I-ERCP yitekhnoloji ebalulekileyo yokuchonga isifo kunye nonyango lwezifo ezibhinqileyo kunye nezifo zepancreating. Kanye xa iphume, ibonelele ngemibono emininzi emitsha ngonyango lwezifo ezinomxholo kunye nezifo zepali. Ayiphelelanga kwi "radiology". Iguqulwe ukusuka kwitekhnoloji yokuqonda isifo sohlobo olutsha. Iindlela zonyango zibandakanya i-sphincterotomy, i-bile duckar ye-duct, i-bile drainage kunye nezinye iindlela zokunyanga izifo ze-bile kunye nezifo zenkqubo ye-pancreatic.
Izinga lempumelelo le-bile yokukhetha i-ercp inokufikelela ngaphezulu kwe-90%, kodwa kusekho iimeko apho kufikelela kunzima khona kubangela ukungaphumeleli kwe-bile. Ngokwesivumelwano sakutsha nje ekufumaneni isifo kunye nonyango lwe-ERCP, ubunzima obunzima bunokuchazwa njenge: Ixesha lokukhetha i-huct ducp engaphezulu kwe-ERCP engaphezulu kwe-ERCP ingaphezulu kwamaxesha ama-5. Xa usenza i-ERCP, ukuba i-bile huct inzima kwezinye iimeko, iindlela ezifanelekileyo kufuneka zikhethwe ngexesha lokuphucula umgangatho wempumelelo ye-bile duct. Eli nqaku liqhuba uphononongo olucwangcisiweyo lweendlela ezininzi ze-inxuls ezisetyenziselwa ukusombulula i-huct hucking ye-suoct, ngenjongo yokubonelela ngesicwangciso sokuphendula i-duct hucp.
I-I.IngleGeiire qoko, sgt
Indlela ye-SGT kukusebenzisa umlingane wokuqhubeka nokuqhubeka nokuzama ukuzama ukungcolisa i-bile duct emva kokuba iWire Wire Wire ingena kwi-pact supctic. Kwiintsuku zokuqala zokuphuhliswa kwetekhnoloji ye-ERCP, i-SGT yayiyindlela eqhelekileyo yokungafundiswa kwento encedisayo. Inzuzo yayo kukuba kulula ukusebenza, ukulungisa i-nipple, kwaye kungathatha ukuvulwa kwe-pancreatic vact, kwenza kube lula ukufumana ukuvulwa kwe-bile duct duct.
Kukho iingxelo kwi-Theliteiterature esuka emva kokungabinamntu okuqhelekileyo ukusilela, ukukhetha i-SGT-i-Inteunation inokuyigqiba ngempumelelo i-huct huct engaphakathi malunga ne-70% -8% yamatyala. Le ngxelo ikwabonisa ukuba kwiimeko zokungaphumeleli kwe-SGT, nokuba uhlengahlengiso kunye nokusetyenziswa kokuphinda kabiniisikhokeloItekhnoloji ayiphuculi i-Inder yeP3 ye-Inthong ye-bile kwaye ayikhange inciphise izehlo ze-Post-Ercp Pancreatitis (PEP).
Olunye uphononongo lubonakalisile ukuba inqanaba lempumelelo le-SGT Intubation liphantsi kunelo uphinda kabiniisikhokeloItekhnoloji kunye ne-TransPANCreary Popillary Phincterotomy yeTekhnoloji. Xa kuthelekiswa nemizamo ephindaphindiweyo ye-SGT, ukuphunyezwa kwangoko kokuphinda kabiniisikhokeloItekhnoloji okanye iTekhnoloji ye-Pe-Pundonika ngaphambi kwexesha inokufumana iziphumo ezingcono.
Ukusukela kuphuhliso lwe-ERCP, itekhnoloji entsha yeetekhnoloji entsha sele iphuhlisiwe ukuba kunzima. Xa kuthelekiswa nenyeisikhokeloItekhnoloji, izibonelelo zibonakala ngakumbi kwaye izinga lempumelelo liphezulu. Ke ngoko, utshatileisikhokeloItekhnoloji okwangoku isetyenziswe uqobo.
II.UFIROBLE-Isikhokelo seWire yeWire Gire ye-Wire ye-Wire, i-DGT
I-DGT ingabizwa ngokuba yi-Pencreatic Dactic Supent Indlela yokuSebenza yeWire yeWire, eyokushiya icingo yesikhokelo ingena kwi-pactreatic ductic ukuya kumkhondo kwaye ihlale isetyenziselwe i-cire yesikhokelo se-pactreatic cire wire. Ukukhetha i-nule duct intuub.
Izibonelelo zale ndlela zezi:
(1) ngoncedo lweisikhokelo, I-fuct pupct kulula ukuyifumana, yenza i-hule duct engagungqiyo;
(2) I-wire yesikhokelo inokulungisa i-nipple;
(3) phantsi kwesikhokelo se-pancreatic ducticisikhokelo.
Udumoncee et al. uqaphele ukuba umahluko wesikhokelo se-ANA THEATER unokufakwa kwi-biopsy hole ngexesha elifanayo, kwaye emva koko uxele imeko yemeko ye-pancreatic ducreatic pact yesikhokelo, kwaye wagqiba kwelokubaisikhokeloUkuhlala kwindlela ye-pancreatic tyct ye-pancreatic tyct iphumelele i-hule duct. Ixabiso linempembelelo entle.
Isifundo kwi-DGT nguLiu Deren Et Al. ifumanise ukuba emva kokuba i-DGT yenziwa kwizigulana ezine-ercp ende e-ercp ye-ercp ye-ercp ye-duct, i-Intunityrey Impumelelo ifikelele kwi-95.65% ephakamileyo kune-59.00% ye-59.09 ye-59.09% ye-59.09 ye-59.09 ye-59.09 ye-59.09 ye-59.09 yeempumelelo.
Isifundo esifanelekileyo nguWang Fuquan et al. Chaza ukuba xa i-DGT isetyenziswe kwizigulana ezine-ercp escp ye-ercp ye-ercp ye-ercp ye-hucp ye-duct kwiqela lezinto ezivavanyayo, i-Intunityrey impumelelo ye-Intuning yayiphezulu njenge-96.0%.
Ezi zifundo zilapha ngasentla zibonisa ukuba ukusetyenziswa kwe-DGT kwizigulana ezine-fucle enzima ye-ercp kunokuphucula ngokufanelekileyo izinga lempumelelo ye-bile duct.
Iintsilelo ze-DGT ikakhulu ziquka la manqaku mabini alandelayo:
(1) I-pancreaticisikhokelomhlawumbi ilahlekile ngexesha le-hule duct, okanye yesibiniisikhokeloinokungena kwi-pancreatic fuct suct kwakhona;
.
Ngokwembono ye-PEP ye-PEP, i-PEP ye-PEP ye-DGT iphantsi kuneyona nto ixhaphakileyo ye-nuct. Isifundo esinokubakho esichaziweyo ukuba i-PEP ye-PEP emva kwe-DGT yayiyi-2.38% kuphela kwizigulana ze-ERCP ezinesifo se-bile hacketion. Olunye uncwadi lubonisa ukuba nangona i-DGT inomgangatho ophezulu wempumelelo ye-bile duct, i-Post-Dan-Dan-Dancreatitis isemphakame xa kuthelekiswa nezinye iindlela zokulungisa i-PACT kunye nokuvulwa kwayo. Ngaphandle koku, ukuvumelana ekhaya nakwamanye amazwe ukuba bakwazi ukuvalela ukuba kwiimeko ze-duct ezinzima, xa i-Inteubuyity inzima kakhulu kuba itekhnoloji ye-DGT iphinde isebenze nzima, kwaye isetyenziswa kakhulu.
I-III.wire yesikhokelo se-Canning-Pal-Pal-Ponts Stent, Wgc-P5
I-WGC-PS inokubizwa ngokuba yi-The Chact Stect Pent Indlela yokuSebenzisa. Le ndlela kukubeka i-packorric duct suct kunye neisikhokeloIphosa ngokungalunganga i-pancreatic ductic, emva koko yakhupha iisikhokelokwaye wenze i-duct ye-fuct ngaphezulu kwe-stent.
Isifundo nguHakuta et al. ibonise ukuba ukongeza ekuphuculeni inqanaba lokuphucula i-ITUUTOS ngokukhokela ukungafundi, i-WGC-PS inokukhusela kwakhona ukuvulwa kwe-pancreatic ductic kwaye inciphisa kakhulu i-PEP.
Isifundo kwi-WGC-PS nge-zou Chuanxin et al. Chaza ukuba inqanaba lempumelelo le-insububution lisebenzisa indlela yokuthatha inxaxheba yethutyana ye-PACT ifikelele kwi-97.67%, kwaye imeko ye-PEP yancitshiswa kakhulu.
Olunye uphando lufumanise ukuba xa i-ducric stent ifakwe ngokuchanekileyo, ithuba le-pancreatives enzima kwi-pancreatis enzima ngexesha lokuncitshiswa kwezinto ezinzima.
Le ndlela isenazo iintsilelo ezithile. Umzekelo, i-Pencreatic Dectic Stent ifakwe ngexesha lokusebenza kwe-ERCP inokuhanjiswa; Ukuba i-stent kufuneka ibekwe ixesha elide emva kwe-ERCP, kuya kubakho ithuba eliphezulu lebhlogo ye-STET kunye nothintelo lwe-duct. Ukwenzakala kunye nezinye iingxaki ukuze kunyuke kwi-PEP ye-PEP. Sele, amaziko sele eqalisile ukufunda i-pacracreatic ye-pactreatic yethutyana enokuthi ihambe ngokuzenzekelayo kwi-pactreatic ductic. Injongo kukusebenzisa i-pactic stectic suct ukukhusela i-PEP. Ukongeza ekunciphiseni imeko yeengozi ze-PEP, ezo ziqwengana zinokuphepha nakwezinye izinto zokususa impahla kunye nokunciphisa umthwalo kwizigulana. Nangona izifundo zibonakalise ukuba i-packoric yethutyana ye-pactreatic stents inefuthe elihle ekunciphiseni i-PEP, isicelo sabo sekliniki sisenemida. Umzekelo, kwizigulana ezinee-ductic ductoric ze-pancreatic kunye namasebe amaninzi, kunzima ukufaka i-ductic suct ye-pacting. Ubunzima buya kunyuswa kakhulu, kwaye lo msebenzi ufuna inqanaba eliphezulu leengcali ze-endoscopists. Kukwakufanelekile ukuba uqaphele ukuba i-ducric ye-packortic inqanawa ibekwe akufuneki ibe mde kakhulu kwi-duodenal lumen. Ukuncancisa kakhulu kunokubangela ukungafezeki kwe-duodenal. Ke ngoko, ukhetho lwendlela ye-Pencreatic Stoctoric Stopment Indlela yokuSebenza ngoku kufuneka iphathwe ngononophelo.
IV.TRANS-PANCreatosphinecterotomy, TPS
Itekhnoloji ye-TPS isetyenziswa ngokubanzi emva kokuba uWire Wire wire ungena kwi-pancreatic ductic ngempazamo. The septum in the middle of the pancreatic duct is incised along the directionof the pancreatic duct guide wire from 11 o'clock to 12 o'clock, and then the tube is inserted in the direction of the bile duct until the guide wire enters the bile duct.
Isifundo ngu-Dai Xin et al. I-TPS ethengisiweyo kunye nezinye iitekhnoloji ze-insubulids ezincedisayo. Ingabonwa ukuba izinga lempumelelo letekhnoloji ye-TPS liphezulu kakhulu, ifikelela kwi-96.74%, kodwa ayibonisi iziphumo ezingekahlawulwa xa kuthelekiswa nezinye iitekhnoloji ze-insubulting. Izibonelelo.
Kuxelwe ukuba iimpawu zetekhnoloji ye-TPS ibandakanya la manqaku alandelayo:
(1) Ukuncitshiswa kuyinto encinci kwi-pancreabicalical
(2) Imeko yezicelo zendawo iphantsi;
(3) Ukukhethwa kwendlela yokusika kulula ukuyilawula;
.
Izifundo ezininzi zichazile ukuba i-TPS ayinakuphucula ngokufanelekileyo umyinge wempumelelo we-hung ye-bile ye-bile ye-bile ye-bile ye-bile, kodwa ikwakonyusa isimo sengxaki emva kwe-ERCP. Abanye abaphengululi bacebisa ukuba ukuba i-pancreatic intuubnung gact okanye i-paodenal ye-duodenal ye-duodenal ye-duodenal yenzeka ephindaphindiweyo, i-TPS kufuneka ithathelwe ingqalelo kuqala. Nangona kunjalo, xa kusenziwa isicelo se-TPS, ingqalelo kufuneka ihlawulwe kwi-pancreatic fuctoric stectic stenosis kunye nokuphinda kwenziwe i-pancreatitis, enokwenzeka ingozi ye-TPS.
V.Oprecut sthincterotomy, pst
Indlela ye-PST isebenzisa ibhendi ye-papillary njengomda ophezulu wento yangaphambi kokuchaphazeleka kunye nentsimbi ye-1 ukuya kwi-1 ukuya kwelesi-1 ukuya kwi-1 ukuya kwi-1 ukuya kwi-1 ukuya kwelesi-1 ukuya kwi-1 ukuya kwi-1 ukuya kwelesi-1 ukuya kwi-1 ukuya kwi-1 ukuya kwi-1 ukuya kwelesi-1 ukuya kwi-1 ukuya kwi-1 ukuya kwelesi. Apha i-PST ibhekisa ngqo kwi-nipple ye-nipple spincter phincrine pre-isebenzisa i-arcuates. Njengesicwangciso sokujongana nentsana enzima ye-hule ye-ercp, itekhnoloji ye-PST ithathelwe ingqalelo ukuba lukhetho lokuqala lwentsana. I-Endoscopic Nipple SPHINCTER PHINCERION i ibhekisa kwi-Endoscopic ye-Endoscopic ye-Pepilla Thism kunye nenani elincinci lomsipha we-bile duct, kwaye emva koko usebenzise i-aisikhokelookanye i-catheter ibambe i-duct duct duct.
Ufundisiso lwasekhaya lubonise ukuba inqanaba lempumelelo le-PST liphezulu njenge-89.66%, engafaniyo kakhulu kwi-DGT nakwi-TPS. Nangona kunjalo, i-PEP ye-PEP kwi-PST iphakame kakhulu kune-DGT kunye ne-TPS.
Okwangoku, isigqibo sokusebenzisa le tekhnoloji ixhomekeke kwizinto ezahlukeneyo. Umzekelo, enye ingxelo yathi i-PST isetyenziswe kakuhle kwiimeko apho i-duodenal paodenal ichasayo okanye igqitywe, njenge-duodenal stenosis okanye engalunganga.
Ukongeza, xa kuthelekiswa nezinye iindlela zokujongana, i-PST inesimo esiphakamileyo seengxaki ezinjenge-PEP, kwaye iimfuno zomsebenzi ziphezulu, ke lo utyando lwenziwe kakuhle ngo-tooscopists onamava.
Vi.needle-nume papillotomy, NKP
I-NKP yindlela yentsana encediswayo yentsana. Xa Intsusa inzima, isitshixo senaliti sinokusetyenziselwa ukufumanisa inxalenye ye-papilla okanye i-sphinctocter ukusuka ekuvuleni i-duodenal papilla kwicala le-11-16, kwaye emva koko usebenzise iisikhokelookanye i-catheter ekufumanekeni ngokufakwa kwi-bile duct eqhelekileyo. Njengesicwangciso sokunxibelelana se-duct enzima ye-huct ephezulu, i-NKP inokuphucula ngokufanelekileyo inqanaba lempumelelo le-huct enzima. Kwixa elidlulileyo, yayikholelwa ngokubanzi ukuba i-NKP inganyusa isimo se-PEP kwiminyaka yakutshanje. Kwiminyaka yakutshanje, iingxelo ezininzi zokuhlaziya kwakhona zibonisa ukuba i-NKP ayinyusi umngcipheko wezicelo zendawo. Kufanelekile ukuba uqaphele ukuba ukuba i-NKP yenziwa kwinqanaba lokuqala lokungasebenzi, iya kuba luncedo olukhulu ukuphucula izinga lempumelelo. Nangona kunjalo, okwangoku akukho mvumelwano kwixesha lokufaka i-NKP ukufezekisa iziphumo ezilungileyo. Olunye uhlolisiso luxele ukuba inqanaba lentsusa lwe-NKP isetyenzisiwe ngexeshaI-ERCPNgaphantsi kwemizuzu engama-20 yayiphezulu kakhulu kune-NKP ifakwe emva kwemizuzu engama-20 kamva.
Izigulana ezinobunzima be-huct duct ye-huct ziya kungenelwa kakhulu kule ndlela ukuba zinezibhloko ze-nipp okanye i-duct duct ye-bilect. Ukongeza, kukho ingxelo yokuba xa udibana namatyala obunzima obunzima, ukusetyenziswa kwee-TPs kunye ne-NKP inereyithi ephezulu yokuphumelela kunokusebenza yedwa. Ukungancedi kakuhle kukuba iindlela zobuchwephesha ezininzi zisebenza kwi-nipple ziya kwandisa ubume bezinto ezinzima. Ke ngoko, kufuneka uphando olungakumbi ukubonisa ubungqina bokuba ukhetha intsingiselo yangoko ukuze unciphise ubume beengxaki okanye ukudibanisa amanyathelo okulungisa kakhulu ukuphucula umgangatho wempumelelo.
Vii.needle-nume fissulotomy, enoke
Indlela ye-NKF ibhekisa ekusebenziseni isitshixo senaliti ukubhoboza i-MUCOSA malunga ne-5mm ngaphezulu kwe-5mm ngaphezulu kwe-wire ye-wire okanye i-bile yokuphuma kwe-orifice yokufumana i-bile kunye ne-incovionof i-wicule. Ukukhetha i-duct duct ye-huct yenziwa kwindawo yejaundice. I-NKF ye-NKF inqumlwe ngaphezulu kwe-nipple evaliweyo. Ngenxa yobukho be-bile ductus, inciphisa ukonakala kwe-thermal kunye nomonakalo woomatshini wokuvulwa kwe-pactreatic, enokunciphisa imeko ye-PEP.
Isifundo nguJin et al. Khombiso ngaphandle kwenqanaba lempumelelo ye-NK Tube Intubation inokufikelela kwi-96.3%, kwaye akukho PIPOPE. Ukongeza, izinga lempumelelo le-NKF kwi-SEFICS iphakame njenge-92.7%. Ke ngoko, olu phando lucebisa i-NKF njengoko ukhetho lokuqala lwe-duct duct. . Xa kuthelekiswa ne-papillomomyyotomy, ingozi ye-NKF isemkhulu, kwaye inomdla kwiingxaki ezifana nokungafezeki kunye nokopha, kwaye kufuna inqanaba eliphezulu lokusebenza kwe-endoscopist. Indawo yokuvula echanekileyo yefestile, ubunzulu obufanelekileyo, kunye nendlela yokujonga ichanekile ukuba ifundwe ngokuthe ngcembe. Inkosi.
Xa kuthelekiswa nezinye iindlela ze-pre-quation, i-NKF yeyona ndlela ilula kakhulu kunye nenqanaba lempumelelo ephezulu. Nangona kunjalo, le ndlela ifuna ukuziqhelanisa ixesha elide kunye nokuqokelelwa okuqhubekayo ngumqhubi ukuba nobuchule, ke le ndlela ayifanelekanga ukuba abaqaleki.
Viii.repeat-ercp
Njengoko kuchaziwe apha ngasentla, kukho iindlela zokujongana nobunzima obunzima. Nangona kunjalo, akukho siqinisekiso sempumelelo ye-100%. Uncwadi olufanelekileyo luphosile ukuba xa i-bile duct inzima kwezinye iimeko, ixesha elide kunye nokungenisa okuninzi okanye isiphumo sokungena kwe-thermal okanye i-thermal panetion ye-odon paoden paoden paoden paoden paema edema. Ukuba umsebenzi uyaqhubeka, hayi kuphela ukuba i-bile suubation ayiphumelelanga, kodwa ithuba leengxaki liya kwanda. Ukuba le meko ingentla yenzekile, unokucinga ukuphelisa okwangokuI-ERCPukusebenza kuqala kwaye wenze i-ERCP yesibini ngexesha lokukhetha. Emva kokuba iPapilloema inyamalala, ukusebenza kwe-ERCP kuya kuba lula ukufezekisa ubuntu obunempumelelo.
I-Donnellan et al. yenziwe yesibiniI-ERCPUkusebenza kwizigulana ezingama-51 ezilele kwi-ERCP yahluleka emva kokuzixhaphazela inaliti, kwaye amatyala angama-35 aphumelele, kwaye imeko yengxaki ayizange inyuke.
Kim et al. Yenza umsebenzi wesibini we-ERCP kwizigulana ezingama-69 eziphumeleleI-ERCPEmva kokuchaphazeleka kweswekile, kwaye amatyala angama-53 aphumelele, kunye nenqanaba lempumelelo lama-76.8%. Amatyala aseleyo angaphumelelanga nakwenzeka ukuba kwenziwe umsebenzi wesithathu we-ERCP, kunye nenqanaba lempumelelo lama-79.7%. , kwaye imisebenzi emininzi ayizange ikhusele ubume bengxaki.
Yu li et al. okwenziwe okwesibiniI-ERCPKwizigulana ezingama-70 ezilahlelayo i-ERCP emva kwento yokufumana amandla enaliti, kwaye amatyala angama-50 aphumelele. Inqanaba elipheleleyo lempumelelo (i-ERCP yokuqala ye-ERCP) inyuke ukuya kuthi ga kwi-90.6%, kwaye izehlo zeengxaki azizange zinyuke kakhulu. . Nangona iingxelo ziqinisekisile ukuba ukusebenza kwe-ERCP yesibini, isithuba phakathi kwemisebenzi emibini ye-ERCP akufuneki ibe lide kakhulu, kwaye kumatyala athile, ukulibaziseka kwe-filing subring kuya kwandisa imeko.
Ix.endoscopind-iqumrhu ekhokelwa yi-cheinage, eus-bd
U-Eus-BD yinkqubo ehlasela inaliti esebenzisa inaliti yokufumana i-gellbladder evela esiswini okanye i-duodenum lumen ephantsi kwesikhokelo se-ultrasound, emva koko senze i-intuation ye-duodenal, emva koko yenza ukuba ixhase i-duoden papilla, emva koko yenze ukuba ixhase i-duodella, emva koko yenze ukuba ixhase i-dubillard papilla, emva koko yenza ukuba ixhase i-duodenal papilla, emva koko yenze ukuba ixhase i-duoden papilla, emva koko yenze ukuba ixhaswe i-intuub. Obu buchule buquka zombini iindlela ze-intrahepatic kunye nezongezelelweyo.
Uphononongo lokubuyisela kwakhona lunike ingxelo yokuba inqanaba lempumelelo le-EUS-BD, kwaye imeko yezicelo zendawo i-13 kuphela yayiyi-13% kuphela. Kwisifundo sokuthelekisa, i-EUS-BD xa kuthelekiswa netekhnoloji yangaphambili, i-insubure impumelelo yayiphezulu, ifikelela kwi-98.3%, eyayingaphezulu kwe-90.3% ye-90.3 yeepesenti. Nangona kunjalo, ukuza kuthi ga ngoku, xa kuthelekiswa nobunye ubuchwepheshe, kusekho ukunqongophala kophando malunga nokusetyenziswa kwe-EUS ngobunzimaI-ERCPI-IngAubation. Akukho datha engonelanga ukubonisa ubungqina bokuphumelela kwe-sull ye-bile ye-EUS ekhokelayoI-ERCPI-IngAubation. Olunye uphononongo lubonakalisile ukuba liyinciphisile indima ye-POPOPE ye-POPTOperative Akuqinisekisi.
I-X.Precutaneous TransHical Choinageage, PTCD
I-PTCD yenye indlela yendlela yoviwo engenasihlazo enokusetyenziswa ngokudibeneyo kunyeI-ERCPKwinto enzima ye-hule, ngakumbi kwiimeko zokuchaswa okungafanelekanga. Le ndlela isebenzisa inaliti yokuqina inaliti yokungena nge-bile duct duct, kwaye ichukumiseke i-bile ductly nge-fuctisikhokelo. Olunye uhlolisiso luhlalutya izigulana ezingama-47 ezinesifo se-hule duct duct esiphantsi sendlela ye-PTCD, kwaye ireyithi yempumelelo yafikelela kwi-94%.
Isifundo yi-yang et al. Chaza ukuba ukusetyenziswa kwe-EUS-BD ngokucacileyo kucacile xa kufike i-hild stenosis kunye ne-hild stenosutic bile duct, ngelixa i-PTCD inezibonelelo zokungqinelana ne-bile ducker axis kwaye iguqulwe ngakumbi izixhobo. I-bile duct intaction kufuneka isetyenziswe kwizigulana ezinjalo.
I-PTCD ngumsebenzi onzima ofuna uqeqesho lwexesha elide lexesha elide kunye nokugqitywa kwenani elaneleyo lamatyala. Kunzima kwi-novices ukugqiba lo msebenzi. I-PTCD ayinzima kuphela ukusebenza, kodwaisikhokeloIngamonakalisa i-nuct duct ngexesha lokuhambela phambili.
Nangona ezi ndlela zilapha ngasentla zinokuphucula kakhulu inqanaba lempumelelo ye-duct ye-hule enzima, ukhetho kufuneka luqwalaselwe ngokufanelekileyo. Xa usenzaI-ERCP, Sgt, i-DGT, i-WGC-PS kunye nezinye iindlela zinokuqwalaselwa; Ukuba ezi ndlela zilapha ngasentla ziyasilela, i-edoscopists ezinamava zinokwenza iindlela zefuthe langaphambili, ezinjenge-TPS, i-NKP, NKF, njl.; Ukuba kunjalo ukuba i-hucle i-guile intatty ayinakugqitywa, ikwisekondana yonyuloI-ERCPunokukhethwa; Ukuba akukho nanye kwezi ndlela zingasentla zinokusombulula ingxaki yobunzima, imisebenzi ehlaselayo enje nge-EUS-BD inokuzama ukusombulula ingxaki, kwaye unyango lonyango lungakhethwa ukuba kukho imfuneko.
Thina, iJiangxi Zhuoruhiuhua Stores Commer Coouth Cooder of Endopscopic Enses, ezinjengeenqokhobo ze-biopsy, i-hemoclip, i-scyp yenaliti, ibrautha ye-clirother,isikhokelo, Ibhasikithi yokubuyisa ilitye, I-Nasal Biling Drasheter Casheter catheternjl njl. Esetyenziswa ngokubanzi e-EMR,I-ERCP. Iimveliso zethu kufuneka ziqinisekiswe, kwaye izityalo zethu ziqinisekisiwe. Impahla yethu ithunyelwe eYurophu, iMntla Melika, eMbindi Mpuma kunye nenxalenye yeAsia, kwaye ifumana umthengi wokuqonda kunye nokudumisa!
IXESHA LOKUQALA: UJan-31-2024