He aha ka Hana Whipple? Ke Kumu, ke Kaʻina Hana & Hoʻōla

ʻO ka hana Whipple he ʻoki nui e wehe ana i nā ʻāpana o kou pancreas, ʻōpū liʻiliʻi, a me nā ʻōkana ʻē aʻe e pili ana. Hana nā kauka i kēia hana paʻakikī i ka wā mua e mālama i ka maʻi maʻi pancreas a me nā maʻi koʻikoʻi ʻē aʻe e pili ana i ke poʻo o kou pancreas.

Loaʻa i kēia ʻoki kona inoa mai Kauka Allen Whipple, nāna i hoʻomohala mua i ke ʻano hana i ka makahiki 1930. ʻOiai he mea hoʻoweliweli, ua kōkua ka hana Whipple i nā tausani o nā kānaka e hakakā i ka maʻi maʻi pancreas a me nā maʻi ʻē aʻe. ʻO ka hoʻomaopopo ʻana i ka mea e pili ana i kēia ʻoki hiki ke kōkua iā ʻoe e mākaukau a hilinaʻi i kāu huakaʻi lapaʻau.

He aha ka hana Whipple?

ʻO ka hana Whipple, i kapa ʻia hoʻi ʻo pancreaticoduodenectomy, e wehe i ke poʻo o kou pancreas me nā ʻāpana pili o kāu ʻōnaehana digestive. Wehe kāu kauka lapaʻau i ke poʻo o ka pancreas, ka ʻāpana mua o kou ʻōpū liʻiliʻi (duodenum), kou gallbladder, a me kahi ʻāpana o kāu bile duct.

Ma hope o ka wehe ʻana i kēia mau ʻāpana, hoʻopili hou kāu kauka lapaʻau i nā ʻōkana i koe i hiki i kāu ʻōnaehana digestive ke hana. E noʻonoʻo e like me ka wehe ʻana i kahi ʻāpana o nā paipu pili a laila hoʻopili hou i nā mea a pau i hana hou ka ʻōnaehana. Lawe maʻamau ka ʻoki i 4 a 8 mau hola e hoʻopau ai.

Aia ʻelua ʻano nui o nā hana Whipple. Wehe ka Whipple maʻamau i kahi ʻāpana o kou ʻōpū me nā ʻōkana ʻē aʻe. Mālama ka pylorus-preserving Whipple i kou ʻōpū holoʻokoʻa, hiki ke kōkua i ka ʻai ʻana ma hope o ke ʻoki.

No ke aha e hana ʻia ai ka hana Whipple?

Paipai nā kauka i ka hana Whipple i ka wā mua e mālama i ka maʻi maʻi pancreas i loaʻa i ke poʻo o kou pancreas. ʻO kēia ka manawa maikaʻi loa no ka lāʻau lapaʻau ke ʻole i laha ka maʻi maʻi i nā ʻāpana ʻē aʻe o kou kino.

Hana ʻia ka ʻoki ʻana no nā maʻi koʻikoʻi ʻē aʻe e pili ana i ka wahi like. Aia kēia mau mea i nā ʻōpū i loko o kāu ʻōpū bile, ʻōpū liʻiliʻi, a i ʻole ka wahi kahi e hui ai kou pancreas me kou ʻōpū liʻiliʻi. I kekahi manawa, ʻo ka pancreatitis maʻi e hoʻoulu ai i ka ʻeha nui a ʻaʻole pane i nā lāʻau lapaʻau ʻē aʻe e koi pū ʻia i kēia ʻoki.

E ʻōlelo wale kāu kauka i kēia kaʻina hana inā ʻoi aku ka maikaʻi ma mua o nā pilikia. E nānā pono lākou i kou olakino holoʻokoʻa, ka nui a me kahi o kāu ʻōpū, a inā ua laha ka maʻi ma mua o ka ʻōlelo ʻana i ka ʻoki.

He aha ke kaʻina hana no ka ʻoki ʻana ʻo Whipple?

Hana ʻia ke kaʻina hana ʻo Whipple i ʻelua mau ʻāpana nui: ka wehe ʻana a me ke kūkulu hou ʻana. E hoʻohana kāu hui ʻoki i ka anesthesia maʻamau, no laila e hiamoe loa ʻoe i ka wā o ka hana holoʻokoʻa.

I ka wā o ka wehe ʻana, e hana kāu kauka lapaʻau i kahi ʻoki i loko o kou ʻōpū luna e komo i ka pancreas a me nā ʻōkana a puni. E nānā pono lākou i ka wahi e hōʻoia ai ʻo ka ʻoki ʻana ke koho kūpono. A laila e wehe lākou i ke poʻo o kou pancreas, duodenum, gallbladder, a me kahi ʻāpana o kou ʻōpū bile.

ʻO ka ʻāpana kūkulu hou e pili ana i ka hoʻopili hou ʻana i kāu mau ʻōkana i koe. Hoʻopili kāu kauka lapaʻau i ka pancreas i koe i kou ʻōpū liʻiliʻi, hoʻopili i kou ʻōpū bile i kou ʻōpū, a hoʻopili hou i kou ʻōpū. Hiki i kēia i ka bile a me nā wai pancreatic e kahe pono i loko o kāu ʻōnaehana digestive.

Hiki i kekahi mau kauka lapaʻau ke hoʻohana i nā ʻenehana liʻiliʻi me nā ʻoki liʻiliʻi a me nā mea hana kūikawā. Eia naʻe, ʻo ka hapa nui o nā kaʻina hana ʻo Whipple e koi mau i ka ʻoki hāmama kuʻuna ma muli o ka paʻakikī.

Pehea e hoʻomākaukau ai no kāu kaʻina hana ʻo Whipple?

ʻO ka hoʻomākaukau ʻana no ka ʻoki ʻana ʻo Whipple e pili ana i kekahi mau ʻanuʻu e hōʻoia ai aia ʻoe i ke kūlana maikaʻi loa. E alakaʻi kāu hui lapaʻau iā ʻoe ma kēlā me kēia koi, akā hoʻomaka ka hoʻomākaukau ʻana i 1-2 mau pule ma mua o ka ʻoki.

E noi paha kāu kauka iā ʻoe e hooki i kekahi mau lāʻau lapaʻau, ʻo ia hoʻi nā mea hoʻoheheʻe koko, ma kahi o hoʻokahi pule ma mua o ke ʻoki ʻana. Pono nō hoʻi ʻoe e pale i ka ʻai ʻana a i ʻole ka inu ʻana i kekahi mea ma hope o ke aumoe i ka pō ma mua o kāu kaʻina hana. Pono kekahi poʻe e ʻauʻau me ke kopa antibacterial kūikawā i ka pō ma mua a me ke kakahiaka o ke ʻoki ʻana.

Eia nā ʻanuʻu hoʻomākaukau nui e ʻōlelo ai kāu hui lapaʻau:

• E hoʻopau i nā hoʻokolohua koko ma mua o ke ʻoki ʻana a me nā scans kiʻi
• E hui me kahi anesthesiologist e kūkākūkā i ka mālama ʻeha
• E hoʻonohonoho i kekahi e hoʻokele iā ʻoe i ka home a noho pū me ʻoe i ka wā mua
• E hoʻomākaukau i kou home me nā mea maʻalahi a me nā noho ʻoluʻolu
• E hahai i nā alakaʻi meaʻai kikoʻī inā ʻōlelo kāu kauka iā lākou
• E hooki i ka puhi ʻana inā puhi ʻoe, no ka mea, hiki i kēia ke keakea i ka hoʻōla

E hāʻawi kāu hui ʻokiʻoki iā ʻoe i nā ʻōlelo kikoʻī e pili ana i kou kūlana. Mai kānalua e nīnau i nā nīnau e pili ana i kekahi mea i maopopo ʻole.

Pehea e heluhelu ai i kāu hopena ʻoki ʻo Whipple?

Ma hope o kāu kaʻina hana Whipple, e nānā kāu kauka lapaʻau i nā ʻiʻo a pau i wehe ʻia ma lalo o ka microscope. Hōʻike kēia hōʻike pathology iā ʻoe i ka ʻike nui e pili ana i kou kūlana a kōkua i ka hoʻolālā ʻana i kāu mau hana aʻe.

E hōʻike ka hōʻike pathology inā ua loaʻa nā cell cancer a, inā pēlā, ke ʻano a me ke kahua o ka maʻi kanesa āu. E nānā pū kāu kauka i nā kihi o ka ʻiʻo i wehe ʻia e ʻike inā ua maʻemaʻe lākou i nā cell cancer. ʻO nā palena maʻemaʻe ke ʻano ua wehe paha ke kauka lapaʻau i nā maʻi kanesa a pau.

Inā ua ʻoki ʻia ʻoe no ka maʻi kanesa, hiki i kāu hōʻike ke komo i ka ʻike e pili ana i nā lymph nodes. Wehe ke kauka lapaʻau i nā lymph nodes kokoke i ka wā o ke kaʻina hana e nānā inā ua laha ka maʻi kanesa ma laila. Kōkua kēia ʻike i ka hoʻoholo ʻana inā pono ʻoe i ka lāʻau lapaʻau hou e like me ka chemotherapy.

E wehewehe ana kāu kauka lapaʻau i kēia mau hopena me ka piha i ka wā o kāu hālāwai ma hope. E kūkākūkā lākou i ke ʻano o nā mea i loaʻa no kāu wānana a inā pono ʻoe i ka lāʻau hou.

Pehea e mālama ai iā ʻoe iho ma hope o ke ʻoki ʻana iā Whipple?

He hana mālie ka hoʻōla ʻana mai ke ʻoki ʻana iā Whipple e koi ana i ke ahonui a me ka nānā pono ʻana i nā pono o kou kino. Noho ka hapa nui o nā kānaka i ka haukapila no 7-10 mau lā ma hope o ke ʻoki ʻana, akā pono paha kekahi poʻe i ka lōʻihi e pili ana i ko lākou hoʻōla ʻana.

E nānā pono kāu hui lapaʻau iā ʻoe no nā pilikia i ka wā o kou noho ʻana i ka haukapila. E hoʻomaka ʻoe me nā wai maʻemaʻe a holomua mālie i nā meaʻai paʻa i ka wā e hoʻoponopono ai kāu ʻōnaehana digestive. He mea nui ka mālama ʻana i ka ʻeha i kāu hoʻōla ʻana, a e hana pū kāu hui me ʻoe e hōʻoluʻolu iā ʻoe.

Ke hoʻi ʻoe i ka home, pono ʻoe e hahai i nā alakaʻi kikoʻī e kākoʻo i kou hoʻōla ʻana. Pono paha ʻoe e ʻai i nā meaʻai liʻiliʻi, pinepine, no ka mea, hana ʻokoʻa kāu ʻōnaehana digestive i kēia manawa. Hiki i kāu kauka ke kuhikuhi i nā mea hoʻohui enzyme pancreatic e kōkua i ka ʻai ʻana.

ʻO ka hoʻōla piha ʻana e lawe maʻamau i 2-3 mau mahina, akā ʻoi aku ka maikaʻi o kekahi poʻe i ka wā mua a pono kekahi poʻe i ka manawa hou. E loaʻa iā ʻoe nā hālāwai ma hope e nānā i kou hoʻōla ʻana a e kamaʻilio i nā hopohopo.

He aha nā mea pilikia no ka pono e ʻoki ʻia iā Whipple?

Hiki i kekahi mau mea ke hoʻonui i kou hiki ke hoʻomohala i nā kūlana e koi ai i ke ʻoki ʻana iā Whipple. He hana nui ka makahiki, no ka mea, pili pinepine ka maʻi maʻi pancreatic i ka poʻe ma luna o 65.

Hiki i ka mōʻaukala ʻohana a me nā mea genetic ke hoʻonui i kou pilikia. Inā loaʻa i nā ʻohana pili ka maʻi maʻi pancreatic a i ʻole kekahi mau maʻi genetic, loaʻa paha iā ʻoe ka manawa kiʻekiʻe e hoʻomohala i nā pilikia pancreatic. Hoʻonui nui ka puhi ʻana i kou pilikia o ka maʻi maʻi pancreatic, e like me ka hoʻohana ʻana i ka waiʻona nui i nā makahiki he nui.

Eia nā mea pilikia nui e makaʻala:

• Ua ʻoi aku ma luna o 65 makahiki
• Moʻolelo ʻohana o ka maʻi kanesa o ka pancreas
• Puhi paka a i ʻole moʻolelo o ka puhi paka
• Pancreatitis maʻi
• Maʻi kō, ʻoi loa inā e ulu koke ana i nā mākua kahiko
• Momona
• Nā maʻi genetic kekahi

ʻAʻole ia he manaʻo e pono ana ʻoe i ke ʻoki ʻana inā loaʻa kēia mau mea pilikia, akā pono e kūkākūkā me kāu kauka. Hiki i nā nānā maʻamau ke kōkua i ka ʻike ʻana i nā pilikia i ka wā mua i ka wā e pono ai ka lapaʻau.

He aha nā pilikia e hiki ke loaʻa i ka ʻoki Whipple?

E like me nā ʻoki nui ʻē aʻe, loaʻa i ke kaʻina hana Whipple kekahi mau pilikia a me nā pilikia e hiki ke loaʻa. Eia naʻe, ke hana ʻia e nā kauka lapaʻau i ʻike ʻia ma nā kikowaena loea, palekana a maikaʻi ka ʻoki.

ʻO nā pilikia maʻamau e pili ana i ka hoʻokuʻu ʻana o ka ʻōpū i hoʻopaneʻe ʻia, kahi e lōʻihi ai ka manawa o kou ʻōpū ma mua o ka maʻamau e hakahaka ma hope o nā meaʻai. Hiki i kēia ke hana i ka nausea a me ka luaʻi ʻana akā maʻamau e hoʻomaikaʻi me ka manawa. ʻO ka pancreatic fistula, kahi e kahe ana ka wai pancreatic mai ka pilina ʻoki, ʻo ia kekahi pilikia e hiki ke loaʻa i ka maʻamau e hoʻōla iā ia iho.

Eia nā pilikia e hiki ke nānā ʻia e kāu hui ʻoki:

• Hoʻokuʻu ʻia ka ʻōpū i hoʻopaneʻe ʻia (hākahaka mālie ka ʻōpū)
• Pancreatic fistula (kahe ʻana o ka wai pancreatic)
• Maʻi ma ke kahua ʻoki
• Ke kahe ʻana o ke koko e pono ai ka lapaʻau hou
• Nā koko koko i kou mau wāwae a i ʻole nā ​​māmā
• Maʻi kō inā ua wehe ʻia ka pancreas
• Nā pilikia digestive e pono ai nā mea hoʻohui enzyme

Hiki ke mālama ʻia ka hapa nui o nā pilikia me ka mālama olakino kūpono. Loaʻa i kāu hui ʻoki ka ʻike nui i ka lawelawe ʻana i kēia mau kūlana a e hana wikiwiki lākou e hoʻoponopono i nā pilikia e kū mai ana.

I ka manawa hea wau e ʻike ai i ke kauka e pili ana i ka ʻoki Whipple?

Pono ʻoe e hoʻokaʻaʻike koke i kāu kauka inā loaʻa iā ʻoe kekahi mau hōʻailona hōʻailona ma hope o ka ʻoki Whipple. Hiki i kēia mau hōʻailona ke hōʻike i nā pilikia e pono ai ka nānā ʻana i ka lāʻau lapaʻau.

E kelepona koke i kāu kauka inā loaʻa iā ʻoe ke kuni ma luna o 101°F, ka ʻeha nui o ka ʻōpū e ʻoi aku ka maikaʻi ʻole, ka nausea mau a me ka luaʻi ʻana, a i ʻole nā hōʻailona o ka maʻi a puni kāu ʻoki. Pono nō hoʻi ʻoe e ʻimi koke i ka mālama ʻana inā ʻike ʻoe i ka melemele ʻana o kou ʻili a i ʻole nā maka, hiki ke hōʻike i kahi pilikia o ka bile duct.

Eia nā hōʻailona hōʻailona e koi ai i ka lāʻau lapaʻau koke:

• Kuni ma luna o 101°F (38.3°C)
• ʻEha nui o ka ʻōpū e ʻoi aku ka maikaʻi ʻole
• Luaʻi mau e pale ana i ka ʻai a i ʻole ka inu
• Nā hōʻailona o ka maʻi (ʻulaʻula, mehana, ka wai mai ka ʻoki)
• Melemele o ka ʻili a i ʻole nā maka
• Pāpaʻa nui a i ʻole hiki ʻole ke mālama i nā wai i lalo
• ʻEha o ka umauma a i ʻole ka pilikia o ka hanu

Mai kānalua e hoʻokaʻaʻike i kāu hui lapaʻau me nā hopohopo, ʻoiai inā he mea liʻiliʻi lākou. Makemake lākou e lohe mai iā ʻoe e pili ana i kahi mea liʻiliʻi ma mua o ka hopohopo ʻole ʻana a i ʻole ka nalo ʻana i kahi hōʻailona nui.

Nā nīnau i nīnau pinepine ʻia e pili ana i ke kaʻina hana Whipple

Q.1 ʻO ke kaʻina hana Whipple ka lāʻau lapaʻau maikaʻi loa no ka maʻi kanesa pancreatic?

ʻO ke kaʻina hana Whipple ka koho lapaʻau maikaʻi loa no ka maʻi kanesa pancreatic i loaʻa ma ke poʻo o ka pancreas, ʻoiai ke ʻole ka maʻi kanesa i laha i nā ʻōkana ʻē aʻe. Hāʻawi ke ʻoki i ka manawa maikaʻi loa no ke ola lōʻihi a me ka hoʻōla ʻana i kēia mau hihia.

Eia naʻe, ʻaʻole kūpono nā mea a pau me ka maʻi kanesa pancreatic no kēia ʻoki. E noʻonoʻo kāu kauka i nā mea e like me kou olakino holoʻokoʻa, ka nui a me kahi o ka maʻi, a inā ua laha ka maʻi kanesa ma mua o ka ʻōlelo ʻana i ke ʻoki. I kekahi manawa, ʻoi aku ka maikaʻi o ka chemotherapy a i ʻole ka radiation therapy ma muli o kāu kūlana.

Q.2 Hoʻōla ke ʻoki ʻana o Whipple i ka maʻi kanesa pancreatic?

Hiki i ka ʻoki ʻana ʻo Whipple ke hoʻōla i ka maʻi maʻi pancreatic, akā pili ka hopena i nā mea he nui e like me ke kahua o ka maʻi maʻi a inā ua wehe ʻia nā pūnaewele maʻi maʻi a pau. Ke wehe ka ʻoki ʻana i nā maʻi maʻi i ʻike ʻia a maopopo nā palena, nui ka poʻe e loaʻa ana ka hoʻōla lōʻihi a i ʻole ka hoʻōla.

He ʻokoʻa ka helu ola ʻelima makahiki ma hope o ka ʻoki ʻana ʻo Whipple ma muli o ke kahua o ka maʻi maʻi i ka wā i ʻike ʻia ai. ʻOi aku ka maikaʻi o ka poʻe me ka maʻi maʻi maʻi mua ma mua o ka poʻe me ka maʻi holomua. E kūkākūkā kāu kauka i kāu wānana kikoʻī e pili ana i kāu kūlana pilikino.

Q.3 Pehea ka lōʻihi o ka hoʻōla ʻana mai ka ʻoki ʻana ʻo Whipple?

ʻO ka hoʻōla ʻana mai ka ʻoki ʻana ʻo Whipple maʻamau he 2-3 mau mahina no ka hapa nui o ka poʻe, akā hoʻōla nā kānaka a pau i ko lākou wikiwiki ponoʻī. E hoʻolilo paha ʻoe i 7-10 mau lā i ka haukapila i ka wā mua, a laila e hoʻomau i ka hoʻōla ʻana ma ka home me ka hoʻonui ʻana i nā pae hana.

I nā pule mua, pono ʻoe e lawe mālie i nā mea a e kālele ana i ka ʻai ʻana i nā meaʻai liʻiliʻi a pinepine i ka wā e hoʻoponopono ai kāu ʻōnaehana digestive. Hiki i ka hapa nui o ka poʻe ke hoʻi i nā hana māmā i loko o 4-6 mau pule, akā hiki ke lawe i kekahi mau mahina e manaʻo ai ua hoʻi maʻamau.

Q.4 Hiki iā ʻoe ke ola maʻamau ma hope o ka ʻoki ʻana ʻo Whipple?

ʻAe, nui ka poʻe e ola ana i nā ola piha a maʻamau ma hope o ka ʻoki ʻana ʻo Whipple, akā pono paha ʻoe e hana i kekahi mau hoʻoponopono i kāu hana maʻamau i kēlā me kēia lā. E hana ʻokoʻa kāu ʻōnaehana digestive, no laila pono paha ʻoe e ʻai i nā meaʻai liʻiliʻi, pinepine a pono paha i nā mea hoʻohui enzyme pancreatic.

Hoʻomohala kekahi poʻe i ka maʻi diabetes ma hope o ka ʻoki ʻana inā ua wehe ʻia kahi ʻāpana nui o ka pancreas, akā hiki ke mālama ʻia kēia me ka lāʻau lapaʻau. Hiki i ka hapa nui o ka poʻe ke hoʻi i ka hana, huakaʻi, a hauʻoli i kā lākou hana maʻamau i ka wā i hoʻōla piha ai lākou mai ka ʻoki ʻana.

Q.5 He aha nā meaʻai e pale ai au ma hope o ka ʻoki ʻana ʻo Whipple?

Ma hope o ke ʻoki ʻana ʻo Whipple, pono ʻoe e makaʻala i nā meaʻai paʻakikī ke ʻeli ʻia a i ʻole kiʻekiʻe i ka momona, ʻoiai i nā mahina mua o ka hoʻōla. ʻO kāu hana pancreatic i hōʻemi ʻia, ʻo ia hoʻi, pilikia paha ʻoe i ka ʻeli ʻana i nā meaʻai momona me ka ʻole o nā mea hoʻohui enzyme.

Ma keʻano maʻamau, pono ʻoe e kaupalena i nā meaʻai palai, nā ʻiʻo momona, a me nā huahana waiū momona kiʻekiʻe a hiki i kou ʻike ʻana i ka maikaʻi o kou kino e ʻae ai iā lākou. E kālele ana i nā protein lean, nā carbohydrates maʻalahi ke ʻeli ʻia, a me ka nui o nā wai. E hāʻawi kāu hui mālama ola kino i nā alakaʻi meaʻai kikoʻī e pili ana i kāu holomua hoʻōla.