Njira ndi zotsatira pambuyo kuchotsedwa kwa pancreatic

Njira ya laparoscopic imagwiritsidwa ntchito, opareshoni imachitidwa pansi pa opaleshoni yayikulu.

Laparoscope imayikidwa kudzera pazing'ono zazing'ono, malo omwe amayendetsedwa amawunikira, zotumiza zamagetsi, duodenum imatsekedwa ndikuchotsedwa, gawo loyandikira la lymph limachotsedwa, nthawi zina ziwalo zoyandikana zimayenera kuchotsedwa pang'ono.

Pambuyo pa izi, kulumikizana kwatsopano kumapangidwa pakati pamimba ndi matumbo aang'ono ndi thupi la kapamba.

Opaleshoniyo ndi yowopsa, ndipo imabweretsa zotsatira zowopsa pambuyo pochotsa mutu wa kapamba:

• kuphwanya mayamwidwe a michere mokhudzana ndi kuchotsedwa kwa gawo lofunika kwambiri la chiwalo chomwe chimapanga michere yothandiza kugaya chakudya,
• Kulephera kwa kagayidwe kazakudya zam'mimba ndi chitukuko cha matenda a shuga.

Pankhani yochotsa mutu nthawi zambiri mumakhala:

• zotupa zamitsempha ndi mitsempha yamagazi yoyandikana ndi England,
• magazi
• matenda.

Pafupifupi nthawi zonse, chifuwa cha postoperative chokhala ndi chinsinsi chachikulu cha kuperewera chimayamba. Malangizo omwe amalimbikitsidwa ayenera kutsatiridwa kwa zaka zambiri. Zitha kukhala chifukwa chakuti pakamwa pokhapokha pakayikiridwa mankhwala ena, ndi zakudya zapadera kwakanthawi. Munthu pambuyo pakuchita opaleshoni amalandira kulumala.

Kugwira ntchito kwa Beger

Kafukufuku wapadera wa mutu wokhudzidwa ndi kapamba popanda kuchotsa duodenum adapangidwa ndikuyambitsidwa ndi Beger mu 1972. Pogwira ntchito imeneyi, babu m'mimba ndi duodenal babu omwe ali pafupi ndi chindacho amasungidwa, zomwe sizisokoneza gawo la chakudya kudzera mumgawo wokugaya. Kubisa kwa gastropancreatoduodenal kuchokera ku ndulu ndi kapamba kudzera mumatumbo ang'onoang'ono amasungidwa.

Zotsatira za kafukufukuyu, zotsatira zabwino zidapezeka mu nthawi yogwirira ntchito, pamaziko omwe njirayo idalandila akatswiri odziwa bwino ntchito yawo komanso kugwiritsa ntchito njira zambiri. Pogwiritsa ntchito njirayi, kapamba wam'mimba amapulumutsidwa m'mphepete mwa kumasulidwa kwa mitsempha yapamwamba komanso ya portal. Pali kuthekera kwa magazi ndi zovuta zomwe zilipo chifukwa cha matenda kapamba, makamaka, ndi chitukuko cha matenda oopsa a portal. Mwazinthu izi, kuwonekera pamitsempha kumakhala koopsa ndikutaya magazi kwambiri.

Kusankha kwa duodenum kosungiramo mutu popanda kudutsa zikondamoyo pamtunda wama portal kumagwiritsidwanso ntchito - mtundu wa Bernese wogwira ntchito pa Beger.

Kuchotsa mchira

Ngati caudal (caudal) gawo la kapamba amakhudzidwa, distal pancreatomy imachitika. Mitsempha ikachitika mchira, womwe umagwira ndulu, gawo lake kapena chiwalo chimachotsedwa kwathunthu. Ndulu zimapangidwanso pamodzi ndi zotengera. Zikatero, zovuta za carbohydrate metabolism ndi kukula kwa matenda a shuga sizichitika. Nthawi yokonzanso imatenga milungu iwiri.

Mu chotupa choyipa ndi kufalikira kwa mchira ndi thupi la kapamba, Corporocaudal resection wa zomwe zimakhudzidwa amagwiritsidwa ntchito. Opaleshoni yotereyi imayendera limodzi ndi splenectomy - kuchotsa ndulu.

Opaleshoni Frey

Makamaka mayendedwe amkati ndi kuchotsedwa kwathunthu kwa mutu kapena mchira kumatanthauza kugwira ntchito kwa Frey pamatumbo, komwe kumakhala kovuta, kowopsa, komanso kovuta kuchitira opareshoni. Amachitika kawirikawiri komanso pokhapokha pazovuta kwambiri, chifukwa njira yake imakhala yovuta kwambiri komanso si yabwino konse. Izi ndi njira zopangira opaleshoni yofunika kwambiri, zomwe ndi izi:

• wathunthu komanso wofunikira pancreatic necrosis,
• kuvulala kwa gawo lalikulu la
• neoplasms yoyipa yokhala ndi kuchuluka kwakukulu kwa minofu yowonongeka.

Nthawi ya ntchito itadalira mphamvu ya opareshoni. Ngati kuyambiranso kwa mchira kudachitika, matendawa amakomera kwambiri, opaleshoniyo imavomerezedwa ndi odwala, zovuta sizimabwera.

Full pancreatic resection

Kuchotsa kwathunthu kwa chiwopsezo sikofunikira komanso mwapadera. Ndi zilizonse, ngakhale zowopsa kwambiri, ndikofunikira kuteteza chiwalo. Pachifukwa ichi, njira zonse zotetezera zimagwiritsidwa ntchito:

• wapadera kulowetsedwa mankhwala
• mankhwala
• physiotherapy.

Kukonzanso kumatanthawuza gawo la ntchito zovuta: kuti apangitse kapamba, dotolo ayenera kukhala wodziwa bwino komanso wodziwa zambiri. Izi ndizovuta chifukwa cha kuyandikira kwa msempha, nthambi zake zowoneka bwino komanso ziwalo zoyandikana kwambiri zomwe zimatseketsa opaleshoni. Izi zikuphatikiza:

• m'mimba
• duodenum
• chikhodzodzo
• ndulu
• chiwindi.

Opaleshoni imatha maola 6.

Kuchotsa kosafunikira kwa kapamba kumachitika kokha ndi necrosis yake, pakafunika kupulumutsa wodwalayo. Izi zimafuna umboni wokwanira.

Zowoneka za opareshoni

Chidziwitso cha ntchito ndi magawo a gland:

• minofu yake imavulala mosavuta ndipo sangabwezeretse pambuyo povulala,
• michere pa opaleshoni ya gland yowonongeka imatha kulowa m'matumbo ndikuyambitsa necrosis ya ziwalo zoyandikana, peritonitis, chitukuko cha kugwedezeka kwathunthu,
• Cancreas imayamba kugwiritsidwa ntchito pazinthu zilizonse - pali milandu yodziwika bwino ya kapangidwe ka kapamba chifukwa cha ziwalo zamtundu wakutali ndi kapamba,
• Makoma a chiwalo ndi osalimba, seams pa iwo amakhala osadalirika.

Njira yokonzanso pambuyo pancreatectomy

Kukhala nditachotsa kapamba ndi ndulu, makamaka poyamba, ndizovuta. Pali kupweteka kosalekeza pamalo omwe amalepheretsa kulumikizika komanso kumva njala: kumaletsedwa kudya m'masiku ochepa, panthawi yotsatira chakudya champhamvu chimayenera kuchitika. Zitenga nthawi yayitali bwanji, adokotala azindikira.

Pofuna kupewa zovuta, njira yothandizira imachitika:

• antibacterial
• odana ndi yotupa
• mankhwala a insulin.

Kutalika kwa nthawi yayitali, nthawi zina kwa moyo, kumayikidwa. Dzina, mlingo ndi nthawi ya makonzedwe zimayikidwa ndi adotolo, poganizira kuchuluka kwa opereshoni ndi momwe wodwalayo alili. Ngati kuwongolera kwa mutu kapena mchira wa chithokomiro kumachitidwa, ndiye kuti gawo lomwe latsala lidzatenge gawo la ntchitoyi pakapita nthawi. Ndi kuchotsedwa kwathunthu, mavuto amabwera ndi chithandizo chamankhwala komanso zakudya.

Zakudya atachotsa kapamba

Pambuyo pakuchita opaleshoni yochotsa zikondamoyo, munthu amakhala ndi chakudya cha moyo wonse. Kuti mukhalepo, muyenera kupanga zakudya kukhala njira ya moyo. Mfundo zabwino kwambiri za zakudya zopatsa thanzi ndizotsatira:

• kuchulukitsa
• kupatula
• kulowetsedwa kwa chakudya chololedwa chokha kapena chololedwa komanso kukana kwamtundu wololedwa (muyenera kugwiritsa ntchito tebulo lapadera losonyeza zopatsa mphamvu ndi mndandanda wazakudya zomwe zololedwa kujambula mndandanda woyenera ndikuwerengera mtengo wake wa caloric).

Pambuyo pa opareshoni, ndikofunikira:

Zakudya zokazinga, zokometsera, zokometsera, zamchere ndizoletsedwa.

Mavuto oyambilira atatha opaleshoni

Mavuto oyambilira amatha kuchitika nthawi yomweyo. Izi zikuphatikiza:

• kutuluka magazi osiyanasiyana,
• kulumikizana kwa mitengo yaminga,
• kuvulala kwambiri kwa ziwalo zoyandikira ndi necrosis chifukwa chakuwonongeka kwa ma enzymes awo othandizira kuchokera ku kapamba, omwe amalowa m'mimba mkati mwa opaleshoni,
• kutsika kwakuthwa kwa kuthamanga kwa magazi chifukwa cha mankhwala ochita kupanga,
• chikomokere
• matenda.

Kuvuta kwamavuto nthawi zambiri kumakhala kokwanira mwa anthu:

• onenepa kwambiri
• oledzera
• ndi kwambiri matenda a mtima dongosolo.

Pambuyo pa opareshoni, zotsatirazi zimayamba:

Zotsatira za opaleshoni ya pancreatic

Momwe matulukidwe pambuyo pa chitsulo amapangidwira. Imakulitsidwa ndi gawo la kapamba mu thupi la munthu - ili ndi chiwalo chokha chomwe chili ndi magulu awiri osiyana:

Chifukwa chake, pakatha nthawi yothandizira, vuto la enzyme komanso matenda osokoneza bongo amatha kukhala ndi mwayi wambiri. Izi ndi zovuta matenda omwe amabweretsa zovuta zazikulu. Zotsatira zake zimafuna:

• Kutsatira zakudya zokhwima, kuphwanyidwa komwe kungapangitse kuwonongeka kwakuthwa pamkhalidwe,
• ntchito kwa nthawi yayitali mankhwala: michere ndi hypoglycemic.

Kodi munthu angathe kukhala wopanda chamba?

Mankhwala amakono apeza njira yothetsera vuto la moyo popanda kapamba. Palibe chiwalo chimodzi chomwe chitha kusintha zomwe zimagwira m'thupi. Kuyambiranso kwa chithokomiro kumabweretsa chiwopsezo chachikulu muumoyo waumoyo ngati malingaliro azachipatala sanatsatidwe. Koma mutha kukhala ndi moyo wabwinobwino, chokhacho choyipa ndichakudya chokhazikika komanso kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali. Mukuyambiranso kukonzanso, mungafunike thandizo la katswiri wazama psychology yemwe angakuthandizeni kumvetsetsa kufunika kokhala ndi moyo wabwino mtsogolo.

Ndikofunika kumvetsetsa kuti munthu sangayembekezere kudzanso kwina, komwe kumakulitsa vutolo. Zomwe zidachitika kale, ndikakayikira matenda, zitsogolera mwayi wopezeka kuchipatala. Simungathe kuphonya nthawi yomwe chithandizo chingachitike popanda opaleshoni, ndikupulumutsa chiwalo chofunikira.