaikaʻi laparoscopic i ka nui o ka ʻike mai ka lāʻau lapaʻau.

O ke Keena o ka Oncology Department a MC Ihilov-Surasky.

Hoʻohana pinepine ka maʻi pancreatic i kahi protocol chemotherapy i kapa ʻia ʻo FOLFIRINOX. Aia pū

‼ Ua hōʻike ʻia ka noiʻi hou ʻana i kēia protocol e hiki iā ʻoe ke hoʻomalu i ka maʻi (me nā kiʻekiʻe holomua) ʻoi aku ka maikaʻi ma mua o ka protocol kuʻuna me ka gemcitabine.

e kau ʻia ke ahonui

lapaʻau i kēlā me kēia mau

He kumukūʻai no ka mālama ʻana i ka maʻi pancreatic ma ʻIseraʻela?

Loaʻa pinepine i ka Hui Pūʻulu Kauka Israel i nā nīnau e pili ana i ke kumukūʻai o ka maʻi a me ka mālama ʻana i ka maʻi maʻi pancreatic. No laila, e hāʻawi aku i nā kumukūʻai kiʻekiʻe no kekahi mau ʻano o ka mālama ʻana.

HoʻolahaUila
Paona o ka ʻōpū$480
Kuhi i ka tomomaʻi kikowaena$1520
ʻO ka biopsy pancreatic$4050
ʻO ka hōʻoki ʻana o ka pīpī me kahi halihali o kahi lā 10 i kahi keʻena kūʻokoʻa pilikino$51 000

ʻOi aku ka paʻakikī o ka hoʻomaʻamaʻa maʻi maʻi pancreatic. ʻO kahi mea loeaʻike loea wale nō e hiki ke hoʻokō me ka wehe ʻole i ka hapahapa o ke kelepona a koho i ke protocol chemotherapy pololei no kahi maʻi maʻi. Inā ʻaʻole maʻalahi ia e koho i ke kauka a pono ʻoe i nā ʻōlelo aʻoi mai - hoʻopili iā mākou.

Hāʻawi ka Pū ʻIa Kauka Israeli i nā maʻi me nā kūkākūkā manuahi manuahi. E hoʻopihapiha i ka palapala hoʻopili a e loaʻa iā ʻoe kahi pane i loko o ka lā aʻe.

He aha nā hana e hana ʻia ma nā pancreas a he weliweli lākou?

ʻO nā ʻano mea i koe iho ai:

  1. Ka huina piha. I kekahi manawa pono i ka mea noiʻi e hoʻoholo i nā mea nui i ka wā o ke kaʻina hana. Hoʻonohonoho ka wawao ma kahi o 7 mau hola.
  2. ʻO ka subtotal pancreatectomy kahi hana hoʻoilina o ka pancreas. Hoʻokahi wahi liʻiliʻi o ka lālā wale nō, e kokoke ana i ka duodenum.
  3. ʻO ka hōkuhi Pancreato-duodenal ka hana paʻakikī loa. Hoʻokuʻu ʻia ka pancreas, duodenum, gall bladder a me kahi ʻāpana o ka ʻōpū. Ua hoʻohālikelike ʻia i ke kahe ʻana o nā pope malignant. He mea pōʻino me ka hiki nui o ka hōʻeha i nā ʻili e hoʻopuni ana, ka loaʻa i nā hoʻopiʻi postoperative a me ka make.

Laparoscopy

ʻO ka ʻoi ʻana o Laparoscopic, i hoʻohana mua ʻia no nā kumu diagnostic, hiki i kēia manawa ke hoʻomaikaʻi i ke kūlana o ka mea maʻi me ka necrosis pancreatic a me nā hua manu benign o ka pancreas.

Hōʻano ʻia ka hana i ka wā hōʻemi pōkole, hōʻemi haʻahaʻa o nā ʻōpiopio.

Ke hoʻohana nei i ka pālahalaha endoscopic, ua hoʻokuʻi ʻia ke kino ma o kahi incision liʻiliʻi, a me ka mālama wikiō ʻana i palekana ai ke kaʻina hana.

Huki hoʻopau

Hoʻopili ʻia ke kāpae ʻana o nā hana ʻoi pancreatic ma ʻelua ala:

  1. Hoʻomaka hoʻomaka. Loaʻa ka komo ʻana i ke io i ka dissection o ka ligament gastrocolic, ma hope o ka hoʻokaʻawale ʻana o ka vealele mesenteric maikaʻi loa. Ma nā ʻaoʻao kiʻekiʻe a lalo, ʻo ka pancreas, mālama ʻia i nā sutures. Ma hope o ka hoʻowalewale ʻia, ua hoʻoki ʻia ke poʻo o ke kino o ka isthmus a hoʻokaʻawale ʻia mai ka urena ʻoi aku ka maikaʻi.
  2. Operation Frey - wehe ʻāpana o ka wahi ventral o ke poʻo o ka pancreas me ka pancreatojejunostomiasis longitudinal.

Hoʻolālā ʻia ka hoʻololi ʻana ka pancreas no ka maʻi maʻi maʻa nui.

Hāʻawi ʻia kahi hana like no ka maʻi maʻamau. ʻO nā kumulane e like me ke hoʻololi ʻana o nā kino ʻē aʻe.

Loaʻa ka pancreas no ka hoʻololi ʻana mai ka mea ʻōpio ʻōpio me ka make kino o ka lolo. Kēia hui hana e pili me ka kiʻekiʻe kiʻekiʻe o ka hōʻole ʻana i ka mea transplanted, no laila, e lawe ʻia ana e kū'ē i ke kāʻei o ke ʻano o ka immunosuppressive therapy.

I ka loaʻa ʻole o nā hoʻopiʻi, hoʻonui ʻia ka metabolism, e nalowale ka pono no ka hoʻomalu ʻana i ka insulin.

Hoʻopau piha i ke kino

Kuhi ʻia ka huina o nā huina no nā maʻi i hele pū ʻia e nā nekrosis o nā ʻili o nā io. Kahi ʻia ka hana ma hope wale nō o ka hoʻopaʻa ʻana ʻana i ke kino, ma ke alo o nā hōʻailona ʻano. Ma hope o ka hoʻopau pihaʻana o ka pancreas, pono ka mea maʻi i kahi ola o nā huina o ka enzyme, insulin, kahi meaʻai kūikawā, ka ʻike maʻamau i ka endocrinologist.

Kahi? Ulu

Ua pili kēia ala i ka wehe ʻana o ka pancreas i loko o ka ʻōpū o ka ʻōpū. Hoʻohana ʻia ia no nā maʻi i hele pū ʻia e ka pancreatic necrosis me ke hu ʻole ʻana o ka aʻa a me ke ʻano o nā voids.

I ka wā o ka hana, neʻe ʻia ka peritoneum, hoʻokaʻawale ka mea ola mai nā ʻili e puni ana a hoʻohuli ʻia i ke kua o ka omentum. Ma hope o ka hoʻoulu ʻana i ka maʻi, ka hana ʻana o ka exudate inflammatory, nā huahana decompos i nā mea make a me ka wai pancreatic i ka wa hou o ka wā o ka retroperitoneal.

Hoʻokua

He hana ala e ka ʻoi aku ai i ka hoʻoō ʻana i ka jaundice obstructive. He haʻahaʻa haʻahaʻa haʻahaʻa a me nā maʻalahi i ka hoʻokō ʻia.Hoʻomaʻamaʻa ke ʻano ʻoihana dute pancreatic i ka endoscopically. I ka wā o ka hana, ua kau ʻia kahi moʻo keleawe, hoʻopili ʻia me ka hoʻōlaʻi ʻana i ka antibacterial. Hoʻemi kēia i ka hopena o ka stent blockage a me ka maʻi maʻi.

Palapala ʻia

Hana ʻia kahi ʻano like me ka hoʻomohala ʻana i nā hopena pōpilikia ma hope o ke komo komo ʻana. ʻO ka nui o ka hoʻohana ʻana i ka pāheʻe ma muli o ke kiʻekiʻe nui o nā hoʻopiʻi kūikawā i ka wā postoperative. ʻO nā hana nui o ka hana ka manawa kūpono a me ka hoʻopau ʻana o ka exudate inflammatory, ke kāpae ʻana i ka ʻōpū purulent.

ʻO ka maʻi maʻi pancreatic

ʻO ka mea maʻomehu kahi mea mua loa i ka kaʻina hana.

ʻO kahi kaʻina hoʻokolohua kūpono loa e pili ana i kēia mau mea:

  • ʻōlelo o ka anesthesia, ka ʻike ʻana i ka hoʻomaha ʻana o nā io,
  • loaʻa i nā pancreas,
  • loiloi ʻōlohelohe
  • ka lawe ʻana i ke kahe mai ka ʻeke e hoʻokaʻawale ana i ka pancreas mai ka ʻōpū,
  • ka hemo ʻana o nā hakakā i luna,
  • hoihoi a me ka pili ana i nā hematomas,
  • ke ala o nā ʻāpana o nā mea i hoʻopau ʻia, a me nā kumu o kahi mea o ke kino,
  • ka hoopau ana i kahi hapa o ka huelo a i ole poʻo me kahi mahele o ka duodenum ma ke alo ʻana o ke koʻi benign,
  • hoʻoiho wai
  • kūlia pili
  • ka hoʻopili ʻana i nā lole ʻaile.

Aia nō ka lōʻihi o ka hana ma ke kumu, kahi mea i lilo i mea hōʻike no kona hoʻokō, a ʻo 4-10 mau hola.

ʻO nā kumukūʻai kūpono loa no ka uluʻana o ka maʻi ma ka pancreas:

  • ke poʻo i kū - 30-130 tausani mau rubles.,
  • pau loa pancreatectomy - 45-270 tausani rubles,
  • huina duodenopancreatectomy - 50.5-230 tausani rubles,
  • ka hana ʻana o ka umauma pancreatic - 3-44 mau tausani rubles.,
  • ka wehe ʻana o kahi papa pancreatic benign e ka hopena endoscopic - 17-407 tausani rubles.

ʻO ka wā kūpono

Hoʻopili ka mea hoʻomanawanui postoperative i kēia mau ʻoihana penei:

  1. Noho ma ka waihona mālama mālama kino. Mālama ka papa i 24 mau hola a kau i ka nānā ʻana i nā hōʻailona koʻikoʻi o ke kino: ke koko, ke koko, ke ʻano wela o ke kino.
  2. Ke hoʻololi nei i ka ʻoihana keʻena. ʻO ka lōʻihi o ka mālama inpatient he 30-60 mau lā. I ka manawa o kēia, hana ke kino a hoʻomaka ke hana maʻamau.
  3. Hoʻopuka i ka maʻi postoperative Mālama i kahi meaʻai therapeutic, normalization o ke kiʻekiʻe o ka glucose koko, ke kau nei i ka hoʻomākaukau ʻana o ka enzyme, nā hana physiotherapeutic.
  4. ʻO ka hoʻokō me ka hoʻomaha o ka moena, ʻo ka hui o ke aupuni kūpono loa o ka lā ma hope o ka hoʻokuʻu ʻana mai ka haukapila.

Ma hope o ka hana ʻana, pono e hoʻopau i ka wai nui.

Nā lula o kaʻai ʻana i ka papa ʻaina ma hope o ka hoʻomaʻamaʻa ʻana o ka pancreatic:

  1. Kūlike me ka hoʻi o ka hoʻohana ʻana i ka meaʻai. ʻAi ma kahi o 5-6 mau manawa i ka lā.
  2. Hoʻopili i ka nui o nā meaʻai i hoʻopau ʻia. ʻAʻole pono ka lawelawe i kahi 300 g, ʻoi aku hoʻi i nā mahina mua ma hope o ka hoʻomaʻamaʻa ʻana.
  3. I ka wai hohonu. Pono e wehe i nā toxins a mālama i kahi ʻano koko.
  4. ʻO ka hoʻokō ʻana me ka papa inoa o nā huahana i ʻae ʻia a pāpā ʻia. E hōʻole i ka waiʻona, nā ʻona ʻona, ke kuhi, ka pōkoke, ke kofe, nā kīʻawe, nā kīlī.

Nā hopena ma hope o ka hoʻomaʻemaʻe ʻana

ʻO ka hopena maʻamau e pili ana i ka hōʻoki ʻana i ka pancreatic i ke ʻano o ka mahana ʻana o ke kino.

ʻO nā hopena maʻamau loa o ka hana maʻi pancreatic:

  • kahe koko kūloko
  • ʻōpalaola
  • fiva
  • hana ʻino (hoʻomā a me ka luaʻi, constipation, peʻa ʻia e ka maʻi)
  • ka hoʻopili ʻana o nā maʻi maʻi bacterial,
  • ka hoʻokumu ʻana o fistulas a me nā mele,
  • peritonitis
  • ʻeha hopuna o ka ʻeha
  • ka ulu ʻana o nā kūlana haʻalulu,
  • ka hopena o ka maʻi maʻi
  • kikoʻī manu nīnūnū ma hope o ke kau ʻana,
  • hūnā polū.

Hoʻomaka hoʻokele ola

ʻO ka lōʻihi a me ka kiʻekiʻe o ke ola o ka mea maʻi e hilinaʻi i ke ʻano maʻamau o ke kino, ke ʻano o ka hana, hoʻokō ʻia me nā ʻōlelo a ke kauka i ka wā hōʻola.

ʻO ka hōʻola Pancreato-duodenal ke kiʻekiʻe kiʻekiʻe o ka make.

Hoʻomili ʻia ka hoʻonāukiuki me ka maʻi pākia me ka nui o ka hopena o ka hoʻomaha. ʻO ka awelika 5 mau makahiki ola ma hope o ia ʻano hana, ʻaʻole iʻoi aku ma mua o 10%. Loaʻa i ka mea maʻi nā manawa like ʻole e hoʻi i ke ola maʻamau ma hope o ka haʻalele ʻana o ke poʻo a i ʻole ʻoi o ke kino i ka pancreatitis aʻokiʻoki a i ʻole nā ​​makign.

Nā Hōʻike Manaʻo Pancreatic

Polina, 30 makahiki, Kiev: "2 mau makahiki i hala aku nei ua hana ʻo ia i ka hana e wehe ai i ke kino a me kahi o ka pancreas. Ua helu aku nā kauka i nā manawa ola e like me ka mea liʻiliʻi. ʻAʻole iʻoi aku ka nui o ke koena o ka waihona o ke koena ma ka 4 cm.

Ua hala wau no 2 mau mahina i loko o ka haukapila, nā antibacterial a me nā mea hōʻeha, nā lawelawe ʻana i ka hoʻoulu. Ma hope o kekahi mau mahina, hoʻomaikaʻi ka kūlana, akā, ʻaʻole i hiki ke loaʻa ka paona.

Ke hahai nei au i ka meaʻai paʻa, e inu i nā lāʻau. ”

Alexander, 38 makahiki, Chita: "No 3 mau makahiki, ʻeha i ka ʻōpū o ka epigastric i hōʻeha ʻia, nā maʻi kauka i nā maʻi like ʻole. Ma 2014, ua komo ʻo ia i loko o ke keʻena hoʻokipa ʻana i kahi kūlana koʻikoʻi, kahi i loaʻa ai kahi poʻo pancreatic. Ua paʻakikī ka wā e hoʻōla, ma 2 mau mahina i nalowale he 30 kg. Ke hahai nei wau i kahiʻai ikaika no 3 mau makahiki i kēia manawa, e māhuahua iki ana ke kaumaha. "

ʻO ka hoʻomaʻamaʻa pancreatic: hōʻailona, ​​nā ʻano, prognosis

ʻO ke pancreas kahi ʻāpana kūʻokoʻa i loko o ka manaʻo ʻana he lua ia o nā mea ʻula ʻole a me loko. Hoʻopuka ʻo ia i nā enzyme e pono ai no ka hoʻoneʻe ʻana a komo i ka wahī ma o ka ʻōpū ma o nā kumu excretory, a me nā homela e komo pololei i ke kahe koko.

Aia ka pancreas ma ka papa luna o ka ʻōpū o ka ʻōpū, pololei ma hope o ka ʻōpū, retroperitoneally, hohonu loa. Ua hoʻokaʻawale ʻia ke kumu i 3 mau ʻāpana: ke poʻo, ke kino a me ka huelo.

Hoʻopili ia i nā mea nui he nui: ʻo ka poʻo e puni i ka duodenum, kona ʻaoʻao posterior e pili kokoke ana i ka lolo kūpono, kahi kūleʻa adrenal, aorta, kiʻekiʻe a kūlou i nā vena cava, nā ipu nui he nui, a me nā mania.

Ke ʻano papahele

ʻO ke pancreas he ʻāpana kūʻokoʻa ʻaʻole wale nō i loko o nā ʻano o kāna hana, akā no nā ʻano o ka hoʻolālā a me kahi hoʻi. He hui parenchymal kēia, na mea i hoʻopili ʻia ai a me ke ʻano o ka lolo, me ka pulu paʻa o nā punawai a me nā kīʻaha koko.

Eia kekahi, hiki iā mākou ke ʻōlelo no kēia ʻike iki o ka ʻiliʻōlelo e pili ana i ka etiology, pathogenesis, a no laila, i ka mālama ʻana i nā maʻi e pā pono ana iā ia (ʻoi aku ka maʻi a me ka maʻi pancreatitis). Piʻi mau ke kauka i nā maʻi like ʻole, ʻoiai e hiki ʻole ke wānana ʻia ke ʻano o nā maʻi pancreatic.

ʻO kēia hoʻolālā o kēia kiko, me kona kūlana ʻoluʻolu e hoʻonāukiuki i nā mea lapaʻau.

ʻO ke komo ʻana i kēia wahi me ka hoʻomohala ʻia o nā hoʻopiʻi he nui - hehihe, ʻaihue, hoʻihoʻi, ka hoʻokuʻu ʻana i nā ʻenemi i waho o ke kino a me ka hoʻolalelale ʻana o nā kiko kokoke.

No laila, hiki iā mākou ke ʻōlelo, ke hana nei ka pancreas no nā kumu olakino wale nō - i ka manawa maopopo ʻole ʻaʻohe ala ʻē aʻe e hōʻoluʻolu i ke kūlana o ka mea maʻi a pale paha i kona make.

Nā hōʻailona no ka ʻoihana

  • Hoʻokomo ʻia nā huehue me ka necrosis pancreatic a me peritonitis.
  • ʻO ka pancreatitis Necrotic me ka suppuration (kahi hōʻike hōʻike piha no ka hoʻokō hōʻeha).
  • Nahea.
  • Nā ʻeha hōʻemi.
  • ʻO nā Tumors
  • ʻO Cysts a me nā pseudocysts, ka mea i hoʻopili ʻia e ka maʻi kaumaha a me ka lewa ʻole i waho.
  • ʻO ka maʻi pancreatitis me ka ʻeha nui.

Hoʻohana no ka maʻi pancreatitis maʻa

Pono e haʻi ʻia ʻaʻohe kumu kūlike no ka hōʻike ʻana no ka hana ma ka maʻi pancreatitis. Akā aia kekahi mau hōʻeha huhū, kahi i hui pū ʻia ai nā poʻe lapaʻau: hiki ʻole ke kōkua ʻole ke hoʻomohala ʻole i ka make o ka mea maʻi. Ua hoʻopili ʻia kaʻi ʻana me:

  • Hoʻokomo ʻia ʻo ka maʻi pancreatic necrosis (purulent fusion o ka lau gland).
  • ʻO ka hana ʻole o ka mālama conservative i ʻelua lā.
  • Hoʻopuka nā pancreatic.
  • Peritonitis purulent.

ʻO ka hāpai ʻana o ka necrosis pancreatic ka hopena maikaʻi loa o ka hoʻopiʻi ʻana o ka maʻi pancreatitis. Me ka pancrotitis necrotic e loaʻa i ka 70% o nā hihia. Ke ʻole o ka ʻeha radical (operation), kokoke i ka make ma 100%.

ʻO ka hana hoʻopiʻi no ka neʻe ʻana o ka pancreatic i hoʻopaʻa ʻia he laparotomy wehe, necrectomy (ka hemo ʻana o ka nui make), ka puʻu ʻana o ka moena postoperative.

Ma ke ʻano he kānāwai, i nā manawa pinepine (ma ka 40% o nā hihia) he pono i ka laparotomies i hoʻihoʻi hou ʻia ma hope o kekahi manawa manawa e hoʻihoʻi hou i nā kiko necrotic.

I kekahi manawa no ka huki ʻole o ka ʻōpū o ka ʻōpū (hoʻokaʻa hema), me ke kaʻe o ke kahe, ke ʻoki koke nei kahi wahi o ka neʻe ʻana o ka necrosis.

ʻO kēia manawa naʻe, ʻo ka hana e koho ai no kēia hoʻopiʻi ʻana, ʻo ka necrectomy i hui pū ʻia me ka nui o ka postoperative ka hopena: ma hope o ka lawe ʻana i ka kiko necrotic i ke kahua postoperative, kaomi kahe silicone e waiho ʻia ma ke ʻano ikaika me ka antiseptics a me ka hopena o ka antibiotika e mālama ʻia ana, me ka manaʻo like pū kekahi (suction).

Inā ʻo ke kumu o ka maʻi pancreatitis he maʻi gallstone, i ka manawa like, hana ʻia ka cholecystectomy (lawe aku i ka puhopu).

hema: laporoscopic cholecystectomy, ʻākau: wehe cholecystectomy

ʻAʻole kōkua ʻia nā hana minimally invasive, e like me ka laparoscopic surgery, no ka pancreatic necrosis. Hiki ke lawe ʻia ia ma ke ʻano he hana kū wale ʻana i nā maʻi maʻi koʻikoʻi e hōʻemi i ka edema.

Hoʻopuka nā pancreatic ku e kūʻē i ke kua o ka necrosis kaupalena i ka maʻi a i ʻole ma ka manawa lōʻihi me ka manaʻo i nā pseudocysts.

ʻO ka pahuhopu o ka mālama ʻana, e like me kekahi kīnā ʻole, ka autopsy a me ka hoʻoheheʻe. Hiki ke lawelawe ʻia ka hana ma kekahi mau ʻano:

  1. Ka wanaʻao. Hoʻopili ʻia kahi laparotomy, kahi wehe a wehe ʻia a hoʻopuʻi kona ana a maloʻo kahi hoʻomaʻemaʻe.
  2. Kahawai lau laparosc: ma lalo o ka kāohi o ka laparoscope, wehe ʻia kahi puka ʻole, ua wehe ʻia nā ʻōhua ʻole-ola, a ua hoʻonohonoho ʻia nā kahawai, e like me ka pancreatic necrosis nui.
  3. Holoi kikowaena: ua wehe ʻia kahi hiʻi ma hope o ka ʻōpū. Hiki ke hana ʻia kēlā hana me ka laparotomically a i ʻole laparoscopically. ʻO ka hopena - nā ʻike o ka nalo i puka mai ma o ka fistula art i hoʻokumu ʻia i loko o ka ʻōpū. Hoʻoikaika ka hupa, i paʻa ka ʻoi fistulous.

Hana ka maʻi pseudocyst pancreatic

Hoʻokumu ʻia nā Pseudocysts i ka pancreas ma hope o ka hoʻonā ʻana o ke kaʻina ʻoʻokiʻoki. He pseudocyst kahi lua ʻole me kahi membrane paʻa i hoʻopiha ʻia me ka wai pancreatic.

Hiki i ka nui o nā Pseudocysts ke nui (ʻoi aʻe ma mua o 5 cm ka lōʻihi), ʻona i ka:

  • Hiki iā lākou ke hoʻokaʻawale i nā kiko, nā pali.
  • E hōʻeha i ka maʻi kaumaha.
  • Hiki i ka ʻona a me ke kūkulu ʻana i kahi pohō.
  • Hiki i nā cysts ke hoʻoulu ʻia o nā enzyme digestive e hiki ai ke hoʻomaloʻo i ka vascular a me ke koko.
  • Ma ka hope loa, hiki i kahi leho ke haki i loko o ka ʻōpū o ka ʻōpū.

ʻO kēlā mau palaka nui, me ka ʻehaʻeha a i ʻole ke hoʻokaʻawale ʻana o nā papa pale, e hoʻopaʻa ʻia ma ka ʻalo ʻana a i ʻole ke kahawai. ʻO nā ʻano nui o nā hana me ka pseudocysts:

  1. Kūkākūkā ʻia o waho o ka pōkō.
  2. ʻO ka hele ʻana o ka cyst.
  3. Mahu o loko. ʻO ka loina nui ka hoʻokumu ʻana mai o kahi anastomosis o kahi cyst me kahi ʻōpū a i ʻole kahi meʻa o ka ʻāpana.

ʻO ka pale aku ka wehe ʻana o kahi hapa o kahi mea. Hoʻomaʻamaʻa pinepine ʻia nā hopena o ka pancreas i ka wā i hōʻeha ʻia e ka maʻi keʻa, me nā ʻeha, ʻaʻole i emi pinepine me ka pancreatitis maʻi.

Ma muli o nā hiʻohiʻona anatomical o ke kolo koko i ka pancreas, hiki i kahi o nā hapa ʻelua ke kāpae ʻia.

  • O ke poʻo me ka duodenum (ʻoiai he koko koko lākou).
  • ʻĀpana ʻāpana (ke kino a me ke kāʻei).

Hoʻomoe ʻana ʻo Pancreatoduodenal

ʻO kahi hana maʻamau a hoʻomohala maikaʻi (ʻo ia hoʻi ka hana a Whipple).

ʻO kēia o ka wehe ʻana i ke poʻo o ka pancreas me ka envelope o ka duodenum, gall bladder a me kahi ʻāpana o ka ʻōpū, a me nā nīnū līpika kokoke.

Hoʻāla pinepine ʻia me nā maʻi nā mea ma ke poʻo o ka pancreas, nā maʻi o ka Villa papilla, a me kekahi mau mea me ka maʻi pancreatitis.

Ma kahi o ka laweʻana i ke kino i hoʻopili ʻia me nā ʻili e hoʻopuni ana, kahi hana koʻikoʻi koʻikoʻi ʻo ka hana hou ʻana a me ka hoʻokumu ʻana mai o ka huina wai a me ka pancreatic huna mai ka pancreatic stump. ʻO kēia ʻāpana o ka digestive tract e like me ka reassembling. Ua haku ʻia kekahi anastomoses:

  1. ʻO ka hoʻopuka o ka ʻōpū me ka jejunum.
  2. Hoʻokomo ʻia ka pancreatic dull me ka pōpoki peʻemeu.
  3. ʻO ka palupalu a ka pahu maʻamau.

Aia he ala no ka hoʻoneʻe ʻana i ka papa pancreatic ʻaʻole i loko o ka ʻōpū, akā i loko o ka ʻōpū (pancreatogastroanastomosis).

Distal pancreas resection

Hoʻopau ʻia ia me nā ʻili o ke kino a i ʻole ʻoi paha. Pono e ʻōlelo ʻia nā nika hewaʻole o kēia alakaʻi i kēlā me kēia manawa like ʻole, no ka mea ulu koke lākou i loko o nā moku ʻōpū.

No laila, ʻo ka hana pinepine pinepine o ia hana me ka mau maʻi benign. Hoʻohana pinepine ʻia ka wehe maʻa me ka wehe ʻana o ka spleen.

ʻO ka wehe ʻana i ka wehe ʻokoʻa me ka hoʻomohala ʻana i ka maʻi mellitus o ka maʻi mellitus i ka wā postoperative.

Distal pancreatectomy (ka lawe ʻana i ka huakaʻi pancreatic me ka spleen)

I kekahi manawa ʻaʻole hiki ke wānana ka nui o kahi hana. Inā ma ka hōʻike ʻana ua hōʻike ʻia ua pālahalaha nui ke ʻano, ua hiki ke hoʻokaʻawale i kahi ʻōpū holoʻokoʻa. Ua kapa ʻia kēia hana ʻo ka pancreatectomy ʻokoʻa.

Hoʻokumu ʻia no ka maʻi pancreatitis kūlohelohe

Hoʻokomo ʻia ka wawaahi ma ka maʻi pancreatitis ma ke ʻano he hana wale ʻana o ke ʻano o ka mea maʻi.

  • Kūkulu ʻia o nā wahī (me ke kuhi hewa ʻana o ka paepae o nā kolo, kahi anastomosis me kahi jejunum i hoʻokumu ʻia).
  • ʻO ka noho ʻana a me ka hoʻoheheʻe ʻana o nā cysts.
  • ʻO ka pale ʻana o ke poʻo me ka jaundice obstrate a i ʻole ka stenosis o ka duodenum.
  • ʻO ka pancreatectomy (me ka maʻi mau loa o ka maʻi ʻeha, ka jaundice obstructive) me ka pōʻino o ke kino.
  • Inā he mau pōhaku i loko o nā papa pancreatic e hōʻole i ka puka ʻana o ka mea huna a e hōʻeha paha i ka ʻeha nui, hiki i kahi hana ke ʻano wirsungotomy (ʻokiʻoki i ka wai a me ka wehe ʻana o ka pōhaku) a i ʻole ka wai o ka wahī ma luna o ke kiʻekiʻe o ka aʻalolo (pancreatojejunoanastomosis) hiki ke hana.

ʻO nā wā kūpono a me ka wā kūpono

ʻAʻole ʻokoʻa loa ka hoʻomākaukau ʻana no ka hoʻomaʻamaʻa ʻana ma ke pancreas no ka hoʻomākaukau ʻana no nā hana ʻē aʻe.

ʻO ka mea kūʻokoʻa ka hana i ka pancreas e lawe i ka nui no nā kumu olakino, ʻo ia hoʻi, aia wale nō i nā kūlana i ʻoi aku ka nui o ka ʻae ʻole o ka luaʻi ʻana i kahi ʻoi aku ka paʻakikī.

No laila, ʻo kahi contraindication no kēlā me kēia hana he mea koʻikoʻi koʻikoʻi wale nō o ka mea maʻi. Hana ʻia ka hana pancreatic ma lalo o ka hana maʻamau.

Ma hope o ka hoʻomaʻamaʻa ʻana i ka pancreas, hana ʻia ka mālama ʻai makua no nā lā mua (e hoʻoiho ʻia nā hoʻonā aʻai i ke koko ma o ka dropper) a i ʻole hoʻokomo ʻia kahi ʻōpū o ka ʻōpū i ka wā o ka hana ʻana a hoʻopili ʻia nā ʻano wai ʻai pono i loko o ka ʻōpū ma loko.

I ʻekolu mau lā ma hope, hiki iā ia ke inu mua, a laila e ʻohi i ka meaʻai semi-wai ʻole me ka paʻakai a me ke kō.

ʻO ke ola ma hope o ka haʻalele a wehe paha i ka pancreas

ʻO ka pancreas, e like me ka mea i ʻōlelo ʻia, he kuleana koʻikoʻi a he ʻano kūikawā no ko mākou kino. Hoʻolaha ia i kekahi helu o nā digestive enzyme, ʻo ia wale nō Hoʻokumu ka pancreas i nā kūmole e hoʻoponopono i ka metabolism kalepa - insulin a me glucagon.

Eia nō naʻe, pono e hoʻomaopopo ʻia i ka hiki o nā hana ʻelua o kēia mea ke kūleʻa maikaʻi ʻia e nā loli substitution. ʻAʻole hiki i ke kanaka ke ola, no ka laʻana, ʻaʻohe a ate, akā inā ʻaʻohe pancreas me ke ola kūpono a me ka loaʻa ʻana o ka maʻi kūpono, hiki iā ia ke ola no nā makahiki he nui.

He aha nā kānāwai o ke ola ma hope o nā hana ma ka pancreas (ʻoi aku hoʻi no ka haʻalele ʻana i kahi ʻāpana a i ʻole ka hanu holoʻokoʻa)?

  • Hoʻohui maikaʻi i ka meaʻai a hiki i ka hopena o ke ola. Pono ʻoe eʻai i nā ʻāpana liʻiliʻi nā manawa 5-6 i ka lā. Pono ka maʻalahi o ka ʻai me ka liʻiliʻi o ka momona momona.
  • ʻO ka wehe loa ʻana i ka waiʻona.
  • Hoʻokele i ka hoʻomākaukau ʻana o ka enzyme i ke kapa enteric i ʻōlelo ʻia e kekahi kauka.
  • Ka nānā ponoʻī o ke kō koko. ʻO ka hoʻonuiʻana i ka maʻi diabetes me ka haʻalele ʻana i kahi hapa o ka pancreas, ʻaʻole ia he kuleana koʻikoʻi. Wahi a nā kumuwaiwai like ʻole, e hoʻomohala ʻia ʻo ia ma 50% o nā hihia.
  • Ke hoʻomau nei i ka maʻi diabetes mellitus - hana i ka maʻi maʻi e like me nā mea i kau ʻia e ka endocrinologist.

ʻO ka maʻamau ma nā mahina mua ma hope o ka hoʻomaʻamaʻa ʻana, ua hui ke kino:

  1. ʻO ka mea maʻi, ma ke ʻano he lula, ua lilo ka paona.
  2. ʻO ka hōʻeha, nā kaumaha a me ka ʻeha o ka ʻōpū ma hope o ka ʻai ʻana.
  3. Nā nānā pinepine ʻia nā kīwaha i maʻamau (maʻa mau ma hope o kēlā me kēia pāʻina).
  4. Hoʻokomo ʻia ka nāwaliwali, malaise, a me nā hōʻailona o ka nui o ka huaora ma muli o ka malabsorption a me nā mea paʻa ʻana.
  5. I ka koho ʻana i ka insulin insulin, hiki i nā hanana hypoglycemic pinepine i ka manawa mua (no laila, ke kuhikuhi ʻia e mālama i ka pae o ke kō ma mua o nā hana maʻamau).

Akā holomua, e pili ke kino i nā kūlana hou, aʻo ka mea maʻi i ka hoʻoponopono ʻana iho, a komo ka ola i kahi rut maʻamau.

Waiho I Kou ManaʻO HoʻOpuka