Ukunyuka Kwemithwalo Yokulahleka: I-Duodenal Switch
Ukuguqulwa kokunyuka kwesisindo somzimba kuyaziwa ngamagama amaninzi, kubandakanywa iDVD kunye ne-biliopancreatic diversion ngokutshintsha kwe-duodenal. Le nkqubo yindlela yokudibanisa i-malabsorptive kunye nokunyanzeliswa kokunciphisa umzimba. Oku kuthetha ukuba inkqubo inciphisa inani leekhalori ezinokubanjelwa ngamathumbu ngokunciphisa inani lomathumbu odibeneyo kunye nokunciphisa ubungakanani obunokubakho ngesisu nokusetyenziswa ngumzimba.
Utshintsho lwe-duodenal ludibanisa nokudalwa kwesikhwama sesisu esilinganiselweyo esineengxenyana ezithintekayo emathunjini amancinci . Oku kuvumela isiguli ukuba sinciphise isisindo ngaphandle kokutshintsha kakhulu indlela yokutya - xa kuthelekiswa nezinye iindidi zokulahleka kwemilinganiselo. Isisu sikwazi ukubamba malunga nee-ounces zokutya ezi-ezintandathu ukuya kweyesithandathu, ngelixa ezinye iinkqubo eziqhelekileyo zisishiya zikwazi ukugcina isigxina esinye kwisigidi esisodwa.
Inkqubo yoTshintsho lweDuodenal
Inkqubo yokutshintsha i-duodenal isenziwa esibhedlele okanye kwisiko lokuhlinzwa, usebenzisa i- anesthesia jikelele . Inkqubo ye- laparoscopic , utyando luqala nge-incinci yee-intshi ezininzi kwiindawo zesisu nangaphakathi kwesisu.
Isisu sihlala siqhotyoshelwe kwisigaba sokuqala samathumbu amancinci, i- duodenum , eyahlukana nayo yonke intlungu encinci. I-duodenum iyaqhotyoshelwe kwingxenyana ephantsi kakhulu emathunjini amancinci, ngokugqithisa ubuninzi beqhezu lesibini nelesithathu lesisu esincinci.
Oku kuthetha ukuba izahlulo zamathumbu amancinci aphelelwe ngumzimba azikwazi ukufumana ukutya okunomsoco ekudleni, ngokunciphisa inani lomathumbu elithatha ukutya, iikhalori eziphantsi kakhulu, amaminerali kunye namavithamini.
Ugqirha ugqiba ukuba akukho ndawo ephazamisayo, kwaye ke izixhobo zihoxiswa kwaye izigqibo zivaliwe, ngokuqhelekileyo kunye ne- sutures okanye i-tape engenakunyumba.
Ubomi Emva kokuguquka kweDuodenal
Utyando lwe-Duodenal lube nemiphumo emihle, kunye nesigulane esiphezulu silahlekelwa ngu-70 ukuya kuma-80% wobunzima obunzima kwiminyaka emibini elandela inkqubo. Nangona kunjalo, izigulane ezikhetha olu hlobo lotyando lusemngciphekweni omkhulu wokunqongophala kwezondlo kunokuba nezinye iintlobo zokuhlinzwa ngokulahleka. Kunokwenzeka ukukhusela ukungondleki emva kwale nkqubo, kodwa izondlo zokutya, kuquka iivithamini kunye nezamaminerali, kuya kufuneka ukuba kube yimfuneko kwixesha lokuphila kwesigulane.
Inkqubo kulindeleke ukuba ibe yinkqubela kwi-biliopancreatic diversion (BPD), inkqubo endala. Abagqirha babekholelwa ukuba ngokugcina i-pyloric sphincter evala isisu, ukutya kwakuya kuba nethuba lokunciphisa kangcono, ukunciphisa izinga lokungondleki kunye ne-vitamin deficiencies kunye nokukhusela ukulahlwa kwesifo emva kokuhlinzwa. Nangona kunjalo, uphando luye lwabonisa ukuba akukho ntlukwano kwimilinganiselo yokungondleki emva kokuhlinzwa okubini.
Kwixesha elide, ezininzi izigulane ezikhetha olu hlobo lotyando liphela kunye neziphumo ezimileyo. Umzimba awukwazi ukugaya konke ukutya okuthathiweyo, ukuguqulwa kwendlela yokuphila akuyona nto ebaluleke kakhulu njengokuba kunjalo kunye nezinye iintlobo zokuhlinzwa .
Ukongezelela, izigulane ziyakwazi ukutya iindawo ezininzi kunokuba zinezinye iindidi zokunciphisa umzimba, ukuvumela ukwanelisa isigulane.
Nangona iindleko zokutya ezinkulu kunye nokulahlekelwa kwindleko enzima kungekhona nje kuphela kodwa kunokukwazi ukugcinwa ziyakhathalela kakhulu izigulane eziza kubakho, abagqirha abambalwa benza loo nkqubo, ngoko ukwenza ukuhanjelwa kokutyelela kunokuba ngumngeni emva kokuhlinzwa ukuba isiguli sifanele sihambe umgama ukubona ugqirha. Ukukwazi kwakho ukugcina ulandelelwano lwakho lwentlanganiso emva kokuhlinzwa kufuneka kuthathelwe ingqalelo xa ukhetha lo msebenzi-kwaye ugqirha oza kuwenza.
Imithombo:
> Ubungcali beBatric Surgery For Utility Obesity. Uxwebhu loLwazi lwaBathengi. Isizwe seSizwe soSifo sikashukela kunye neeNtsholongwane zeNtsholongwane. Matshi 2008. http: // http://win.niddk.nih.gov/publications/gastric.htm
> Jones, uNicolas V. Christou, MD, PhD, Khangela uDidier Khangela, MD, kunye noLloyd D. MacLean, MD, PhD. "Ukunyusa Umzimba Emva kwexesha elifutshane kunye neLong-Limb Gastric Bypass kwizigulane ezilandelwe ixesha elide kuneminyaka eli-10." U-Annal of Surgery 2006 ngoNovemba; 244 (5): 734-740.