Ga marasa lafiya tare da pseudocysts na pancreatic, ingancin sabon nau'in nau'in naman kaza guda biyu yana da yawa.

Pseudocyst na Pancreatic yana daya daga cikin rikice-rikice na pancreatitis, kamar yadda bayyanar cututtuka na yau da kullum yana da tasiri mai mahimmanci akan ingancin rayuwar marasa lafiya. A halin yanzu, hanyoyin jiyya na pseudocysts na pancreatic sun haɗa da aikin tiyata, magudanar huɗa, da magudanar endoscopic transluminal. A cikin 'yan shekarun nan, endoscopic transluminal magudanun ruwa a hankali ya zama daidaitaccen hanyar magani, galibi ana shiryar da shi ta hanyar endoscopic duban dan tayi (EUS) don kafa tashar magudanar ruwa mai inganci tsakanin cyst da ciki ko duodenum, don cimma magudanar ciki na cyst. A cikin aikin asibiti, nau'ikan stent yawanci ana sanya su tsakanin tashoshi don tabbatar da kyakkyawan yanayin buɗe su.

Akwai nau'ikan stent iri-iri a cikin aikin asibiti, kuma abin da aka saba amfani da shi na pigtail stent yana da ƙananan haɗarin ƙaura. Koyaya, saboda ƙananan diamita na ciki, toshewar stent sau da yawa yana faruwa. Cikakkun rufaffiyar rufaffiyar girman kai na stent na ƙarfe yana da fa'idodi kamar girman diamita na ciki, ƙananan haɗarin toshewa, da kyakkyawan tasirin magudanar ruwa ga cysts. A cikin 'yan shekarun nan, Koriya ta Kudu ta samar da wani sabon nau'i na nau'i na naman kaza guda biyu (Hoto na 1), wanda ke da girman diamita da tsayi, kuma an sanye shi da kayan aiki mai mahimmanci. Nazarin da suka gabata sun gano cewa wannan sabon stent yana da tasiri mai yawa na asibiti.

An nuna Cyst akan MR

An danne rami na ciki kuma ya zama karami

Pseudocyst a karkashin endoscopic duban dan tayi

Fitowar ruwa cikin sauri bayan sanya stent

Binciken Int Roduction

Wani bincike a Koriya ta Kudu ya nuna cewa ga marasa lafiya da ke da alamun pseudocysts na pancreatic, yin amfani da sabon nau'in ƙarfe na naman kaza sau biyu na iya rage alamun bayyanar da kyau, kawar da cysts na pancreatic, kuma yana da lafiya. An buga labarin a cikin fitowar Satumba na Gastrointestinal Endoscopy (2019, 90 (3): 507-513).

Wannan binciken ya haɗa da marasa lafiya tare da pseudocysts na pancreatic bayyanar cututtuka, waɗanda ke da diamita fiye da 6 cm, babu sassan ciki, kuma suna kusa da cavities na ciki da duodenal. Ban da daidaikun mutanen da ke da ingantattun abubuwa a cikin pseudocysts, matattu waɗanda ke da lahani, da kuma daidaikun mutane waɗanda ke da pseudocysts waɗanda ba za a iya bi da su ƙarƙashin jagorancin EUS ba. Ga marasa lafiya da suka yi rajista, ana yin huda na farko na EUS don kafa hanyar shiga cikin kogon ciki ko duodenal cavity da cyst, sannan a bi da dilation da sake ginawa da kuma sanya sabon stent na naman kaza sau biyu. An yi CT scan makonni 4 bayan jiyya don kimanta tasirin magudanar ruwa na cyst (Hoto 2).

Hoto 2: Maganin pseudocyst na pancreatic ta amfani da sabon nau'i na naman kaza guda biyu: A, CT yana nuna babban pseudocyst pancreatic; B. EUS ya jagoranci transgastric cyst huda tiyata; C. Kula da wayar jagora tana shiga ciki na cyst a karkashin X-ray fluoroscopy; D. Shigar da SPAXUS stent a ƙarƙashin jagorancin EUS; E. Sanya stent mai gani a ƙarƙashin X-ray fluoroscopy; F. Lura da nasarar dasa stent a ƙarƙashin endoscopy kai tsaye; G. CT hotuna masu biyo baya bayan aikin sanya stent; H. Bayan sanya stent, an lura da aikin stent yana da kyau a karkashin endoscopy; I. Nasarar cire stent karkashin endoscopy

An yi rajistar marasa lafiya 34 a cikin binciken, ciki har da maza 26 da mata 8, tare da matsakaicin shekaru 51.7. Matsakaicin diamita na pseudocysts na pancreatic ya kasance 9.23 cm. Sai dai majiyyaci ɗaya wanda ya kasa aiwatar da tsarin sakin stent, sauran marasa lafiya 33 sun sami nasarar kammala aikin stent, tare da nasarar fasaha na 97.1% (33/34); Daga cikin marasa lafiya 33 da suka yi nasarar sanya stent, mai haƙuri 1 ne kawai ya sami mummunan sakamako na magudanar ruwa, yayin da sauran marasa lafiya 32 suka sami taimako na asibiti da bacewar cyst, tare da nasarar aikin asibiti na 94.1% (32/34). Akwai lokuta 3 na kamuwa da cuta na pseudocyst da kuma 1 yanayin rashin aiki na stent a lokacin lokacin aiki, tare da ƙimar rikitarwa na 11.8% (4/34).

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A al'adance, yawancin marasa lafiya tare da pseudocysts na pancreatic suna buƙatar magani na tiyata don cimma magudanar ruwa da kawarwa. Tare da haɓaka fasahar endoscopic, maganin endoscopic na pancreatic pseudocysts a hankali ya zama hanyar jiyya na yau da kullun, tare da inganci da aminci mai yawa, amma akwai kuma wasu matsalolin fasaha.

Babban mataki na maganin endoscopic don pseudocysts shine kafa tashoshi tsakanin lumen digestive tract lumen da cyst, da kuma sanya stent da ya dace don cimma magudanar ciki na cyst. Diamita da tsayin stent duka suna shafar tasirin magudanar ruwa. A halin yanzu, abin da aka saba amfani da shi na filastik pigtail sau biyu yana da ƙaramin diamita kuma yana da saurin toshewa; Ƙarfe da aka rufe yana da ɗan gajeren tsayi kuma yana da sauƙi don motsawa, wanda ke rinjayar tasirin warkewa; A cikin 'yan shekarun nan, sabon ƙaddamar da nau'i na nau'i biyu na naman kaza na karfe yana da diamita mafi girma na ciki kuma ana iya daidaita shi zuwa girman da ya dace daidai da tsawon bangon fili na narkewa da tashar cyst.

Wannan binciken shine farkon binciken mai yiwuwa na multicenter wanda ke niyya ga sabon labari, da nufin kimanta ingancinsa a cikin marasa lafiya tare da pseudocysts na pancreatic alamun cutar. Masu binciken sun fara amfani da allurar huda 19G EUS don huda cikin cyst ta bangon ciki ko duodenal. Bayan an faɗaɗa balloon don samar da tashoshi mai girman da ya dace, an saka catheter mai dacewa kuma an sanya stent. An ƙididdige tasirin jiyya bisa la'akari da taimako na alamar haƙuri da canje-canje a diamita na cyst.