Umgudu ovamile we-bile uxhuma i-gallbladder ne-duodenum. Le ndlela evamile ye-bile iyisiteshi umsebenzi waso ukukhipha inyongo ku-duodenum, isitho esakha uhlelo lokugaya ukudla. Ngakho-ke uBile udlala indima ebalulekile ekugayeni ukudla. Umgudu ovamile we-bile, oletha le nyongo engxenyeni yokuqala yamathumbu amancane, wakhiwa ngokuhlangana komsele ovamile we-hepatic kanye nomgudu we-cystic. Iningi lokuphazamiseka kwendlela ye-bile kungumphumela wamatshe enyongo, lawa matshe amancane kwesinye isikhathi akha ngenxa yokuvalwa kwenyongo ngamatshe enyongo, abala abe ngamatshe amancane.

Umgudu ovamile we-bile wakhiwa ngokuhlangana komgudu ovamile we-hepatic kanye nomgudu we-cystic. Ngakho-ke, i-bile canaliculi, la mapayipi amancane aqoqa inyongo ekhiqizwa amaseli wesibindi (amaseli abizwa nangokuthi ama-hepatocyte), ayahlangana akhe amapayipi enyongo. Futhi, la mapayipi enyongo ayahlangana futhi aholela emgudwini ofanele we-hepatic kanye nomgudu wesobunxele we-hepatic, nawo ohlangana ndawonye ukwakha umgudu ovamile we-hepatic. Yile ndlela evamile ye-hepatic, ehlanganiswe yi-cystic duct, uhlobo lwephaketheni elivela ku-bilary vesicle, ezokwakha umgudu ovamile we-bile. Kusukela emgudwini ovamile we-bile, i-bile izokwazi ukungena kwi-duodenum, leyo ngxenye yokuqala yamathumbu amancane alandela isisu. I-bile ekhishwa ngale ndlela evamile ye-bile izobamba iqhaza emisebenzini yokugaya ukudla komzimba.

Ngokwemvelo, umgudu ovamile we-bile wenza ukuthi kube lula ukukhipha inyongo ngesibani se-hepato-pancreatic singene e-duodenum. Ukungena kule ngxenye yomgudu wokugaya ukudla, i-bile izobamba iqhaza ekugayeni. Eqinisweni, umgudu othwala inyongo efihliwe isibindi ubizwa ngokuthi umgudu omkhulu we-bile oshiya isibindi futhi ubizwa ngokuthi umgudu we-bile ovamile uma usuhlanganiswe nomgudu we-cystic, okusho lokho kwenyongo.

Indima ye-bile ekugayeni

IBile ikhiqizwa esibindini ngaphambi kokuthwalwa ngemigudu ye-bile bese ikhishwa ngomgudu ovamile we-bile. Isibindi sikhiqiza cishe i-500-600 mL ye-bile nsuku zonke. Le bile yakhiwe ikakhulukazi ngamanzi kanye nama-electrolyte, kodwa futhi nezinhlanganisela zemvelo, ikakhulukazi nosawoti we-bile. Lawa sawoti we-bile, ake akhishwa engxenyeni yokuqala yamathumbu amancane, i-duodenum, bese enemisebenzi ebalulekile yokwenza oncibilikise amavithamini e-liposoluble, kodwa futhi namafutha afakiwe: lokhu-ke kusiza ukugaya kanye nokumuncwa kwawo. . Ngaphezu kwalokho, i-bile iqukethe nezingulube ze-bile, lezi zinhlanganisela ezibangelwa ukubhujiswa kwamaseli abomvu egazi nengxenyana yazo ezokhishwa emzimbeni ngesitokisi.

Ukusikwa kwe-gallbladder

Ukudla kukhipha ama-hormone emathunjini. Ngaphezu kwalokho, izinzwa ezithile ziyakhuthazeka (ezibizwa ngokuthi izinzwa ze-cholinergic), okwenza ukuthi inyongo inyakaze. Lokhu kuzobe sekukhipha okuqukethwe kwayo okungu-50 kuya ku-75% ku-duodenum, ngomgudu ovamile we-bile. Ekugcineni, usawoti we-bile uzungeza usuka esibindini uye emathunjini bese ubuyela esibindini izikhathi eziyishumi kuya kweziyishumi nambili ngosuku.

Iningi lokuphazamiseka kwendlela ye-bile kungumphumela wamatshe enyongo, lawo matshe amancane akha emibhobho yenyongo. Ekugcineni, kutholakala izifo ezintathu eziyinhloko zamapayipi e-bile: ukugcinwa kwe-biliary, izicubu namatshe.

• Uma kwenzeka ukugcinwa kwe-biliary, i-bile ayifinyeleli i-duodenum. Iyama emgodini ovamile we-bile noma esinyeni. Lokhu kuvinjelwa kubangela ingcindezi eyeqile emibhobho yenyongo. Lokhu kubangela ubuhlungu be-hepatic colic;
• Lo mkhuba wokugcinwa kwe-biliary ungadalwa yisimila emathangeni e-bile noma ku-bile yamanyikwe. Lezi zicubu zingaba yingozi noma zibe yingozi. Ngaphezu kwalokho, angathinta amapayipi enyongo avela ngaphakathi nangaphandle kwesibindi;
• Amatshe aqhakazile akhula kule nyongo abangelwa ukuvalwa kwenyongo ngodaka lwenyongo, olubala lube ngamatshe amancane. Ngakho-ke, i-lithiasis yomgudu omkhulu we-bile ubonakala ngokuba khona kwamatshe emigodini ye-bile. Lawa ma-gallstones, ngokunembile, angabangelwa ukuvela kasawoti we-cholesterol ongaxazululeki emithonjeni ye-bile. Kwesinye isikhathi leli nyongo ligudlulela emgodini omkhulu we-bile, umgudu ovamile we-bile. Ngemuva kwalokho kubanga ukuhlaselwa okubuhlungu, okungalandelwa umkhuhlane kanye ne-jaundice ngenxa yokuvaleka komsele ovamile we-bile.

Ukwelashwa kwe-lithiasis yomgudu ovamile we-bile kuvame ukuhlanganiswa okuhlukahlukene.

• Ngakolunye uhlangothi, i-cholecystectomy (ukususwa kwe-gallbladder) yenza kube nokwenzeka ukucindezela ukwakheka kwamatshe enyongo;
• Ngakolunye uhlangothi, itshe elikhona emgodini ojwayelekile we-bile lingasuswa phakathi nalesi cholecystectomy, noma ngisho nasezinsukwini ezilandela ukungenelela kwe-gastroenterologist, ngesikhathi sokuhlinzwa okubizwa nge-endoscopic sphincterotomy.

Ukususwa kwe-gallbladder akubangeli noma yiluphi ushintsho olukhulu lomzimba. Ngaphezu kwalokho, ngeke kudingeke ukulandela ukudla okukhethekile ngemuva kwalokho.

I-choledochal lithiasis kwesinye isikhathi iyalingana: ingatholwa ngesikhathi sokuhlolwa. Lapho ibangela ukuvinjelwa kwe-biliary, okubizwa nangokuthi i-cholestasis, kubangela i-jaundice (i-jaundice) kanye nobuhlungu bohlobo lwe-colic type. Ukuxilongwa kwesinye isikhathi kungasolwa ngokuhlolwa ngudokotela ohlinzayo.

Ukuhlolwa okujule kuyodingeka:

• Ezingeni lezinto eziphilayo, kungaba khona izimpawu ze-cholestasis, njengokunyuka kwe-bilirubin, i-gamma GT (GGT noma i-Gammaglutamyl-transferase), ne-PAL (i-alkaline phosphatase) kanye naleyo yama-transaminases;
• I-ultrasound yesisu ingabonisa ukunwebeka kwamapayipi enyongo;
• I-endoscopic ultrasound, okungenzeka ihlotshaniswe noma cha ne-bili-MRI izokwenziwa kaningi, ngenhloso yokubona ngeso lengqondo i-lithiasis futhi ngaleyo ndlela iqinisekise ukuxilongwa.

Ngokwesiko, igama elithi cholédoque livela esiGrekini "kholé" okusho ukuthi "inyongo", kepha futhi "nenyongo" kanye "nentukuthelo". Ngokomlando, kufanele kuqashelwe ukuthi e-Antiquity, futhi kuze kube yilapho kutholakala ku-physiology yomuntu okwenza umuthi ube ngowesayensi ngokweqiniso, kwakuyisiko ukuhlukanisa lokho okwakubizwa ngokuthi "amahlaya" amane kaHippocrates. Elokuqala kwakuyigazi: livela enhliziyweni, lalichaza uhlamvu lwegazi, oluchaza umlingiswa oqinile nothonile, futhi futhi luthokozela ngokweqile. Esesibili kwakuyi-pituitis, enamathiselwe ebuchosheni, yayihambisana nesimo se-lymphatic, esibizwa nangokuthi i-phlegmatic. Okwesithathu kwama-humours ahlongozwa nguHippocrates bekuyinyongo ephuzi, eqhamuka esibindini, ebesihambisana nokuthukuthela okuthukuthele. Ekugcineni, ibile elimnyama noma le-atrabile, elivela ebuchosheni, labekwa icala ngomlingiswa odangele.