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,ERCPUa ulu ka ʻenehana 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,ERCPKe hoʻololi mālie nei i ke kumu hoʻohālike maʻamau no ka hōʻailona 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 diagnostics, 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 o ka hoʻomohala ʻana 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 hoʻi. Eia nō naʻe, ke kū nei hoʻi i nā palena i ka hoʻohana ʻana i ka lāʻau lapaʻau, e like me nā paepae loea kiʻekiʻe a me ka hilinaʻi ikaika i nā lako.

 

HouERCPʻO ka hapa nui o nā ʻenehana he ʻekolu mau māhele: nā ʻōnaehana endoscopic no nā ʻāpana bile a me pancreatic, nā endoscopes lahilahi loa, 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 ʻana.

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 mea houERCPʻO ka ʻenehana 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 ka hoʻomaikaʻi ʻana i ka pololei o ka diagnostics, cholangiopancreatography (ERCP) hiki i nā kauka ke nānā pololei i ka bile a me ka mucosa duct pancreatic, e hoʻomaikaʻi nui ana i ka hiki ke hoʻokaʻawale ma waena o nā strictures benign a me malignant. KuʻunaERCPhilinaʻi ʻia i nā mea hoʻohālikelike e ʻike i ke ʻano luminal, a ʻo ka loiloi ʻana o nā ʻeha 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, ʻae ka cholangiopancreatography (CP) i ka nānā pololei ʻana 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 ka 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, kuʻunaERCPhe kiʻekiʻe ka holomua no ka wehe ʻana i nā pōhaku ʻauwai pancreatic ma lalo o 5mm ke anawaena, akā ʻoi aku ka kiʻekiʻe 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 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 oERCPi 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 endoscopy biliary a me ka pancreatic duct 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 nā lāʻau lapaʻau maʻamauERCPʻo ia 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 kuʻuna.ERCPhui, akā ua hōʻike ka hui TCP i kahi pōmaikaʻi koʻikoʻi ma nā helu pilikia.

ʻO ka mea houERCPKe kū nei ka ʻenehana i kekahi mau palena i ka hoʻohana 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 i 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 ka hoʻololi ʻana i ka PTCD a i ʻole ke ʻoki ʻana.

  

Nā ʻano hoʻomohala hou o ka wā e hiki mai anaERCPʻO ka ʻenehana nui e kālele 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 kaERCPnā hiki 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 diagnostics, 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, paipai ka ʻaelike 2025 i ka hoʻokomo ʻia ʻana oERCPi 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 a me ka hoʻolaha ʻana o ka ʻenehana,ERCPe manaʻo ʻia e hoʻopili ʻia ma nā ʻoihana lapaʻau hou aʻe, e hāʻawi ana i nā lawelawe hōʻoia a me ka mālama ʻana i ʻoi aku ka pololei a me ka maikaʻi no nā poʻe maʻi me nā maʻi biliary a me ka pancreatic.

 

 

 

Hōʻuluʻulu Manaʻo a me nā Manaʻo

 

ERCP, he ʻenehana hou, e hōʻike ana i kahi 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 diagnostics ma o ka ʻike pololei a me ka biopsy pololei, hoʻemi i ka pilikia o nā pilikia ma ka hoʻonui ʻana i ke kaʻina hana a me ka hoʻopōkole ʻana i ka manawa mālama, a pōmaikaʻi i nā mea 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.ERCPhoʻomaʻamaʻa a me ka hoʻopukapuka 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,ERCPhiki ke noʻonoʻo ʻia ka mālama ʻana i kōkua ʻia e nā ʻenehana hou. Eia kekahi, ua ʻōlelo ʻia e hoʻomaikaʻi hou i ka hana a me ke kumukūʻai oERCP, e hoʻoponopono i nā pilikia o ka laulā ʻana a me ka transparency o nā ʻōnaehana i kōkua ʻia e AI, a paipai i ka hoʻohana ākea ʻana oERCPma nā haukapila mālama mua.

 

ERCPNā mea kūʻai wela moʻo 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 nā forceps biopsy, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes,uea alakaʻi, hīnaʻi kiʻi pōhaku, cathete hoʻokahe wai nasal biliary etc. i hoʻohana nui ʻia ma EMR, ESD,ERCPUa hōʻoia ʻia kā mākou huahana e CE a me ka ʻae ʻia e ka 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 kekahi ʻāpana o ʻAsia, a ua loaʻa nui ka ʻike a me ka hoʻomaikaʻi ʻia e ka mea kūʻai aku!