ʻEnehana ERCP Hou: Ka Hana Hou a me nā Pilikia i ka ʻIke a me ka Lāʻau Lapaʻau Minimally Invasive

I nā makahiki he 50 i hala iho nei, ua ulu ka ʻenehana ERCP mai kahi mea hana diagnostic maʻalahi i kahi kahua minimally invasive e hoʻohui ana i ka hōʻailona a me ka mālama ʻana. Me ka hoʻolauna ʻana o nā ʻenehana hou e like me ka biliary a me ka pancreatic duct endoscopy a me ka ultra-thin endoscopy, ke hoʻololi mālie nei ʻo ERCP i ke kumu hoʻohālike diagnostic a me ka mālama ʻana no nā maʻi biliary a me ka pancreatic. Ua holomua nui ia i ka hoʻomaikaʻi ʻana i ka pololei o ka diagnostic, ka hoʻonui ʻana i ka laulā o nā hōʻailona, ​​​​a me ka hōʻemi ʻana i ka pilikia o nā pilikia, e hōʻike ana i ke ʻano hoʻomohala o "ke ʻoki kino lapaʻau e lilo i ʻoki kino a me ke ʻoki kino e lilo i minimally invasive," e hāʻawi ana i nā mea maʻi hou aku me nā koho lapaʻau pololei a maikaʻi. Eia nō naʻe, ke kū nei hoʻi i nā palena i ka noi lapaʻau, e like me nā paepae loea kiʻekiʻe a me ka hilinaʻi ikaika i nā lako.

 

ʻO nā ʻenehana ERCP hou e hāʻule nui i ʻekolu mau māhele: nā ʻōnaehana endoscopic no nā ʻāpana bile a me pancreatic, nā endoscopes ultra-thin, a me nā ʻōnaehana hou i hoʻomohala ʻia ma ka home. Hāʻawi nā ʻōnaehana Endoscopic e like me SpyGlass lāua ʻo Insight-eyeMax i ka ʻike pololei a kōkua i ka mālama pololei.

I waena o lākou, ʻo ka ʻōnaehana SpyGlass he anawaena catheter waho o 9F-11F a me ke anawaena kahawai hana o 1.2mm a i ʻole 2.0mm, e hiki ai i ke kanaka hoʻokahi ke hoʻokomo i ka subscope duct biliary a me pancreatic no ka nānā pololei ʻana i ka mucosa. Hōʻike ka ʻōnaehana Insight-eyeMax i ka maikaʻi kiʻi wehewehe kiʻekiʻe 160,000-pixel, kahi kahua ʻike 120°, a me kahi uhi pahee loa, e hāʻawi ana i kahi kahua ʻike maopopo a ākea. Hoʻohana nā endoscopes lahilahi i kahi anawaena paipu liʻiliʻi (ʻoi aku ka liʻiliʻi ma mua o 5mm) e komo pololei i ka duct bile, akā ma muli o ke ʻano paʻakikī o ke ala gastrointestinal luna, pono pinepine nā mea hana kōkua e like me nā balloons anchoring, nā cannulas waho, a me nā pahele. Loaʻa i kēia mau ʻōnaehana nā pono i ka nānā ʻana i ka mucosa duct bile a me ka hana ʻana i nā biopsies, akā ʻoi aku ka paʻakikī o ka hana ʻana.

 

 

SpyGlass	ʻIke maka-Max

 

ʻO ka pōmaikaʻi nui o ka ʻenehana ERCP hou, ʻo ia ka hoʻokō ʻana i kahi lele mai ka nānā ʻana pololei ʻole i ka hōʻailona pololei, e hiki ai i nā kauka ke nānā pono i nā ʻeha o ka bile a me ka pancreatic duct mucosa a hana i nā biopsies pololei a me nā lāʻau lapaʻau i ka manawa like i ka wā o ke kaʻina hana diagnostic. Hōʻike nui ʻia kona waiwai lapaʻau i ʻekolu mau ʻano: ka hoʻomaikaʻi ʻana i ka pololei o ka diagnostic, ka hoʻonui ʻana i ka laulā o nā hōʻailona, ​​a me ka hoʻemi ʻana i ka pilikia o nā pilikia.

I ke ʻano o ka hoʻomaikaʻi ʻana i ka pololei o ka diagnostics, hiki i ka cholangiopancreatography (ERCP) ke ʻae i nā kauka e nānā pololei i ka bile a me ka pancreatic duct mucosa, e hoʻomaikaʻi nui ana i ka hiki ke hoʻokaʻawale ma waena o nā benign a me nā malignant strictures. Hilinaʻi ka ERCP kuʻuna i nā mea hoʻohālikelike e nānā i ke ʻano luminal, a ʻo ka loiloi o nā lesions mucosal e hilinaʻi ʻia i nā hōʻailona ʻaʻole pololei. ʻO ka ʻike o ka palaki ʻana o nā cell bile duct he 45%-63% wale nō, a ʻo ka ʻike o ka biopsy kiko he 48.1% wale nō.

 

I ka hoʻohālikelike ʻana, hiki i ka cholangiopancreatography (CP) ke ʻike pololei i ka mucosa, e hoʻomaikaʻi nui ana i ka ʻike diagnostic. Ke hui pū ʻia me MRCP, hiki i ka helu pololei ke piʻi i 97.4%, a ʻo ka pololei diagnostic no nā pōhaku bile duct >9mm ke anawaena kokoke i 100%. E pili ana i nā hopena lapaʻau, loaʻa i ka ERCP kuʻuna kahi helu holomua kiʻekiʻe no ka wehe ʻana i nā pōhaku pancreatic duct <5mm ke anawaena, akā ʻoi aku ka nui o ka hāʻule ʻana no nā pōhaku paʻakikī (e like me kēlā mau mea >2cm a i ʻole ma hope o ke kūkulu hou ʻana o ka gastrointestinal). Hiki i ka CP i hui pū ʻia me ka laser lithotripsy ke hoʻomaikaʻi i ka helu holomua kokoke i ka pae o ke ʻoki kino hāmama.

Ma ke ʻano o ka hoʻonui ʻana i ka laulā o nā hōʻailona, ​​​​hoʻomaikaʻi nui ka ʻenehana hou i ka holomua o ka ERCP i nā poʻe maʻi ma hope o ke ʻoki hoʻololi ʻana i ka ʻōpū, e hiki ai iā lākou ke hoʻokele i nā maʻi biliary a me pancreatic paʻakikī. No ka laʻana, i nā hihia paʻakikī e like me ka cholangitis post-ate transplant a me ka pancreatic duct IPMN, hiki i ka biliary a me ka pancreatic duct endoscopy ke hāʻawi i kahi ʻike maopopo, e hiki ai ke hōʻoia pololei a me ka mālama ʻana.

 

 

ʻO ka nui o ka pancreatitis ma hope o ka ERCP kuʻuna ma kahi o 3%-10%. ʻO nā ʻenehana hou, ma o ka ʻike pololei ʻana, e hōʻemi i ka hoʻokomo hewa ʻana o ka duct pancreatic, hoʻomaikaʻi i nā kaʻina hana, a hoʻopōkole i ka manawa hana, e hoʻohaʻahaʻa nui ana i ka nui o ka pancreatitis postoperative a me nā pilikia ʻē aʻe. Ma kahi loiloi o 50 mau maʻi me ka cholangiocarcinoma kiʻekiʻe, ua like ka manawa patency stent a me nā hopena lapaʻau ma ka hui transoral cholangiopancreatography (TCP) me nā mea ma ka hui ERCP kuʻuna, akā ua hōʻike ka hui TCP i kahi pōmaikaʻi koʻikoʻi i nā helu pilikia.

Ke kū nei ka ʻenehana ERCP hou i kekahi mau palena i ka hoʻohana ʻana i ka lāʻau lapaʻau. ʻO ka mea mua, he paepae loea kiʻekiʻe kona a he paʻakikī, e koi ana i nā endoscopists akamai. ʻO ka lua, hilinaʻi nui ia i nā lako, me nā kumukūʻai mālama a me ka hana kiʻekiʻe, e kaupalena ana i kona hoʻohana nui ʻia ʻana ma nā haukapila mālama mua. ʻO ke kolu, ua kaupalena ʻia nā hōʻailona, ​​a aia nō ka pilikia o ka hāʻule ʻana o ke kaʻina hana i kekahi mau kūlana. No ka laʻana, i nā hihia o ka stricture gastrointestinal koʻikoʻi (e like me ka esophageal scarring) a i ʻole ka pale piha ʻana o ka tumor, pono nō paha ka hoʻololi ʻana i ka PTCD a i ʻole ke ʻoki ʻana.

  

ʻO nā ʻano hoʻomohala e hiki mai ana o nā ʻenehana ERCP hou e kālele nui ana i ʻekolu mau ʻano: ka hoʻolaha ʻana ma ka pae grassroots, ka hoʻohui ʻana o AI, a me ka hoʻolaha ʻana o ke ʻoki kino i kēlā me kēia lā. E pili ana i ka hoʻolaha ʻana ma ka pae grassroots, nā papahana hoʻomaʻamaʻa a me nā pono kumukūʻai o nā lako hana i hana ʻia ma ka home e hoʻomaikaʻi mālie i nā hiki ERCP o nā haukapila mua. Ma ke ʻano o ka hoʻohui ʻana o AI, paʻa ka ʻenehana ʻike kiʻi manawa maoli i ka hoʻohiki no ka hoʻomaikaʻi ʻana i ka pono diagnostic, akā ke kū nei ia i nā pilikia e like me ka hoʻohālikelike ʻikepili a me ka transparency model, e koi ana i ka hoʻonui hou ʻana.

E pili ana i ka hoʻolaha ʻana o ke ʻoki kino i ke ao, ke paipai nei ka ʻaelike 2025 i ka hoʻokomo ʻia ʻana o ERCP i ka hoʻokele ʻoki kino i ke ao, e hiki ai i ka hapa nui o nā maʻi ke hoʻopau i ke kaʻina hana o ka hoʻokipa ʻana i ka haukapila, ke ʻoki kino, ka nānā ʻana ma hope o ka hana, a me ka hoʻokuʻu ʻana i loko o 24 mau hola. ʻAʻole wale kēia e hoʻopōkole i nā noho haukapila akā e hōʻemi pū i nā kumukūʻai lapaʻau a hoʻomaikaʻi i ka pono o ka hoʻohana ʻana i nā kumuwaiwai lapaʻau. Me ka hoʻomau ʻana o ka ʻike a me ka hoʻolaha ʻana o ka ʻenehana, manaʻo ʻia e hoʻohana ʻia ʻo ERCP ma nā ʻoihana lapaʻau hou aʻe, e hāʻawi ana i nā lawelawe ʻike a me ka mālama ʻana i ʻoi aku ka pololei a me ka maikaʻi no nā maʻi hou aʻe me nā maʻi biliary a me ka pancreatic.

 

 

 

Hōʻuluʻulu Manaʻo a me nā Manaʻo

 

ʻO ERCP, kahi ʻenehana hou, he holomua koʻikoʻi i ka ʻike ʻana a me ka mālama ʻana i nā maʻi biliary a me ka pancreatic. Hoʻomaikaʻi ia i ka pololei o ka diagnostic ma o ka ʻike pololei ʻana a me ka biopsy pololei, hoʻemi i ka pilikia o nā pilikia ma ka hoʻomaikaʻi ʻana i ke kaʻina hana a me ka hoʻopōkole ʻana i ka manawa lapaʻau, a pōmaikaʻi i nā poʻe maʻi hou aku ma ka hoʻonui ʻana i ka laulā o nā hōʻailona. Eia nō naʻe, ke kū nei kēia ʻenehana hou i nā palena i ka noi lapaʻau, e like me nā pale loea kiʻekiʻe a me ka hilinaʻi ikaika i nā lako, e koi ana i ke kākoʻo o nā hui lapaʻau kūikawā a me nā lako holomua. Manaʻo ʻia e hoʻoikaika nā ʻoihana lapaʻau i ka hoʻomaʻamaʻa ERCP a me ka hoʻopukapuka ʻana i nā lako e hoʻomaikaʻi i nā mākau kauka a me ka loaʻa ʻana o nā lako. Manaʻo ʻia hoʻi e koho i nā ʻano lapaʻau kūpono e pili ana i ke kūlana o ka mea maʻi; no nā maʻi biliary a me ka pancreatic paʻakikī, hiki ke noʻonoʻo ʻia ka mālama ʻana iā ERCP i kōkua ʻia e nā ʻenehana hou. Eia kekahi, manaʻo ʻia e hoʻomaikaʻi hou i ka hana a me ke kumukūʻai o ERCP, e hoʻoponopono i nā pilikia o ka laulā a me ka transparency o nā ʻōnaehana i kōkua ʻia e AI, a paipai i ka hoʻohana ākea ʻana o ERCP i nā haukapila mālama mua.

 

Nā mea kūʻai wela o ka ERCP Series mai ZRHmed.

ʻO ka Sphincterotomy	Nā Uea Alakaʻi ʻAʻole Vascular	Nā Hīnaʻi Hoʻihoʻi Pōhaku Hoʻolei ʻia	Nā Catheters Nasobiliary hiki ke hoʻolei ʻia

 

 

ʻO mākou, ʻo Jiangxi Zhuoruihua Medical Instrument Co., Ltd., he mea hana ma Kina e loea ana i nā mea hoʻopau endoscopic, me ka laina GI e like me ka biopsy forceps, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes, guidewire, stone retrieval basket, nasal biliary drainage cathete etc. i hoʻohana nui ʻia ma EMR, ESD, ERCP. Ua hōʻoia ʻia kā mākou huahana e CE a me ka ʻae ʻia e FDA 510K, a ua hōʻoia ʻia kā mākou mau mea kanu e ISO. Ua hoʻokuʻu ʻia aku kā mākou waiwai i ʻEulopa, ʻAmelika ʻĀkau, Hikina Waena a me kahi ʻāpana o ʻAsia, a ua loaʻa i ka mea kūʻai aku ka ʻike a me ka hoʻomaikaʻi ʻia!

 

 

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