Eminyakeni engama-50 edlule, ubuchwepheshe be-ERCP buguquke busuka ekubeni ithuluzi lokuxilonga elilula lwaba yipulatifomu engangenisi kakhulu ehlanganisa ukuxilongwa nokwelashwa. Ngokwethulwa kobuchwepheshe obusha njenge-endoscopy ye-biliary kanye ne-pancreatic duct kanye ne-endoscopy encane kakhulu, i-ERCP ishintsha kancane kancane imodeli yokuxilonga yendabuko kanye nokwelashwa kwezifo ze-biliary kanye ne-pancreatic. Yenze intuthuko enkulu ekuthuthukiseni ukunemba kokuxilonga, yandisa ububanzi bezinkomba, futhi inciphise ingozi yezinkinga, okubonisa ukuthambekela kokuthuthuka "kokuhlinzwa kwezokwelapha okuba ukuhlinzwa okukhulu kanye nokuhlinzwa okuba ukungasebenzi kahle kakhulu," okunikeza iziguli eziningi izinketho zokwelapha ezinembile nezisebenzayo. Kodwa-ke, ibhekene nemikhawulo ekusetshenzisweni kwemitholampilo, njengemingcele ephezulu yobuchwepheshe kanye nokuthembela okuqinile kwemishini.
Ubuchwepheshe obusha be-ERCP buhlukaniswe kakhulu ngezigaba ezintathu: izinhlelo ze-endoscopic ze-bile kanye ne-pancreatic ducts, ama-endoscope amancane kakhulu, kanye nezinhlelo ezintsha ezithuthukiswe ngaphakathi ezweni. Izinhlelo ze-endoscopic ezifana ne-SpyGlass kanye ne-Insight-eyeMax zinikeza ukubona okuqondile futhi zisiza ekwelapheni okunembile.
Phakathi kwazo, uhlelo lwe-SpyGlass lunobubanzi be-catheter yangaphandle obungu-9F-11F kanye nobubanzi besiteshi esisebenzayo obungu-1.2mm noma u-2.0mm, okuvumela ukufakwa komuntu oyedwa kwe-duct subscope ye-biliary kanye ne-pancreatic ukuze kubonakale ngqo i-mucosa. Uhlelo lwe-Insight-eyeMax lunekhwalithi yesithombe ephezulu ye-160,000-pixel, insimu yokubuka engu-120°, kanye nengubo eshelelayo kakhulu, enikeza insimu yokubuka ecacile nebanzi. Ama-endoscope amancane kakhulu asebenzisa ububanzi beshubhu elincane (ngokuvamile ngaphansi kuka-5mm) ukungena ngqo kwi-bile duct, kodwa ngenxa yesakhiwo esiyinkimbinkimbi sendlela engenhla yokugaya ukudla, amathuluzi asizayo afana namabhaluni okubambelela, ama-cannula angaphandle, kanye nama-snare avame ukudingeka. Lezi zinhlelo zinezinzuzo zokubuka i-mucosa ye-bile duct kanye nokwenza ama-biopsies, kodwa kunzima kakhulu ukuzisebenzisa.
 |  |
| I-SpyGlass | I-Insight-eyeMax |
Inzuzo eyinhloko yobuchwepheshe obusha be-ERCP ukuthi bufinyelele intuthuko enkulu kusukela ekubukeni okungaqondile kuya ekuxilongweni okuqondile, okuvumela odokotela ukuthi babone izilonda ze-bile kanye ne-pancreatic duct mucosa ngendlela eqondakala kalula futhi benze ama-biopsies anembile kanye nokwelashwa ngesikhathi esisodwa ngesikhathi senqubo yokuxilonga. Inani layo lomtholampilo libonakala kakhulu ezicini ezintathu: ukuthuthukisa ukunemba kokuxilonga, ukwandisa ububanzi bezinkomba, kanye nokunciphisa ingozi yezinkinga.
Ngokuphathelene nokuthuthukisa ukunemba kokuxilonga, i-cholangiopancreatography (ERCP) ivumela odokotela ukuthi babone ngqo i-mucosa ye-bile kanye ne-pancreatic duct, okuthuthukisa kakhulu ikhono lokuhlukanisa phakathi kwe-benign kanye ne-malignant strictures. I-ERCP yendabuko ithembele kuma-contrast agents ukuze ibone isakhiwo se-luminal, futhi ukuhlolwa kwezilonda ze-mucosal kuncike ezimpawini ezingaqondile. Ukuzwela kokuxubha i-bile duct cell kungu-45%-63% kuphela, kanti ukuzwela kwe-tissue biopsy kungu-48.1% kuphela.
Ngokuphambene nalokho, i-cholangiopancreatography (CP) ivumela ukubona ngqo i-mucosa, okuthuthukisa kakhulu ukuzwela kokuxilonga. Uma ihlanganiswa ne-MRCP, izinga lokunemba lingafinyelela ku-97.4%, kanti ukunemba kokuxilonga kwamatshe e-bile duct >9mm ububanzi kusondele ku-100%. Ngokuphathelene nemiphumela yokwelashwa, i-ERCP yendabuko inezinga eliphezulu lempumelelo yokususa amatshe e-pancreatic duct <5mm ububanzi, kodwa izinga eliphezulu lokuhluleka kwamatshe ayinkimbinkimbi (njengalawo >2cm noma ngemva kokuvuselelwa kwesisu). I-CP ehlanganiswe ne-laser lithotripsy ingathuthukisa izinga lempumelelo lifinyelele ezingeni lokuhlinzwa okuvulekile.
Ngokuphathelene nokwandisa ububanzi bezinkomba, ubuchwepheshe obusha buthuthukisa kakhulu izinga lempumelelo ye-ERCP ezigulini ngemuva kokuhlinzwa kokuphambuka kwamathumbu, okubenza bakwazi ukuphatha izifo ze-biliary kanye ne-pancreatic eziyinkimbinkimbi kakhulu. Isibonelo, ezimweni eziyinkimbinkimbi njenge-cholangitis yokufakelwa kwesibindi kanye ne-pancreatic duct IPMN, i-endoscopy ye-biliary kanye ne-pancreatic duct inganikeza umbono ocacile, okwenza kube lula ukuxilongwa nokwelashwa okunembile.
Ukusabalala kwe-pancreatitis ngemuva kwe-ERCP yendabuko cishe ku-3%-10%. Amasu amasha, ngokubona ngqo, anciphisa ukufakwa kabi kwe-pancreatic duct, athuthukise izinqubo, futhi anciphise isikhathi sokusebenza, anciphise kakhulu ukusabalala kwe-pancreatitis ngemuva kokuhlinzwa kanye nezinye izinkinga. Ekuhlaziyweni kweziguli ezingu-50 ezine-cholangiocarcinoma ephezulu, isikhathi se-stent patency kanye nemiphumela yokwelashwa eqenjini le-transoral cholangiopancreatography (TCP) yayifana naleyo eqenjini le-ERCP yendabuko, kodwa iqembu le-TCP libonise inzuzo enkulu emazingeni ezinkinga.
Ubuchwepheshe obusha be-ERCP busabhekene nemikhawulo ethile ekusetshenzisweni kwemitholampilo. Okokuqala, bunomkhawulo ophezulu wobuchwepheshe futhi buyinkimbinkimbi, budinga odokotela be-endoscopist abanolwazi. Okwesibili, buncike kakhulu emishinini, ngezindleko eziphezulu zokulungisa nokusebenza, okunciphisa ukusetshenziswa kwabo kabanzi ezibhedlela zokunakekelwa okuyisisekelo. Okwesithathu, izinkomba zihlala zilinganiselwe, futhi kusenengozi yokwehluleka kwenqubo ezimweni ezithile. Isibonelo, ezimweni zokuqina okukhulu kwesisu (njengokuqhekeka komphimbo) noma ukuvaleka okuphelele kwesimila, ukuguqulwa kube yi-PTCD noma ukuhlinzwa kungase kudingeke.
Izitayela zentuthuko yesikhathi esizayo yobuchwepheshe obusha be-ERCP zigxila kakhulu ezicini ezintathu: ukukhushulwa ezingeni eliphansi, ukuhlanganiswa kwe-AI, kanye nokwanda kokuhlinzwa kwasemini. Ngokuphathelene nokukhushulwa ezingeni eliphansi, izinhlelo zokuqeqesha kanye nezinzuzo zezindleko zemishini ekhiqizwe ekhaya kuzothuthukisa kancane kancane amakhono e-ERCP ezibhedlela eziyinhloko. Ngokuphathelene nokuhlanganiswa kwe-AI, ubuchwepheshe bokuqaphela izithombe ngesikhathi sangempela buthembisa ukuthuthukisa ukusebenza kahle kokuxilonga, kodwa bubhekene nezinselele ezifana nokulinganisa idatha kanye nokucaca kwemodeli, okudinga ukwenziwa ngcono okwengeziwe.
Ngokuphathelene nokwanda kokuhlinzwa kwasemini, ukuvumelana kuka-2025 kukhuthaza ukufakwa kwe-ERCP ekuphathweni kokuhlinzwa kwasemini, okuvumela iziguli eziningi ukuthi ziqedele inqubo yokulaliswa esibhedlela, ukuhlinzwa, ukubhekwa ngemva kokuhlinzwa, kanye nokuphuma zingakapheli amahora angama-24. Lokhu akugcini nje ngokufinyeza ukuhlala esibhedlela kodwa futhi kunciphisa izindleko zezokwelapha futhi kuthuthukise ukusebenza kahle kokusetshenziswa kwezinsiza zezokwelapha. Ngokuvuthwa okuqhubekayo kanye nokwanda kobuchwepheshe, i-ERCP kulindeleke ukuthi isetshenziswe ezikhungweni zezokwelapha eziningi, inikeze izinsizakalo zokuxilonga kanye nokwelashwa ezinembile nezisebenzayo ezigulini eziningi ezinezifo ze-biliary kanye ne-pancreatic.
Isifinyezo kanye Nezincomo
I-ERCP, ubuchwepheshe obusha, imele intuthuko ebalulekile ekuxilongweni nasekwelapheni izifo zenyongo kanye ne-pancreatic. Ithuthukisa ukunemba kokuxilonga ngokusebenzisa ukubona okuqondile kanye ne-biopsy enembile, inciphisa ingozi yezinkinga ngokwenza ngcono inqubo futhi inciphise isikhathi sokwelashwa, futhi izuzisa iziguli eziningi ngokwandisa ububanzi bezinkomba. Kodwa-ke, lobu buchwepheshe obusha bubhekene nemikhawulo ekusetshenzisweni kwemitholampilo, njengezithiyo zobuchwepheshe eziphezulu kanye nokuthembela okukhulu kwemishini, okudinga ukwesekwa kwamaqembu ezokwelapha akhethekile kanye nemishini ethuthukisiwe. Kunconywa ukuthi izikhungo zezokwelapha ziqinise ukuqeqeshwa kwe-ERCP kanye nokutshalwa kwezimali kwemishini ukuze kuthuthukiswe amakhono odokotela kanye nokutholakala kwemishini. Kunconywa futhi ukukhetha izindlela zokwelapha ezifanele ngokusekelwe esimweni sesiguli; ngezifo zenyongo kanye ne-pancreatic eziyinkimbinkimbi, ukwelashwa kwe-ERCP okusizwa ubuchwepheshe obusha kungacatshangelwa. Ngaphezu kwalokho, kunconywa ukuthuthukisa ukusebenza kanye nezindleko ze-ERCP, ukubhekana nezinkinga zokujwayelekile kanye nokucaca kwezinhlelo ezisizwa yi-AI, kanye nokukhuthaza ukwamukelwa kabanzi kwe-ERCP ezibhedlela zokunakekelwa okuyisisekelo.
Izinto ezithengiswa kakhulu ze-ERCP Series ezivela ku-ZRHmed.
 |  |  |  |
| I-Sphincterotome | Izintambo Zokuqondisa Ezingezona Imithambo Yegazi | Amabhasikidi Okubuyisa Amatshe Alahlwayo | Ama-Catheter e-Nasobiliary alahlwayo |
Thina, Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumkhiqizi eShayina ogxile ezintweni ezisetshenziswayo ze-endoscopic, sifaka umugqa we-GI njenge-biopsy forceps, i-hemoclip, i-polyp snare, inaliti ye-sclerotherapy, i-spray catheter, amabhulashi e-cytology, i-guidewire, ubhasikidi wokubuyisa amatshe, i-nasal biliary drainage cathete njll. ezisetshenziswa kabanzi ku-EMR, ESD, ERCP. Imikhiqizo yethu inesitifiketi se-CE futhi ivunyelwe yi-FDA 510K, kanti izitshalo zethu zinesitifiketi se-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi kanye nengxenye ye-Asia, futhi sithola ukuqashelwa nokunconywa kakhulu kumakhasimende!
I-Sphincterotome、Ucingo Lokuqondisa、Ibhasikidi Lokukhipha Amatshe、Ukudonsa Amanzi E-NasobiliaryI-Catheter、I-ERCP
Isikhathi sokuthunyelwe: Disemba-20-2025