Eminyakeni engama-50 edlule,I-ERCPubuchwepheshe 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-ERCPkancane kancane ishintsha indlela yokuxilonga yendabuko kanye nemodeli yokwelapha izifo zenyongo kanye ne-pancreatic. Ithuthuke kakhulu ekuthuthukiseni ukunemba kokuxilonga, yandisa ububanzi bezinkomba, futhi inciphise ingozi yezinkinga, okubonisa ukuthambekela kokuthuthuka "kokuhlinzwa kwezokwelapha okuba ukuhlinzwa okukhulu kanye nokuhlinzwa okuba ukungenelela okuncane," okunikeza iziguli eziningi izinketho zokwelapha ezinembile nezisebenzayo. Kodwa-ke, ibhekene nemikhawulo ekusetshenzisweni kwemitholampilo, njengemikhawulo ephezulu yobuchwepheshe kanye nokuthembela okukhulu kwemishini.
OkushaI-ERCPubuchwepheshe buhlukaniswe kakhulu ngezigaba ezintathu: izinhlelo ze-endoscopic ze-bile kanye ne-pancreatic ducts, ama-endoscope amancane kakhulu, kanye nezinhlelo ezintsha ezithuthukiswe ekhaya. 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.
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| I-SpyGlass | I-Insight-eyeMax |
Inzuzo eyinhloko yale nguqulo entshaI-ERCPubuchwepheshe buwukuthi bufinyelele ijubane elivela 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 (I-ERCP) ivumela odokotela ukubona ngqo i-bile kanye ne-pancreatic duct mucosa, okuthuthukisa kakhulu ikhono lokuhlukanisa phakathi kwezinkinga ezingengozini kanye nezimbi.I-ERCPkuncike kuma-contrast agents ukuze kubonwe isakhiwo se-luminal, kanti ukuhlolwa kwezilonda ze-mucosal kuncike ezimpawini ezingaqondile. Ukuzwela kokuxubha amaseli e-bile duct 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 angaphezu kuka-9mm ububanzi kucishe kube yi-100%. Ngokuphathelene nemiphumela yokwelashwa, i-cholangiopancreatography yendabukoI-ERCPinesilinganiso sempumelelo ephezulu yokususa amatshe e-pancreatic duct angaphansi kuka-5mm ububanzi, kodwa isilinganiso sokuhluleka esiphezulu samatshe ayinkimbinkimbi (njengalawo angaphezulu kuka-2cm noma ngemva kokwakhiwa kabusha kwesisu). I-CP ehlanganiswe ne-laser lithotripsy ingathuthukisa izinga lempumelelo lifinyelele ezingeni lokuhlinzwa okuvulekile.
Ngokuphathelene nokwandisa ububanzi bezinkomba, ubuchwepheshe obusha buthuthukisa kakhulu izinga lempumeleloI-ERCPezigulini ngemva kokuhlinzwa kokuguqula amathumbu, okuzivumela ukuthi ziphathe izifo ze-biliary kanye ne-pancreatic eziyinkimbinkimbi kakhulu. Isibonelo, ezimweni eziyinkimbinkimbi njenge-cholangitis yangemva kokufakelwa kwesibindi kanye ne-pancreatic duct IPMN, i-endoscopy ye-biliary kanye ne-pancreatic duct inganikeza umbono ocacile, ovumela ukuxilongwa okunembile kanye nokwelashwa.
Ukwanda kwe-pancreatitis ngemuva kokwelashwa kwendabukoI-ERCPcishe kungama-3%-10%. Amasu amasha, ngokubona ngqo, anciphisa ukufakwa kabi kwe-pancreatic duct, athuthukise izinqubo, futhi anciphise isikhathi sokusebenza, okunciphisa kakhulu ukwanda kwe-pancreatitis ngemuva kokuhlinzwa kanye nezinye izinkinga. Ekuhlaziyweni kweziguli ezingama-50 ezine-cholangiocarcinoma ephezulu, isikhathi se-stent patency kanye nemiphumela yokwelashwa eqenjini le-transoral cholangiopancreatography (TCP) yayifana naleyo yendabuko.I-ERCPiqembu, kodwa iqembu le-TCP libonise inzuzo enkulu emazingeni ezinkinga.
OkushaI-ERCPubuchwepheshe 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 kwayo 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 yentshaI-ERCPubuchwepheshe bugxila kakhulu ezicini ezintathu: ukukhushulwa ezingeni eliphansi, ukuhlanganiswa kwe-AI, kanye nokwenza ukuhlinzwa kwasemini kwaziwe. Ngokuphathelene nokukhushulwa ezingeni eliphansi, izinhlelo zokuqeqesha kanye nezinzuzo zezindleko zemishini ekhiqizwe ekhaya kuzothuthukisa kancane kancaneI-ERCPamakhono 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 ukuthuthukiswa okwengeziwe.
Ngokuphathelene nokwanda kokuhlinzwa kwasemini, ukuvumelana kuka-2025 kukhuthaza ukufakwaI-ERCPekuphathweni kokuhlinzwa kwasemini, okuvumela iziguli eziningi ukuthi ziqedele inqubo yokulaliswa esibhedlela, ukuhlinzwa, ukubhekwa ngemva kokuhlinzwa, kanye nokuphuma esibhedlela zingakapheli amahora angama-24. Lokhu akugcini nje ngokufinyeza ukuhlala esibhedlela kodwa futhi kunciphisa izindleko zezokwelapha futhi kuthuthukisa ukusebenza kahle kokusetshenziswa kwezinsiza zezokwelapha. Ngokuvuthwa okuqhubekayo kanye nokuthandwa kobuchwepheshe,I-ERCPkulindeleke ukuthi isetshenziswe ezikhungweni zezokwelapha ezengeziwe, inikeze izinsizakalo zokuxilonga nokwelapha ezinembile nezisebenzayo ezigulini eziningi ezinezifo ze-biliary kanye ne-pancreatic.
Isifinyezo kanye Nezincomo
I-ERCP, ubuchwepheshe obusha, bumelela intuthuko ebalulekile ekuxilongweni nasekwelapheni izifo zenyongo kanye ne-pancreatic. Buthuthukisa ukunemba kokuxilonga ngokusebenzisa ukubona okuqondile kanye ne-biopsy enembile, kunciphisa ingozi yezinkinga ngokwenza ngcono inqubo futhi kunciphise isikhathi sokwelashwa, futhi kuzuzisa iziguli eziningi ngokwandisa ububanzi bezinkomba. Kodwa-ke, lobu buchwepheshe obusha bubhekene nemikhawulo ekusetshenzisweni kwemitholampilo, njengezithiyo zobuchwepheshe eziphakeme kanye nokuthembela okukhulu kwemishini, okudinga ukwesekwa kwamaqembu ezokwelapha akhethekile kanye nemishini ethuthukisiwe. Kunconywa ukuthi izikhungo zezokwelapha ziqiniseI-ERCPukuqeqeshwa kanye nokutshalwa kwezimali kwemishini ukuthuthukisa amakhono odokotela kanye nokutholakala kwemishini. Kunconywa futhi ukukhetha izindlela zokwelapha ezifanele ngokusekelwe esimweni sesiguli; ngezifo eziyinkimbinkimbi ze-biliary kanye ne-pancreatic,I-ERCPukwelashwa okusizwa ubuchwepheshe obusha kungacatshangelwa. Ngaphezu kwalokho, kunconywa ukuthuthukisa ukusebenza kanye nezindlekoI-ERCP, ukubhekana nezinkinga zokujwayela kanye nokucaca kwezinhlelo ezisizwa yi-AI, kanye nokukhuthaza ukwamukelwa kabanzi kweI-ERCPezibhedlela zokunakekelwa okuyisisekelo.
I-ERCPUchungechunge lwezinto ezithengiswayo ezishisayo ezivela ku-ZRHmed.
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| 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,ucingo lokuqondisa, ubhasikidi wokuthola amatshe, i-cathete yokukhipha amanzi ekhaleni njll. ezisetshenziswa kabanzi ku-EMR, ESD,I-ERCPImikhiqizo 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 zithola ukuqashelwa nokunconywa kakhulu ngamakhasimende!
Isikhathi sokuthunyelwe: Disemba-20-2025