ʻO ka gallbladder (mai ka Latin vesica biliaris) hana ma ke ʻano he wahi mālama no ka bile, kahi wai melemele viscous i hūnā ʻia e ke akepaʻa a pili pū i ka hana digestion.

Aia ka gallbladder ma ka ʻaoʻao ʻākau o ka ʻōpū. He ʻeke peʻahi liʻiliʻi ia i loaʻa ma ka ʻaoʻao lalo o ke ake. Green i ke kala a me ka paia lahilahi, ana ʻia ma ka awelika 7 a 12 cm ka lōʻihi. Loaʻa iā ia ma ka awelika 50 mL o ka bile. Ma kona wēlau o lalo, hui pū ke duct cystic i ke dute hepatic maʻamau e hana i ke kēpau bile maʻamau. Ma o kēia kahe e kahe ai ka iwi i loko o ka duodenum, ka ʻāpana mua o ka ʻōpū liʻiliʻi e ukali i ka ʻōpū.

Aia i loko o ka wai ka wai, nā paʻakai bile, bilirubin (pigment e hopena ana mai ka hoʻohaʻahaʻa ʻana o hemoglobin a hāʻawi i ka bile i kona kala melemele ʻōmaʻomaʻo), kolesterol a me nā phospholipids. ʻO nā paʻakai bile a me nā phospholipids wale nō ke komo i ka hana digestion. ʻOiai ʻaʻohe ona enzymes, hiki i ka bile, mahalo i nā paʻakai, e hoʻēmi i ka nui o nā globules momona, a no laila e kōkua i ka hana o nā enzyme digestive.

Pili ka hana a ka gallbladder i ke ʻano o ka duodenum. Ke hakahaka kēia, kahe ka bile i loko o ke kaʻi cystic e mālama ʻia i loko o ka pahu wai. Hoʻopili ka mea hope loa i ka bile ma ka omo hapa ʻana i kāna wai, a no laila e ʻoi aku ka maikaʻi o ka hana o nā paʻakai o ka bile. Ke komo nā meaʻai momona i ka duodenum, ka hūnā ʻia ʻana o cholecystokinin, kahi hormone i hana ʻia e ka ʻōpū, ke kumu e ʻaelike ai ka gallbladder, a laila e hemo ana ka iwi i loko o ke kahe o ka iwi mau. Hoʻohui ʻia ka hope ma ka puka o ka duodenum e ke aʻa pancreatic (e like me ka inoa e hōʻike nei e hele mai ana mai ka pancreas), ka mea lawe i nā enzyme digestive, e lilo i ka uila hepato-pancreatic. I ka manawa i loko o ka ʻōpū liʻiliʻi, hoʻomaka ka bile a me ka wai pancreatic i ka haʻihaʻi o nā meaʻai.

Lithiasis pālua : ke kūkulu ʻia ʻana o nā pōhaku i loko o ka gallbladder a i ʻole ma loko o nā aʻa aʻa. ʻO kēia mau pōhaku, e like me nā ʻiliʻili liʻiliʻi, ua haku ʻia me ka cholesterol crystallized. ʻOkoʻa ko lākou ʻano, ka nui a me ka helu mai kēlā kanaka a kēia kanaka. ʻOiai he benign lākou, hiki i kēia mau pōhaku ke keakea i nā aʻa o ka cystic a me nā bile maʻamau, a no laila ka puka o ka bile i ka duodenum. I kēia hihia, he colic biliary ke kumuhana i hiki ke hala i 4 mau hola.

Loaʻa ka hopena o nā gallstones liʻiliʻi i ka lohi o ke kahe o ka bile a kū i luna a hiki i ke ʻano o ka mea i kapa ʻia he palepole, a loaʻa pū kekahi i kekahi poʻe me ka maʻi AIDS (3).

Ua hiki i kahi noi 4 (2001) ke hoʻomaopopo i nā genes o ka maʻalahi i ka lithiasis i nāʻiole, no laila ke hōʻike nei i kahi kumu kūmole i kēia pathology. Eia kekahi, ʻo kekahi mau lāhui, e like me nā Indians o ʻAmelika Hema, me he mea lā ʻoi aku ka maʻalahi o ka lithiasis.

I kēlā me kēia makahiki, ʻo ka momona ka mea hoʻonui i ka makaʻu no ka hoʻomohala ʻana i nā gallstones. I loko o kahi noi 5 (2012) o 510 mau kānaka nona ka makahiki 000 a hiki i ka 9, ua ʻike ʻia he ʻelua mau manawa ka nui o nā keiki kaumaha i nā pōhaku, ʻoiai ʻewalu mau manawa ke kiʻekiʻe o ka gallstones. nā kumuhana me ka momona nui.

Ma ka laulaha, ʻike nui ʻia nā wahine ma mua o nā kāne i kēia mau gallstones. Hiki i kekahi mau hana ke hoʻonui i ka makaʻu i ka hoʻomohala ʻana i nā pōhaku.

ʻO Cholecystitis : pehu o ka gallbladder, i hiki ke hele pū me ka maʻi. Hana ʻia ia ma muli o ke kū ʻana o nā pōhaku i ka gallbladder a i ʻole ke dule o ka bile maʻamau.

Vesicle porcelain : ma hope o ka cholecystitis, hiki i ka calcium ke hoʻopili i nā paia o ka gallbladder, e hoʻopaʻakeʻa nei. Loaʻa i ke kumuhana kahi vesicle porcelain i kapa ʻia.

ʻO jaundice Cholestatic : Ke ālai ʻia nā aʻa o ka gallbladder, hoʻi ka iwi i loko o ke koko. I ka pau ʻana o ka bilirubin i ka pahu, lilo ia i mea ʻole, ʻoiai e melemele iki ka ʻili. I ka manawa like, piʻi ka pae o ka urir bilirubin, kahi e hopena ai i ka mimi ʻeleʻele loa. ʻO kēia nā ʻōuli o ka jaundice cholestatic.

ʻO Choledochal cista : he pehu maʻamau o nā aʻa oʻa. ʻO ka maʻi mai ka wā hānau, hoʻonui ia i ka makaʻu o ka ulu ʻana i ka maʻi ʻaʻai gallbladder.

Huina pancreatic-biliary maʻamau : anomaly congenital o ka hui ma waena o ka bile maʻamau a me nā ala pancreatic. I kēia hihia, ʻaʻole hiki i nā enzyme i hana ʻia e ka pancreas ke hōʻea i ka duodenum. A laila hiki iā lākou ke hoʻonāukiuki i ka gallbladder.

Maʻi ʻaʻai Gallbladder . ʻO kahi maʻi maʻi maʻamau i Palani, pili nui ia i nā wahine ma mua o ka makahiki 70. ʻIke pinepine ʻia i ka wā e pāhola ai ia i nā mea pili kokoke, hele pū kekahi me ka ʻeha o ka ʻōpū, ka luaʻi a me ka nalo ʻole o ka makemake. Pono e noʻonoʻo ʻia nā mea lāhui e loiloi i kāna hanana. Hōʻike ka Thorotrast (9) (kahi mea hoʻohālikelike i hoʻohana ʻia i nā kiʻi olakino) e hoʻonui pū ai i ka makaʻu o ka ulu ʻana i ka maʻi ʻaʻai pēpē.

Ke helu ʻole ʻia nā pōhaku a ʻaʻole i ʻoi aku i kahi nui, hiki ke mālama i ka hoʻonā ʻana iā lākou, e like me Actigall. ʻO Ablâlika, ʻaʻohe ona hopena maoli i kēlā me kēia lā, ke waiho mau ʻia ma nā hihia o nā gallstones.

Hiki i ka papaʻai ke hoʻohuli i ke kūkulu ʻana o nā gallstones. Mālama kahi papaʻai calorie kiʻekiʻe e hoʻolaulaha i ko lākou helehelena, ʻoiai ka papaʻai momona i nā olonā i hoʻoliʻiliʻi i kēia pākēneka. I ka hanana mua o nā pōhaku, kahi hoʻoponopono nohona (hoʻemi i ka ʻai ʻana o ka momona, kō, hydration maikaʻi, hoʻoikaika kino maʻamau, a me nā mea ʻē aʻe) hiki ke hoʻopau koke i nā ʻeha.

ʻO kekahi mau maʻi ʻōpū, e like me ka maʻi o Crohn, hiki ke pāpālua a i ʻole pākolu ʻia ka nui o nā gallstones (10).

ʻO ke kaha uila o ka ʻōpū: ʻo ka hōʻike maʻalahi a wikiwiki hoʻi e ʻike i nā pōhaku maʻa. Hiki iā ia ke huki 90% o nā helu. Pili ʻia ia me nā hoʻokolohuaolaola (hoʻāʻo koko a me ka hoʻokolokolo bilirubin) i mea e koho ai i ke koʻikoʻi o ke kūlana.

Echo-endoscopy: hiki i kēia ninaninau he iwakāluakū ke nānā iā ʻoe i loko o ka gallbladder a hoʻopaʻa i ka pancreas me ka hoʻohui.

ʻO ka hemo ʻana o ka gallbladder (a i ʻole cholecystectomy)

I ka wā kahiko, hoʻomohala ʻo Galen i ke kumumanaʻo o nā humors ʻehā (11) e like me ke kaulike o nā humors (ke koko, aila melemele, ʻeleʻele, phlegm) e hoʻomalu ai i ke olakino a me ke kino o ke kanaka. Pili ka kinikini melemele i ka huhū, ʻoiai ka bile ʻeleʻele e hoʻoulu ai i ka melankoli a me ke kaumaha. ʻO ka hope, no ka noʻonoʻo, ke kuleana no ka hopohopo a me nā meaʻino. Mai kēia kumumanaʻo Helene e hiki mai ka huaʻōlelo "i ka bile" (12).