Kwiminyaka engama-50 edlulileyo,I-ERCPItekhnoloji iguqukele ekubeni sisixhobo esilula sokuxilonga ukuya kwiqonga elincinci elidibanisa ukuxilongwa nonyango. Ngokuziswa kwetekhnoloji ezintsha ezifana ne-biliary kunye ne-pancreatic duct endoscopy kunye ne-ultra-thin endoscopy,I-ERCPitshintsha kancinci kancinci indlela yokuxilonga kunye nonyango lwezifo zenyongo kunye nepancreas. Iqhubekile phambili kakhulu ekuphuculeni ukuchaneka kokuxilonga, yandisa uluhlu lweempawu, kwaye inciphisa umngcipheko weengxaki, ibonisa indlela yophuhliso "lotyando lwezonyango oluya lutyando ngakumbi kunye notyando oluya lungena kakhulu," lubonelela izigulana ezininzi ngeendlela zonyango ezichanekileyo nezisebenzayo. Nangona kunjalo, ikwajongene nemida ekusebenziseni kweklinikhi, njengemida ephezulu yobugcisa kunye nokuxhomekeka okuqinileyo kwizixhobo.
EntshaI-ERCPIiteknoloji zahlulwe kakhulu kwiindidi ezintathu: iinkqubo ze-endoscopic ze-bile kunye ne-pancreatic ducts, ii-endoscopes ezincinci kakhulu, kunye neenkqubo ezintsha eziphuhliswe apha ekhaya. Iinkqubo ze-endoscopic ezifana ne-SpyGlass kunye ne-Insight-eyeMax zibonelela ngembonakalo ethe ngqo kwaye zinceda kunyango oluchanekileyo.
Phakathi kwazo, inkqubo yeSpyGlass inobubanzi be-catheter yangaphandle obuyi-9F-11F kunye nobubanzi betshaneli esebenzayo obuyi-1.2mm okanye i-2.0mm, okuvumela ukufakwa komntu omnye kwe-biliary kunye ne-pancreatic duct subscope ukuze kubonakale ngqo i-mucosa. Inkqubo ye-Insight-eyeMax inomgangatho womfanekiso ocacileyo we-160,000-pixel, umbono we-120°, kunye noqweqwe olutyibilikayo, olubonelela ngombono ocacileyo nobanzi. Ii-endoscopes ezincinci kakhulu zisebenzisa ububanzi betyhubhu encinci (ngesiqhelo ingaphantsi kwe-5mm) ukungena ngqo kwi-bile duct, kodwa ngenxa yesakhiwo esiyinkimbinkimbi sendlela ephezulu yesisu, izixhobo ezincedisayo ezifana neebhaluni zokubambelela, ii-cannulas zangaphandle, kunye nee-snare zihlala zifuneka. Ezi nkqubo zineengenelo zokujonga i-bile duct mucosa kunye nokwenza ii-biopsies, kodwa kunzima ngakumbi ukuzisebenzisa.
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| I-SpyGlass | I-Insight-eyeMax |
Inzuzo ephambili yento entshaI-ERCPIteknoloji kukuba ifikelele kwinqanaba eliphambili ukusuka ekujongeni ngokungangqalanga ukuya ekuxilongeni ngokuthe ngqo, nto leyo evumela oogqirha ukuba babone izilonda ze-bile kunye ne-pancreatic duct mucosa ngendlela eqondakala ngakumbi kwaye benze ii-biopsies ezichanekileyo kunye nonyango ngaxeshanye ngexesha lenkqubo yokuxilonga. Ixabiso layo leklinikhi libonakala kakhulu kwiinkalo ezintathu: ukuphucula ukuchaneka kokuxilonga, ukwandisa ububanzi beempawu, kunye nokunciphisa umngcipheko weengxaki.
Ngokuphathelele ekuphuculeni ukuchaneka kokuxilonga, i-cholangiopancreatography (I-ERCP) ivumela oogqirha ukuba babone ngokuthe ngqo i-bile kunye ne-pancreatic duct mucosa, nto leyo ephucula kakhulu amandla okwahlula phakathi kwe-benign kunye ne-malignant strictures.I-ERCPixhomekeke kwiiarhente zokwahlulahlula ukuze ibone ulwakhiwo lwe-luminal, kwaye uvavanyo lwezilonda ze-mucosal luxhomekeke kwiimpawu ezingangqalanga. Uvakalelo lwe-bile duct cell brushing yi-45%-63% kuphela, kwaye uvakalelo lwe-tissue biopsy yi-48.1% kuphela.
Ngokwahlukileyo koko, i-cholangiopancreatography (CP) ivumela ukubona ngqo i-mucosa, nto leyo ephucula kakhulu uvakalelo lokuxilonga. Xa idityaniswe ne-MRCP, izinga lokuchaneka linokufikelela kwi-97.4%, kwaye ukuchaneka kokuxilonga kwamatye e-bile duct angaphezu kwe-9mm ububanzi kusondele kwi-100%. Ngokuphathelele iziphumo zonyango, i-cholangiopancreatography (CP) yendabuko ivumela ukubona ngokuthe ngqo i-mucosa, nto leyo ephucula kakhulu uvakalelo lokuxilonga.I-ERCPinezinga eliphezulu lempumelelo ekususeni amatye e-pancreatic duct angaphantsi kwe-5mm ububanzi, kodwa izinga eliphezulu lokungaphumeleli kwamatye antsonkothileyo (afana nalawo angaphezulu kwe-2cm okanye emva kokwakhiwa kwakhona kwesisu). I-CP kunye ne-laser lithotripsy inokuphucula izinga lempumelelo ukuya kufutshane nenqanaba lotyando oluvulekileyo.
Ngokuphathelele ukwandisa ububanzi beempawu, itekhnoloji entsha iphucula kakhulu izinga lempumeleloI-ERCPkwizigulane emva kotyando lokuguqula amathumbu, nto leyo ebenza bakwazi ukulawula izifo zenyongo kunye ne-pancreatic ezintsonkothileyo. Umzekelo, kwiimeko ezinzima ezifana ne-post-liver transplant cholangitis kunye ne-pancreatic duct IPMN, i-biliary kunye ne-pancreatic duct endoscopy inokubonelela ngembono ecacileyo, ivumela ukuxilongwa ngokuchanekileyo kunye nonyango.
Ukuxhaphaka kwe-pancreatitis emva kwezonyango zendabukoI-ERCPmalunga ne-3%-10%. Iindlela ezintsha, ngokusebenzisa ukubona ngqo, zinciphisa ukufakwa kakubi kwe-pancreatic duct, ziphucula iinkqubo, kwaye zinciphise ixesha lokusebenza, zinciphisa kakhulu ukwanda kwe-pancreatitis emva kotyando kunye nezinye iingxaki. Kuhlalutyo lwezigulane ezingama-50 ezine-cholangiocarcinoma ephezulu, ixesha le-stent patency kunye neziphumo zonyango kwiqela le-transoral cholangiopancreatography (TCP) zazifana nezo zikwi-traditionalI-ERCPiqela, kodwa iqela le-TCP libonise inzuzo enkulu kumazinga eengxaki.
EntshaI-ERCPIteknoloji isajongene nemida ethile ekusetyenzisweni kwayo kwezonyango. Okokuqala, inomlinganiselo ophezulu wobugcisa kwaye iyinkimbinkimbi, ifuna iingcali ze-endoscopist ezinamava. Okwesibini, ixhomekeke kakhulu kwizixhobo, kunye neendleko eziphezulu zokugcinwa kunye nokusebenza, okunciphisa ukusetyenziswa kwayo ngokubanzi kwizibhedlele zokhathalelo lwempilo. Okwesithathu, imiqondiso ihlala imida, kwaye kusekho umngcipheko wokungaphumeleli kwenkqubo kwiimeko ezithile. Umzekelo, kwiimeko zobunzima obukhulu besisu (ezifana nokuqhekeka komlomo) okanye ukuvaleka kwethumba ngokupheleleyo, ukuguqulwa kube yi-PTCD okanye utyando kusenokufuneka.
Iindlela zophuhliso lwexesha elizayo lwezinto ezintshaI-ERCPIteknoloji igxila kakhulu kwiinkalo ezintathu: ukukhuthazwa kwinqanaba lasekuhlaleni, ukuhlanganiswa kwe-AI, kunye nokwaziswa kotyando lwasemini. Ngokuphathelele ukukhuthazwa kwinqanaba lasekuhlaleni, iinkqubo zoqeqesho kunye neenzuzo zexabiso lezixhobo eziveliswa ekhaya ziya kuphucula kancinci kancinciI-ERCPizakhono zezibhedlele eziphambili. Ngokuphathelele ukuhlanganiswa kwe-AI, iteknoloji yokuqaphela imifanekiso ngexesha langempela inesithembiso sokuphucula ukusebenza kakuhle kokuxilonga, kodwa ijongene nemingeni efana nokubekwa kweenkcukacha ezisemgangathweni kunye nokucaca kwemodeli, nto leyo efuna ukuphuculwa ngakumbi.
Ngokuphathelele ukwenziwa kotyando lwasemini lube yinto ethandwayo, isivumelwano sika-2025 sikhuthaza ukubandakanywaI-ERCPkulawulo lotyando lwasemini, nto leyo evumela uninzi lwezigulane ukuba zigqibezele inkqubo yokulaliswa esibhedlele, utyando, ukujonga emva kotyando, kunye nokukhululwa kwisibhedlele kwiiyure ezingama-24. Oku akupheleli nje ekufinyezeni ukuhlala esibhedlele kodwa kunciphisa iindleko zonyango kwaye kuphucula ukusebenza kakuhle kokusetyenziswa kwezixhobo zonyango. Ngokuvuthwa ngakumbi kunye nokusasazwa kobuchwepheshe,I-ERCPkulindeleke ukuba isetyenziswe kwiindawo zonyango ezininzi, ibonelela ngeenkonzo zokuxilonga kunye nonyango ezichanekileyo nezisebenzayo kwizigulane ezininzi ezinezifo zenyongo kunye nepancreatic.
Isishwankathelo kunye neeNgcebiso
I-ERCP, iteknoloji entsha, imele inkqubela phambili ebalulekileyo ekuxilongweni nasekunyangweni kwezifo zenyongo kunye nepancreas. Iphucula ukuchaneka kokuxilonga ngokusebenzisa ukubona ngqo kunye ne-biopsy echanekileyo, inciphisa umngcipheko weengxaki ngokuphucula inkqubo kunye nokunciphisa ixesha lonyango, kwaye inceda izigulane ezininzi ngokwandisa uluhlu lweempawu. Nangona kunjalo, le teknoloji intsha ikwajongene nemida ekusebenziseni kweklinikhi, njengemiqobo ephezulu yobugcisa kunye nokuxhomekeka okunamandla kwizixhobo, okufuna inkxaso yamaqela ezonyango akhethekileyo kunye nezixhobo eziphambili. Kucetyiswa ukuba amaziko ezonyango aqiniseI-ERCPuqeqesho kunye notyalo-mali lwezixhobo ukuphucula izakhono zobugqirha kunye nokufumaneka kwezixhobo. Kukwacetyiswa ukuba kukhethwe iindlela ezifanelekileyo zonyango ngokusekelwe kwimeko yesigulana; kwizifo zenyongo ezintsonkothileyo kunye ne-pancreatic,I-ERCPunyango oluncediswa ziiteknoloji ezintsha lunokuqwalaselwa. Ngaphezu koko, kucetyiswa ukuba kuphuculwe ngakumbi ukusebenza kunye neendlekoI-ERCP, sijongane nemiba yokwenziwa ngokubanzi kunye nokungafihlisi iinkqubo ezincediswa yi-AI, kwaye sikhuthaze ukwamkelwa ngokubanzi kweI-ERCPkwizibhedlele zokhathalelo lwempilo oluphambili.
I-ERCPIzinto ezithengiswayo ezishushu ezivela kwi-ZRHmed.
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| I-Sphincterotome | Iingcingo zesikhokelo ezingezizo zemithambo yegazi | Iibhaskithi zokuBuyisela amatye aLahlwayo | IiCatheters zeNasobiliary ezilahlwayo |
Thina, Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumvelisi eTshayina ogxile kwizinto ezisetyenziswayo ze-endoscopic, kuquka umgca we-GI ofana ne-biopsy forceps, i-hemoclip, i-polyp snare, inaliti ye-sclerotherapy, i-spray catheter, iibhrashi ze-cytology,ucingo lwesikhokelo, ibhaskithi yokuqokelela amatye, i-cathete yokukhupha amanzi empumlweni njl.njl. ezisetyenziswa kakhulu kwi-EMR, ESD,I-ERCPIimveliso zethu ziqinisekisiwe yi-CE kwaye zivunyiwe yi-FDA 510K, kwaye izityalo zethu ziqinisekisiwe yi-ISO. Iimpahla zethu zithunyelwe eYurophu, eMntla Melika, eMbindi Mpuma nakwinxalenye ye-Asia, kwaye zifumana umthengi udumo nodumo ngokubanzi!
Ixesha leposi: Disemba-20-2025