Kwiminyaka engama-50 edlulileyo, iteknoloji ye-ERCP iguqukele ekubeni sisixhobo esilula sokuxilonga ukuya kwiqonga elincinci elidibanisa ukuxilongwa kunye nonyango. Ngokungeniswa kweteknoloji ezintsha ezifana ne-biliary kunye ne-pancreatic duct endoscopy kunye ne-ultra-thin endoscopy, i-ERCP itshintsha kancinci indlela yendabuko yokuxilonga kunye nonyango lwezifo ze-biliary kunye ne-pancreatic. Iqhube phambili kakhulu ekuphuculeni ukuchaneka kokuxilongwa, yandisa ububanzi beempawu, kwaye inciphisa umngcipheko weengxaki, ibonisa indlela yophuhliso "lotyando lwezonyango oluya lutyando ngakumbi kunye notyando oluya lutyando kancinci," lubonelela izigulane ezininzi ngeendlela zonyango ezichanekileyo nezisebenzayo. Nangona kunjalo, ikwajongene nemida ekusebenziseni kweklinikhi, njengemida ephezulu yobugcisa kunye nokuxhomekeka okuqinileyo kwezixhobo.
Iiteknoloji ezintsha ze-ERCP zahlulwe ngokwamaqela amathathu: 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 yeteknoloji entsha ye-ERCP kukuba ifikelele kwinqanaba elivela ekujongeni ngokungangqalanga ukuya ekuxilongeni ngokuthe ngqo, nto leyo evumela oogqirha ukuba babone izilonda ze-bile kunye ne-pancreatic duct mucosa ngendlela eqondakalayo 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 ukuphucula ukuchaneka kokuxilonga, i-cholangiopancreatography (ERCP) ivumela oogqirha ukuba babone ngqo i-bile kunye ne-pancreatic duct mucosa, nto leyo ephucula kakhulu amandla okwahlula phakathi kwe-benign kunye ne-malignant strictures. I-ERCP yendabuko ixhomekeke kwii-contrast agents ukuze ibone ulwakhiwo lwe-luminal, kwaye uvavanyo lwezilonda ze-mucosal luxhomekeke kwiimpawu ezingathanga ngqo. 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 >9mm ububanzi kusondele kwi-100%. Ngokuphathelele iziphumo zonyango, i-ERCP yendabuko inezinga eliphezulu lempumelelo ekususeni amatye e-pancreatic duct <5mm ububanzi, kodwa izinga eliphezulu lokungaphumeleli kwamatye antsonkothileyo (afana nalawo >2cm okanye emva kokwakhiwa kwakhona kwesisu). I-CP edityaniswe ne-laser lithotripsy inokuphucula izinga lempumelelo ukuya kufutshane nenqanaba lotyando oluvulekileyo.
Ngokuphathelele ukwandisa uluhlu lweempawu, ubuchwepheshe obutsha buphucula kakhulu izinga lempumelelo ye-ERCP kwizigulana emva kotyando lokuguqula amathumbu, nto leyo ebenza bakwazi ukulawula izifo ze-biliary 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 ngombono ocacileyo, ovumela ukuxilongwa ngokuchanekileyo kunye nonyango.
Ukuxhaphaka kwe-pancreatitis emva kwe-ERCP yendabuko kumalunga ne-3%-10%. Iindlela ezintsha, ngokusebenzisa ukubona ngqo, zinciphisa ukufakwa kakubi kwe-pancreatic duct, ziphucula iinkqubo, kwaye zinciphise ixesha lokusebenza, zinciphisa kakhulu ukuxhaphaka 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 zikwiqela le-ERCP yendabuko, kodwa iqela le-TCP libonise inzuzo enkulu kumazinga eengxaki.
Itekhnoloji entsha ye-ERCP 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, nto leyo ethintela ukusetyenziswa kwayo ngokubanzi kwizibhedlele zokhathalelo lwempilo. Okwesithathu, imiqondiso isancinci, 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 lwetekhnoloji entsha ye-ERCP zigxile kakhulu kwiinkalo ezintathu: ukukhuthazwa kwinqanaba lesiseko, ukuhlanganiswa kwe-AI, kunye nokwaziswa kotyando lwasemini. Ngokuphathelele ukukhuthazwa kwinqanaba lesiseko, iinkqubo zoqeqesho kunye neenzuzo zexabiso lezixhobo eziveliswe ekhaya ziya kuphucula kancinci amandla e-ERCP kwizibhedlele eziphambili. Ngokuphathelele ukuhlanganiswa kwe-AI, itekhnoloji yokuqaphela imifanekiso ngexesha langempela inesithembiso sokuphucula ukusebenza kakuhle kokuxilonga, kodwa ijongene nemingeni efana nokubekwa kwemigangatho kwedatha kunye nokucaca kwemodeli, okufuna ukuphuculwa ngakumbi.
Ngokuphathelele ukwenziwa kotyando lwasemini lube yinto eyaziwayo, isivumelwano sika-2025 sikhuthaza ukubandakanywa kwe-ERCP kulawulo 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. Ngokukhula ngakumbi kunye nokwandiswa kobuchwepheshe, i-ERCP kulindeleke ukuba isetyenziswe kumaziko ezonyango amaninzi, ibonelela ngeenkonzo zokuxilonga ezichanekileyo nezisebenzayo kunye nonyango kwizigulane ezininzi ezinezifo ze-biliary kunye ne-pancreatic.
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 ngokwenza ngcono inkqubo kwaye inciphise ixesha lonyango, kwaye inceda izigulane ezininzi ngokwandisa uluhlu lweempawu. Nangona kunjalo, le teknoloji intsha ikwajongene nemida ekusebenziseni kweklinikhi, njengemiqobo ephezulu yobugcisa kunye nokuxhomekeka okuqinileyo kwizixhobo, okufuna inkxaso yamaqela ezonyango akhethekileyo kunye nezixhobo eziphambili. Kucetyiswa ukuba amaziko ezonyango aqinise uqeqesho lwe-ERCP kunye notyalo-mali lwezixhobo ukuphucula izakhono zoogqirha kunye nokufumaneka kwezixhobo. Kucetyiswa kwakhona ukukhetha iindlela ezifanelekileyo zonyango ngokusekelwe kwimeko yesigulana; kwizifo zenyongo kunye nepancreas ezintsonkothileyo, unyango lwe-ERCP oluncediswa ziiteknoloji ezintsha lunokuqwalaselwa. Ngaphezu koko, kucetyiswa ukuphucula ngakumbi ukusebenza kunye neendleko ze-ERCP, ukujongana nemiba yokwenziwa ngokubanzi kunye nokungafihlisi kweenkqubo ezincediswa yi-AI, kunye nokukhuthaza ukwamkelwa ngokubanzi kwe-ERCP kwizibhedlele zokhathalelo oluphambili.
Izinto ezithengiswa kakhulu ze-ERCP Series 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, i-guidewire, i-stone retrieval basket, i-nasal biliary drainage cathete njl.njl. ezisetyenziswa kakhulu kwi-EMR, ESD, ERCP. Iimveliso 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 kunye nendumiso ngokubanzi!
I-Sphincterotome、Ucingo lwesikhokelo、Ibhasikithi yokuNciba amatye、Ukukhupha amanzi e-nasobiliaryI-Catheter、I-ERCP
Ixesha leposi: Disemba-20-2025