Nā Mea Hana ERCP Triple Lumen Single Sphincterotome no ka Hoʻohana Endoscopic

1. Anawaena
ʻO ke anawaena o ka sphincterotome he 6Fr maʻamau, a ua hoʻemi mālie ʻia ka ʻāpana apex i 4-4.5Fr.ʻAʻole pono ka nānā nui ʻana o ke anawaena o ka sphincterotome, akā hiki ke hoʻomaopopo ʻia ma ka hoʻohui ʻana i ke anawaena o ka sphincterotome a me nā hana hana o ka endoscope.Hiki ke hāʻawi ʻia kahi uea alakaʻi ʻē aʻe ke kau ʻia ka sphincterotome.
2. Ka lōʻihi o ka maka
Pono e noʻonoʻo ʻia ka lōʻihi o ka maka, ma ke ʻano he 20-30 mm.ʻO ka lōʻihi o ka uea alakaʻi e hoʻoholo i ke kihi arc o ka pahi arc a me ka lōʻihi o ka ikaika i ka wā ʻoki.No laila, ʻoi aku ka lōʻihi o ka uea pahi, ʻoi aku ka kokoke o ka "anu" o ke arc i ke kuhikuhi anatomical o ka pancreaticobiliary duct intubation, ʻoi aku ka maʻalahi o ka intubate holomua.I ka manawa like, hiki i nā uea pahi lōʻihi ke hana hewa i ka sphincter a me nā hale a puni, e hopena i nā pilikia koʻikoʻi e like me ka perforation, no laila aia kahi "pahi akamai" e kūpono i nā pono o ka palekana i ka wā e hālāwai ai ka lōʻihi.
3. ʻIkepili sphincterotome
ʻO ka ʻike ʻana o ka sphincterotome he ʻāpana koʻikoʻi loa ia, ʻoi aku ka maʻalahi o ka mea hoʻohana e hoʻomaopopo maʻalahi a ʻike i ke kūlana o ka sphincterotome i ka wā o ka hana maʻalahi a koʻikoʻi, a e hōʻike i ke kūlana maʻamau a me ke kūlana incision palekana.Ma ka ʻōlelo maʻamau, e kaha ʻia kekahi mau kūlana e like me "start", "start", "midpoint" a me "1/4" o ka sphincterotome, kahi o ka 1/4 mua a me ka waena waena o ka pahi akamai he mau kūlana palekana no ka. ʻoki , hoʻohana maʻamau.Eia kekahi, ʻo ka māka waena o ka sphincterotome he radiopaque.Ma lalo o ka nānā ʻana i ka X-ray, hiki ke hoʻomaopopo maikaʻi ʻia ke kūlana pili o ka sphincterotome i loko o ka sphincter.Ma kēia ala, i hui pū ʻia me ka lōʻihi o ka pahi i hōʻike ʻia ma lalo o ka ʻike pololei, hiki ke ʻike inā hiki i ka pahi ke hana palekana i ka sphincter incision.Eia nō naʻe, loaʻa i kēlā me kēia hui nā loina like ʻole i ka hana ʻana i nā logos, pono e hoʻomaopopo ʻia.