Hoʻohui ka dile bile maʻamau i ka gallbladder i ka duodenum. ʻO kēia kahena o ka bile maʻamau kahi kahawai nona ka hana e hoʻokuʻu ai i ka bile i loko o ka duodenum, ka mea nāna e hana i ka ʻōnaehana digestive. He mea nui ʻo Bile i ka digestion. ʻO ke kēpau bile maʻamau, no laila e lawe i kēia bile i ka ʻāpana mua o ka ʻōpū liʻiliʻi, i hoʻokumu ʻia e ka fusion o ke kahe hepatic maʻamau a me ke dute cystic. ʻO ka hapa nui o nā maʻi dile bile ka hopena o nā pōhaku, ʻo kēia mau ʻiliʻili liʻiliʻi i kekahi manawa ke hana nei no ka clogging o ka gallbladder me nā gallstones, kahi e helu ai e lilo i mau ʻiliʻili.

Hoʻokumu ʻia ke kaila o ka bile maʻamau e ka fusion o ke dute hepatic maʻamau a me ke dute cystic. No laila, ka canaliculi o ka bile, kēia mau duct liʻiliʻi e hōʻiliʻili i ka bile i hana ʻia e nā akepaʻa ate (nā cell i kapa ʻia he hepatocytes), hoʻohui e hana i nā aʻa oʻa. Hoʻohui pū hou kēia mau kīʻaha bile a hoʻonui i ke kēpau hepatic kūpono a me ka lepe hepatic hema, kahi e hui pū ai e hana i ke kaola hepatic maʻamau. ʻO kēia kahe hepatic maʻamau i hoʻohui ʻia e ka cystic duct, kahi ʻano o ka ʻeke e hele mai ana mai ka bilicle vesicle, e hana i ke dule o ka bile maʻamau. Mai ke kahe o ka bile maʻamau, hiki i ka bile ke komo i ka duodenum, kēlā hapa mua o ka ʻōpū liʻiliʻi e ukali i ka ʻōpū. ʻO ka bile i hoʻoili ʻia ma o kēia kaʻau bile maʻamau e komo i nā hana digestive o ke kino.

ʻO ke Physiologically, ka dile bile maʻamau e hiki ai ke hoʻokuʻu i ka bile ma o ka uila hepato-pancreatic i loko o ka duodenum. Ke komo nei i loko o kēia ʻōnaehana paʻa o ka ʻōnaehana digestive, no laila e komo ka bile i ka digestion. ʻO ka ʻoiaʻiʻo, ʻo ke kēpau e hali i ke kīhāpai i hūnā ʻia e ke akepaʻa ua kapa ʻia ʻo ke kahena o ka bile nui e haʻalele ana i ke akepaʻa a kapa ʻia ʻo ke kahe o ka bile maʻamau ke hoʻohui ʻia e ka cystic duct, ʻo ia hoʻi ka ʻōlelo o ka gall gall bladder.

Ke kuleana o ka bile i ka digestion

Hoʻopuka ʻia ka bile i ke akepaʻa ma mua o ka lawe ʻia ʻana ma o nā kaola o ka bile a laila hoʻokuʻu ʻia ma o ke kahena o ka bile maʻamau. Hoʻopuka ke akepaʻa ma kahi o 500-600 mL o ka bile i kēlā me kēia lā. ʻO kēia bile ka mea nui o ka wai a me nā electrolytes, akā ʻo nā mea hoʻohui ʻokanika, a me nā paʻakai ʻoi loa. ʻO kēia mau paʻakai bile, i hūnā ʻia i ka ʻāpana mua o ka ʻōpū liʻiliʻi, ka duodenum, a laila loaʻa nā hana nui e hana ai i ka momona o ka liposoluble vitamins, akā ʻo nā momona hoʻi i lawe ʻia: no laila kōkua kēia i kā lākou digestion a me kā lākou omo. . Hoʻohui ʻia, loaʻa pū ka bile i nā pigment bile, ʻo kēia mau hui i hopena ʻia mai ka luku ʻia ʻana o nā hunaola ʻulaʻula a me kahi hapa o ia mea e hoʻopau ʻia mai ke kino ma o ka pahu.

Ka hoʻohaʻahaʻa ʻana o ka gallbladder

Hoʻokuʻu ka ʻai i nā homone mai ka ʻōpū. Hoʻohui ʻia, hoʻonāukiuki ʻia kekahi mau ʻāʻī (i kapa ʻia nā nerves cholinergic), ka mea e ʻaelike ai ka gallbladder. A laila e heʻe kēia iā 50 a 75% o kāna ʻike i loko o ka duodenum, ma o ke kahena o ka bile maʻamau. ʻO ka mea hope loa, hoʻopuni nā paʻakai bile mai ke ake a i ka ʻōpū a hoʻi i ke ake he ʻumi a ʻumikūmālua manawa i ka lā.

ʻO ka hapa nui o nā maʻi bile duct ka hopena o nā gallstones, kēlā mau pōhaku liʻiliʻi e hana i nā kaola o ka bile. ʻO ka mea hope loa, ʻike ʻia ʻekolu mau maʻi nui o nā dile bile: ka mālama biliary, nā tumors a me nā pōhaku.

• I ka hanana o ka mālama biliary, ʻaʻole komo ka bile i ka duodenum. Kūleʻa ia i ke kaila o ka bile maʻamau a i ʻole i ka wai o ke au. ʻO kēia kaohi ke kumu o ka kaomi nui i nā aʻa o nā bile. ʻO kēia ke kumu o ka ʻeha o ka colic hepatic;
• Hiki ke hoʻokumu ʻia kēia hanana o ka mālama biliary e kahi tumo i nā aʻa aʻa a i ʻole nā ​​aʻa o ka pancreas. Hiki i kēia mau tumors ke benign a hōʻino paha. Hoʻohui ʻia, hiki iā lākou ke hoʻopili i nā aʻa o ka bile mai loko a ma waho o ke ake.
• Hoʻokumu ʻia nā gallstones e ulu nei i loko o ka gallbladder e ka clogging ʻana o ka gallbladder me ka mudstone, kahi e hoʻopili ai a lilo i mau ʻiliʻili. No laila, ʻike ʻia ka lithiasis o ke aʻa nui o ka bile e ke kū ʻana o nā pōhaku i nā kahakaha. Hiki i kēia mau gallstones, ke kumu hou aʻe, ke kumu ʻia e ka hiʻona o nā paʻakai koleka insoluble i nā kaola o ka bile. I kekahi manawa neʻe kēia pōhaku i loko o ke kahena o ka bile nui, ke dule o ka bile maʻamau. A laila ke kumu o kahi hōʻeha hōʻeha, a ukali ʻia paha e ke kuni a me ka jaundice ma muli o ka paʻa ʻana o ke kahe o ka bile maʻamau.

ʻO ka mālama ʻana i nā lithiasis o ke kahe o ka bile maʻamau ka pinepine pinepine multidisciplinary.

• Ma kekahi ʻaoʻao, kahi cholecystectomy (ka hoʻoneʻe ʻana i ka gallbladder) hiki ke hiki ke kāohi i ke kūkulu ʻana o nā gallstones;
• Ma ka ʻaoʻao ʻē aʻe, hiki ke hemo ka pōhaku i loko o ke kahena o ka bile maʻamau i kēia cholecystectomy, a i ʻole i nā lā ma hope o ke komo ʻana e kahi gastroenterologist, i kahi hana i kapa ʻia endoscopic sphincterotomy.

ʻO ka hemo ʻana o ka gallbladder ʻaʻole ia he kumu e hoʻololi ai i ka physiological nui. Eia hou, ʻaʻole pono ia e ukali i kahi papaʻai kūikawā ma hope.

ʻO kahi lithiasis choledochal kekahi manawa asymtomatic: hiki ke ʻike ʻia i ka wā o ka nānā ʻana. Ke kumu ia i keakea biliary, i kapa ʻia hoʻi ʻo cholestasis, kumu ia i ka jaundice (jaundice) a me ka ʻeha o ke ʻano colic ate. Hiki ke kānalua ʻia ka hōʻailona ma o ka hoʻokolokolo ʻana e ke kauka.

Pono nā loiloi hohonu:

• Ma ka pae olaola, aia paha he mau hōʻailona o cholestasis, e like me ka hoʻonui ʻana o ka bilirubin, gamma GT (GGT a i ʻole Gammaglutamyl-transferase), a me PAL (alkaline phosphatase) a me nā transaminases;
• Hiki i ka ultrasound ʻōpū ke hōʻike i ka dilation o nā aʻa aʻa;
• E hana pinepine ʻia kahi ultrasound endoscopic, pili a pili ʻole paha me ka bili-MRI, me ka pahuhopu e ʻike i nā lithiasis a no laila e hōʻoia ana i ka ʻike.

Etymologically, ka huaʻōlelo cholédoque mai ka Greek "kholé" ʻo ia hoʻi "bile", akā "gall" a me "anger" hoʻi. ʻO ka mōʻaukala, pono e hoʻomaopopo ʻia ma ka Antiquity, a hiki i ka loaʻa ʻana o ka physiology kanaka i hana maoli i ka ʻepekema, he mea maʻamau ka hoʻokaʻawale ʻana i nā mea i kapa ʻia nā "humors" ʻehā o Hippocrates. ʻO ka mua he koko: e hele mai ana mai ka puʻuwai, wehewehe ia i ke ʻano o ke koko, kahi e kuhikuhi ai i kahi ʻano ikaika a ikaika, a pili pū hoʻi i ka pilina. ʻO ka lua ka pituitis, pili i ka lolo, hoʻopili ʻia me ka lymphatic temperament, i kapa ʻia hoʻi he phlegmatic. ʻO ke kolu o nā humour i noi ʻia e Hippocrates ka bile melemele, e hoʻomaka ana i ke akepaʻa, i pili pū me ka huhū huhū. ʻO ka mea hope loa, ʻo ka ʻeleʻele a i ʻole atrabile bile, e hele mai ana mai ka lepe, i kuleana ʻia no ke ʻano melanoli.