He aha te Hātepe Whipple? Te Whāinga, te Hātepe & te Whakaora

Ko te hātepe Whipple he pokanga nui e tango ana i ngā wāhanga o tō pūkahukahu, te whekau iti, me ētahi atu okana tata. Ka mahia tēnei mahi uaua e ngā tākuta ki te rongoā i te mate pukupuku o te pūkahukahu me ētahi atu āhuatanga nui e pā ana ki te upoko o tō pūkahukahu.

I ahu mai tēnei pokanga i te ingoa o Dr. Allen Whipple, nāna i whakawhanake tuatahi te tikanga i ngā tau 1930. Ahakoa te ahua whakamataku, kua āwhina te hātepe Whipple i ngā mano tāngata ki te whawhai i te mate pukupuku o te pūkahukahu me ētahi atu āhuatanga. Mā te māramatanga ki ngā mea e pā ana ki tēnei pokanga ka āwhina koe ki te whai wāhi atu me te māia ki tō haerenga rongoā.

He aha te hātepe Whipple?

Ko te hātepe Whipple, e kīia ana ko te pancreaticoduodenectomy, e tango ana i te upoko o tō pūkahukahu me ngā wāhanga hono o tō pūnaha kūnatu. Ka tangohia e tō tākuta pokanga te upoko o te pūkahukahu, te wāhanga tuatahi o tō whekau iti (duodenum), tō pūpū, me tētahi wāhanga o tō ngongo pāpā.

I muri i te tango i ēnei wāhanga, ka hono anō tō tākuta pokanga i ngā okana e toe ana kia taea tonu e tō pūnaha kūnatu te mahi. Whakaarohia me te tango i tētahi wāhanga o ngā paipa hono, ka hono anō i ngā mea katoa kia mahi anō te pūnaha. Ko te tikanga ka 4 ki te 8 haora te roa o te pokanga.

E rua ngā momo hātepe Whipple. Ko te Whipple matarohia e tango ana i tētahi wāhanga o tō puku me ētahi atu okana. Ko te Whipple e tiaki ana i te pylorus e pupuri ana i tō puku katoa, e āwhina ana i te kūnatu i muri i te pokanga.

He aha te take e mahia ai te hātepe Whipple?

Ka tūtohu ngā tākuta i te hātepe Whipple ki te rongoā i te mate pukupuku o te pūkahukahu kei te upoko o tō pūkahukahu. Koinei te tūponotanga pai rawa atu mō te rongoā i te wā kāore anō te mate pukupuku i horapa ki ētahi atu wāhanga o tō tinana.

Ka rongoa hoki te pokanga i ētahi atu āhuatanga kino e pā ana ki te wāhi kotahi. Kei roto i ēnei ko ngā puku i roto i tō ara pūtaiao, whekau iti, te wāhi rānei e tūtaki ai tō pūtaiao ki tō whekau iti. I ētahi wā, ko te mumura pūtaiao mau tonu e pā ana ki te mamae nui, ā, kāore e aro ki ētahi atu rongoā, me whai hoki tēnei pokanga.

Ka tūtohu anake tō tākuta i tēnei tikanga mena ka nui ake ngā painga i ngā tūponotanga. Ka āta tirotiro rātou i tō hauora whānui, te rahi me te wāhi o tō puku, me te horapa o te mate pukupuku i mua i te tūtohu i te pokanga.

He aha te tikanga mō te pokanga Whipple?

E rua ngā wāhanga nui o te tikanga Whipple: te tango me te hanga anō. Ka whakamahi tō rōpū pokanga i te rongoā whānui, nō reira ka moe katoa koe i te wā o te mahi katoa.

I te wā o te tango, ka hanga e tō tākuta pokanga he tapahi i tō puku o runga kia uru atu ki te pūtaiao me ngā okana e tata ana. Ka āta tirotiro rātou i te wāhi kia mōhio kei te tika tonu te pokanga. Katahi ka tangohia e rātou te upoko o tō pūtaiao, duodenum, pūtaiao, me tētahi wāhanga o tō ara pūtaiao.

Ko te wāhanga hanga anō ko te hono anō i ō okana e toe ana. Ka whakapiri tō tākuta pokanga i te pūtaiao e toe ana ki tō whekau iti, ka hono i tō ara pūtaiao ki tō whekau, ka hono anō i tō puku. Mā tēnei ka taea e te wai pūtaiao me te wai pūtaiao te rere tika ki roto i tō pūnaha keri.

Ka whakamahi pea ētahi tākuta pokanga i ngā tikanga iti-whakauru me ngā tapahi iti me ngā taputapu motuhake. Heoi, ko te nuinga o ngā tikanga Whipple e hiahia tonu ana ki te pokanga tuwhera tuku iho nā te uaua e pā ana.

Me pēhea te whakarite mō tō tikanga Whipple?

Ko te whakarite mō te pokanga Whipple e whai ana i ētahi mahi kia mōhio kei te pai koe. Ka ārahi tō rōpū hauora i a koe i ia whakaritenga, engari ka tīmata te whakarite i te 1-2 wiki i mua i te pokanga.

Tērā pea ka tono tō tākuta kia whakamutua e koe ētahi rongoā, inā koa ngā rongoā whakaheke toto, tata ki te wiki i mua i te pokanga. Me karo hoki koe i te kai, i te inu rānei i tētahi mea i muri i te pō i mua i tō tikanga. Ko ētahi tāngata me kaukau ki te hopi patu huakita motuhake i te pō i mua, me te ata o te pokanga.

Koinei ngā mahi whakarite matua ka tūtohu pea tō rōpū hauora:

• Whakaoti i ngā whakamātautau toto i mua i te pokanga me ngā karapa whakaahua
• Tūtaki ki tētahi tākuta rongoā hei kōrero mō te whakahaere mamae
• Whakarite kia whai tangata hei taraiwa i a koe ki te kāinga, me te noho tahi i te tīmatanga
• Whakarite i tō kāinga ki ngā taonga e ngāwari ana te toro atu, me ngā nohoanga pai
• Whaia ngā aratohu kai motuhake mēnā ka tūtohu tō tākuta
• Whakamutua te kai paipa mēnā e kai paipa ana koe, nā te mea ka raru pea tēnei i te whakaora

Ka hoatu e tō rōpū pokanga ki a koe ngā tohutohu taipitopito e hāngai ana ki tō āhuatanga. Kaua e whakaroa ki te pātai pātai mō tētahi mea kāore i te mārama.

Me pēhea te pānui i ngā hua o tō pokanga Whipple?

I muri i tō tikanga Whipple, ka tirohia e tō tākuta pokanga ngā kiko katoa i tangohia i raro i te karu whakanui. E kōrero ana tēnei pūrongo pathology ki a koe i ngā kōrero nui mō tō āhuatanga, me te āwhina i te whakamahere i ō mahi e whai ake nei.

Ka whakaatu te pūrongo pathology mēnā i kitea ngā pūtau mate pukupuku, ā, mēnā i pērā, he aha te momo me te wāhanga o te mate pukupuku kei a koe. Ka tirohia hoki e tō tākuta ngā tapa o ngā kiko i tangohia kia kite mēnā kāore he pūtau mate pukupuku. Ko te tikanga o ngā tapa mārama i tangohia e te tākuta pokanga te mate pukupuku katoa.

Mēnā i pokangahia koe mō te mate pukupuku, tērā pea ka uru mai ngā kōrero mō ngā pona rākau. Ka tangohia e te tākuta pokanga ngā pona rākau tata i te wā o te tikanga kia tirohia mēnā kua horahia te mate pukupuku ki reira. E āwhina ana tēnei kōrero ki te whakatau mēnā e hiahia ana koe ki te rongoā atu pēnei i te chemotherapy.

Ka whakamāramahia e tō tākuta tēnei hua i roto i te kōrero taipitopito i te wā o tō hui whai muri. Ka kōrerohia e rātou te tikanga o ngā kitenga mō tō matapae me te hiahia rānei kia whiwhi rongoā atu.

Me pēhea te tiaki i a koe i muri i te pokanga Whipple?

Ko te whakaora mai i te pokanga Whipple he tukanga haere haere e hiahia ana kia manawanui me te aro nui ki ngā hiahia o tō tinana. Ko te nuinga o te tangata e noho ana i te hōhipera mō te 7-10 rā i muri i te pokanga, ahakoa ka roa pea ētahi i runga i te āhua o tō rātou whakaora.

Ka tino aroturukihia koe e tō rōpū hauora mō ngā raruraru i te wā o tō noho ki te hōhipera. Ka tīmata koe ki ngā wai mārama, ka haere haere ki ngā kai mārō i te wā e whakatikatika ana tō pūnaha kūnatu. He wāhanga nui te whakahaere i te mamae o tō whakaora, ā, ka mahi tō rōpū ki a koe kia noho pai koe.

Kia hoki koe ki te kāinga, me whai koe i ngā aratohu motuhake hei tautoko i tō whakaora. Tērā pea ka hiahia koe ki te kai i ngā kai iti ake, i ngā wā maha ake i te mea he rerekē te mahi o tō pūnaha kūnatu i nāianei. Ka tohutohu pea tō tākuta i ngā tāpiringa enzyme pancreatic hei āwhina i te kūnatu.

Ko te whakaora katoa te tikanga e 2-3 marama, ahakoa ka pai ake ētahi tāngata i mua atu, ā, ka hiahia ētahi atu i te wā roa ake. Ka whai koe i ngā hui whai muri i te wā katoa hei aroturuki i tō whakaora me te whakatika i ngā āwangawanga.

He aha ngā āhuatanga tūpono mō te hiahia ki te pokanga Whipple?

He maha ngā āhuatanga ka whakanui i tō tūponotanga ki te whakawhanake i ngā āhuatanga e hiahia ana ki te pokanga Whipple. He wāhi nui te pakeke, i te mea ko te mate pukupuku pancreatic te nuinga e pā ana ki ngā tāngata neke atu i te 65 tau.

Ka taea hoki e te hītori o te whānau me ngā āhuatanga ira te whakanui i tō tūponotanga. Mēnā he whanaunga tata i pā ki te mate pukupuku pancreatic, ki ētahi momo mate ira rānei, tērā pea ka nui ake tō tūponotanga ki te whakawhanake i ngā raruraru pancreatic. Ka nui ake te tūponotanga o te mate pukupuku pancreatic i te kai paipa, pērā hoki i te inu waipiro nui mō ngā tau maha.

Koinei ngā āhuatanga tūpono nui hei mōhio:

• Neke atu i te 65 tau te pakeke
• Hītori o te whānau mō te mate pukupuku o te pākaru
• Te kai paipa, te hītori rānei o te kai paipa
• Te mumura pākaru mau tonu
• Te mate huka, ina koa ka puta ohorere i roto i ngā pakeke
• Te momomo
• Ētahi momo mate ira

Kāore te whai i ēnei āhuatanga tūpono e kī ana me mahi koe i te pokanga, engari he mea pai kia kōrerohia ki tō tākuta. Mā te tirotiro auau e āwhina ki te kite wawe i ngā raruraru i te wā e whai hua ana te rongoā.

He aha ngā raruraru ka puta i te pokanga Whipple?

Pērā i ngā pokanga nui katoa, he tūponotanga me ngā raruraru ka puta i te pokanga Whipple. Heoi, ki te mahia e ngā tākuta whai wheako i ngā whare rongoā motuhake, he pai, he whai hua hoki te pokanga.

Ko ngā raruraru e tino kitea ana ko te whakawātea puku kua roa, arā, ka roa ake te puku i te tikanga ki te whakawātea i muri i ngā kai. Ka puta pea te whakapairuaki me te ruaki, engari ka pai ake i te wā. Ko te fistula pākaru, arā, ka turuturu te wai pākaru mai i te hononga pokanga, tētahi atu raruraru ka puta pea, ka ora noa iho.

Anei ngā raruraru ka tūpono ka aroturukihia e tō rōpū pokanga:

• Te whakawātea puku kua roa (ka puhoi te whakawātea o te puku)
• Fistula pākaru (te turuturunga o te wai pākaru)
• Te mate i te wāhi pokanga
• Te toto e hiahia ana ki te rongoā atu
• Ngā pūhui toto i ō waewae, i ō pūkahukahu rānei
• Te mate huka ki te nui te pākaru kua tangohia
• Ngā raruraru kūnatu e hiahia ana ki ngā tāpiringa enzyme

Ka taea te whakahaere i te nuinga o ngā raruraru mā te manaaki hauora tika. He nui te wheako o tō rōpū pokanga ki te whakahaere i ēnei āhuatanga, ā, ka tere te mahi ki te whakatika i ngā raruraru ka puta.

Āhea ahau e kite ai i te tākuta mō te pokanga Whipple?

Me whakapā atu koe ki tō tākuta tonu ki te pōti koe i ētahi tohu whakatūpato i muri i te pokanga Whipple. Ka tohu pea ēnei tohu i ngā raruraru e hiahia ana ki te aro mai o te rongoā.

Whakapā atu ki tō tākuta i te wā tonu mēnā ka pūremu koe i te kirika neke atu i te 101°F, te mamae puku nui e kaha ake ana, te whakapairuaki me te ruaki tonu, ngā tohu rānei o te mate i te taha o tō tapahi. Me rapu hoki koe i te manaakitanga tonu mēnā ka kite koe i te kōwhai o tō kiri, o ō kanohi rānei, he tohu tēnei mō te raruraru o te ara pāpā.

Koinei ngā tohu whakatūpato e hiahia ana ki te manaakitanga hauora tonu:

• Kirika neke atu i te 101°F (38.3°C)
• Te mamae puku nui e kaha ake ana
• Te ruaki tonu e ārai ana i te kai, i te inu rānei
• Ngā tohu o te mate (te whero, te mahana, te rerenga wai mai i te tapahi)
• Te kōwhai o te kiri, o ngā kanohi rānei
• Te pāhau nui, te kore rānei e taea te pupuri wai
• Te mamae o te uma, te uaua rānei ki te hā

Kaua e ruarua ki te whakapā atu ki tō rōpū hauora mō ō āwangawanga katoa, ahakoa he iti noa iho. He pai ake ki a rātou te rongo mai i a koe mō tētahi mea iti iho i te mea e māharahara ana koe, e ngaro ana rānei i tētahi tohu nui.

Ngā pātai e pātai pinepine ana mō te tikanga Whipple

Q.1 Ko te tikanga Whipple te rongoā pai mō te mate pukupuku o te pākaru?

Ko te tikanga Whipple te nuinga o te wā te kōwhiringa rongoā pai mō te mate pukupuku o te pākaru kei te upoko o te pākaru, ina koa kāore anō te mate pukupuku i horahia ki ētahi atu okana. E whai wāhi ana te pokanga ki te tūponotanga pai mō te oranga roa me te rongoā pea i ēnei keehi.

Heoi, kāore i te katoa te hunga e mate ana i te mate pukupuku o te pākaru e tika ana mō tēnei pokanga. Ka whakaaro tō tākuta i ngā āhuatanga pēnei i tō hauora whānui, te rahi me te wāhi o te puku, me te mea kua horahia te mate pukupuku i mua i te tūtohu i te pokanga. I ētahi wā, he pai ake pea te rongoā matū, te rongoā iraruke rānei i runga i tō āhuatanga motuhake.

Q.2 Ka rongoā te pokanga Whipple i te mate pukupuku o te pākaru?

Ka taea e te pokanga a Whipple te rongoa i te mate pukupuku pancreatic, engari kei te whakawhirinaki te putanga ki nga mea maha tae atu ki te wahanga o te mate pukupuku me te angitu o te tango i nga pūtau mate pukupuku katoa. Ki te tangohia katoatia te mate pukupuku e kitea ana e te pokanga, me te marama o nga tapa, he maha nga tangata ka eke ki te murunga roa, ki te rongoa ranei.

Ko te reeti oranga e rima tau i muri i te pokanga a Whipple e rereke ana i runga i te wahanga o te mate pukupuku i te wa i kitea ai. Ko nga tangata e mate pukupuku ana i te wa o mua he pai ake te putanga i era e mate ana i te mate matatau. Ka matapakihia e to taakuta to matapae motuhake i runga i to ahuatanga takitahi.

Q.3 E hia te roa ki te ora mai i te pokanga a Whipple?

Ko te whakaora mai i te pokanga a Whipple te tikanga e 2-3 marama mo te nuinga o nga tangata, ahakoa ka ora katoa i runga i to raatau ake tere. Tera pea ka noho koe i te hōhipera mo te 7-10 ra i te tuatahi, katahi ka haere tonu te whakaora i te kainga me te piki haere o nga taumata mahi.

I nga wiki tuatahi, me ata haere koe me te aro ki te kai i nga kai iti, i nga wa maha i te wa e urutau ana to punaha keri. Ka taea e te nuinga o nga tangata te hoki ki nga mahi ngawari i roto i nga wiki 4-6, engari tera pea ka roa nga marama kia tino hoki ki te noho noa.

Q.4 Ka taea e koe te noho noa i muri i te pokanga a Whipple?

Ae, he maha nga tangata e noho ana i nga oranga katoa, noa i muri i te pokanga a Whipple, ahakoa me whakarereke etahi mea ki to mahi o ia ra. Ka rereke te mahi o to punaha keri, no reira tera pea ka hiahia koe ki te kai i nga kai iti, i nga wa maha, a tera pea ka hiahia koe ki nga taapiringa enzyme pancreatic.

Ka pangia e etahi tangata te mate huka i muri i te pokanga mena ka tangohia tetahi waahanga nui o te pancreas, engari ka taea te whakahaere i tenei ma te rongoa. Ka taea e te nuinga o nga tangata te hoki ki te mahi, te haere, me te pai ki o raatau mahi noa i te wa e ora katoa ana ratou i te pokanga.

Q.5 He aha nga kai me karo e au i muri i te pokanga a Whipple?

I muri i te pokanga Whipple, me mōhio koe ki ngā kai e uaua ana ki te keri, e nui ana te ngako rānei, ina koa i ngā marama tuatahi o te whakaora. Ko tō mahi pākaru kua iti te tikanga ka raru pea koe ki te keri i ngā kai momona me te kore e whakamahi i ngā tāpiringa enzyme.

I te nuinga o te wā, me whakawhāiti koe i ngā kai parai, ngā mīti momona, me ngā hua miraka momona kia mōhio rawa koe ki te pai o tō tinana ki a rātou. Aronga ki ngā pūmua hiroki, ngā warowaihā ngāwari ki te keri, me te nui o te wai. Ka whakawhiwhia e tō rōpū hauora ngā aratohu kai motuhake i runga i te ahunga whakamua o tō whakaora.