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H@kwjǮ cu-ioc

hjJ箳 MvJj ohj Sk Jk J[Unv Hv Du. `[@kwj, cu hM箳 K[bv Dio ypj kv ku Dn. lJ< knlj un v! cnCp cu GhjbJ< vC& IC mh nF&u.` l JvblcOu Dp&J, m箮hC DC JvMul DJnjC Mkw vJnl. l mӮvu cv oTv Dp箳 uKbku jbY kjl Dn. hM箳 vJv K[ H[Ch# hMlu K[b Ghjb Tnhn kjl.
hM cnCp k=l箳 Yuc s$Ku o[uu Sk sM hMJ. [WijKu Gboj o[J lM! hC n Gboj pJn [Wij hK uil, lJn l vo&uv Dhjn& jl. hDj HUmjK Dkj Dmuu 7.5 l 12 mW. c. ubyǮ n hMJ k=lv vc&C kuu hjm mJC kc kjl. mcj 50 c. u. jm mJC #cl yUiCj n hMJ. Dhu #clh# Dvk hRv cn nT Mkl. hjm n Sk cnJ hkjm. DVhv k& hjmMJ KUbyuu. pj l JUm i l cCl hjm unv Dl[k[ hnJCj vU hjmJnv(Common bile duct) k=lk[v Dl[k[ plv cOu Sk Lby Il DC l cnCp hM. hM箳 bLcO v hv nl, v DV-jm cuv. hC mE[i箳 mMv U c$ vnc cv ^@kM p[uu jnll. JUJU hMJǮ Dkbv nTv hjm Dl[cO hnl jnl. k=lv vc&C kuu hjm, llu hC DC #jb M<C kv 5 l 10 h lJ kjC kcn hM kjl. ovnn kJlj oJmiCk mcj 20 c. u. hb{j Ʈk JbiC (Mucous) hMl lj nl.
hvmbmL Dm n MW[HU vc&C nl, l cU unv Dl[bhmv GpJk[ Huu Sk olW[ Hhmv. kO kO l v|cl Kbl, lj kO kO vncǮ hDj DkjSJp W blkjkb [kwJj `mJlb$ h`mjK n hMJ ubyuk Dkj OjC kjl. kn JUu l k=l箳 DblY&il [Wijlu inmjK o[v jnl, lj kn JUu kCln hM ci vmumjK Flmll: Gb[jl jnl. ynlbM JUu l SkǮ Dml. c$, kO kO hjcj hMun pU oCi ol.
hM箳 hMJǮ jJn k=lk[v GmvJjJj Iluu Dml. Flk vn lj cK hjmJnvu pUCj n mJl: Sk sKv hjmJnv (Cystic duct) Dml. n jJn (Cystic artery) DC hJnvǮ p[CI[C DC pUCcO DmbK HjHj Puu D{Uv ll. k=lynj n h P[ (Extrahepatic biliary tree) Dhu Hbb jvcO p JJO oKJl, l hnuJj cvJ Mjj- jv klk Jl.
n JJO vJK mp&vu c$ ykUl kl DC kO kO mp&v Mm$Ƭlu vC&n kl. Hmuu Dbop DC vmuu D[K Elpvk hjmLl vc&C k Mkll. DC cnCv hMJj Mm$Ƭ MuMm$箳 cjmoju DC mp&v箳 cvcjlyu DJnvlck jll.
DM hMcO nCj K[ n Dio pil mJ& oMbcO, mJ& JbM-plRcO k<&v D{UCj Dm Dpj Dn. pi箳 SkC ukmbKhk 20 kwk ukbcO n Dpj D{Ul. DcjkcO cC mcj 10 kwk Flk Dn. lj Dhu oMl l pJUhm 4.3 kwk Flk Dn. Gj Yjll DC JM<l: hbpycO yu Dn. n K[ k lj nll, Jj kuJj Dm omv l k, hjm箳 IvcO K[b kjC o[uu Dnl. kumj@u, #j DC kn h-Jbv hjm lj nl. kumj@u c$ cCh# DOk PuJj DC hMv hC M<v IluJj n ku@mj@u s s mHkb hv ci Gjll. nUnU n `mHkcC` yUm Ojll DC llv kumj@u K[ lj nl. FL c$ kumj@u箳 LWyblv D#jM: Mk[bv K[-j#m pvcu ll. pmpm J J{l lmlm hjmlu kumj@u cC J{l. m$b yyll n cC h<bh# DOk Dml DC kbyvpv kjCm ncxv箳 `hum` ICN m$ JOml nC Mkwl Dvk hRv J{l. m$ DC hK[ b mbybO Flk vpk Dn k, Dc箳 hmlkbcOv vlmbybO JC&v A fat, fertile, flamboyant, flatulent female of fifty. ' `hVMǮ mljl, h{ h{ kjCj h$-h$Jl hjbO- {` Dm kuu Dn. DL&l n JC&v lbllbl DC llkm Kj vn. Dio yuJhmv l MbYjhl n K[ Dhu mLmbil kjll. Dc箳 yuMuƮklm JYil iu lv J<lu Mm$Ƭb Dcn vkl D{J Ilu. lJn Dm omv Du k, lv J<hmv yj J<hl箳 Jlu Jm cubJj Dcn hM箳 K[bm Mm$Ƭ ku nl. kumj@u箳 J{J c$cC omj cnJ kjC cnCp hjm DC hMu Puu pblmbmi&. pbl-pJC hMl cjll DC hM c$ lb mcjCL& K[箳 hv Sk L[i ybOl. Dhu oMl JiJiU kj pbl DC k=c hvmbmLl Dio nkwkv Ij kv jnuu Dmll. kn iu, uby[ pbl hjmJnvlv hMln hnll DC lL c$ lb Jp JuǮ mcjCL& Sk mcjk-mlbY ybOu pl. Dl[k[ hjm Jnv vCN ci&l kn `jml jk` Pu k K[bv jbY Pu cnCv mcp. j箳 hMR Nnm nCN kn JkjbcOn (Sickle cell disease) hMcO K[ nll. cOcn J DC mJoEh[箳 iCbcOn n Jkj D{Uv l. yNM iCbv hM箳 K[bhmv kCln $m nl vn. omN SK kjCm h箳 mvHl l D{Uv ll. kn iC c$ Flk moJ vmll. j$Ǯ JU L[Hj Yjh pJC PuJj hl Jj GpJ ypm oK uil. OC hjiUum Jov nl. GpJ Kbk[n Jov nll. KuJj m IC kC nl. Jov n `D@@k` kn cvbhmv kn lmbhl u jnl. Gu DC cUcU pCJl. lW[l k[J J l. kn iCbcO hMu Dvk mp l DC ibYj mbi D{Jl. K[ pj hjmJnvcO D[ku lj hjm Jnv vC kc Lbyl DC DJjOl kJU (obstructive jaundice) nl. [U, vK, lJ bJj njJ hJU Pk l DC Dbiu kb[ m uil. kJUǮ oY&J J{u k bmjK OJu MbKm hJU om uil DC -
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pY Sko k hv o<l Pu k mKjm k[J ui uil. hC mN u#Cbmn pj Lb[ Jpv lh T uiu DC oO jbi M̮m nT uiu, lj c$ llkU Jkdz muu IJ.
ynlk mJ& iCb vov mvHǮ lhml nTv pl. kn iCbv kjClmia n[ (HIDA) mk@vn mJu pl. m mk@v DC Sc. Dj. mk@vvn hci&, mJoEh[ DC hM lhmC kjl l. hM箳 K[b vov vƽl PuJj mp&j kv K[bmnl hM k{v kC muu [@kwj oll. hM k{ucU Hjm kCln Dh nl vn. hC kJU K[ k{v hM ci Ju lj hvn K[ nC Ok mbYJl. hM k{C Mm$Ƭ J<&vJ<x hjbhjk hlv h GI[v ku pl Dm. 1985 hmv nǮ Mm$Ƭ o|yClv (Laparoscopic) hlv ku pl. Dp o|yC Mm$Ƭ nǮ hMm Lc hmblǮ cvu pl. hjbhjk Mm$Ƭ kum iC Ij pu mn oJm DC kcJj pu mn DJ[ uill. lj o|yC Mm$Ƭv n kuJO mn lm DC mn oJm Dm youuu Dnl. Dc箳 yuiC MuƬ JYil o|yCv hM k{uu Dc iC mbOkU k@jc- h- mhM[ KUll DC omN oJM ohj Dhhu Ij pll. Flk n Mm$Ƭ yvk DC vOxk Pu Dn. Mm$Ƭu IyjCN kn cb[URJj K[ JjIUJCN Gmx[D@kwmkuk D@m[ D<O i kjl l.
hjbhjk DJzkcO hM箳 K[bJj ov kj D<O mJuu Dnl. uJnjlHx vc&C nCN hjm cC J{JC DC hM Dkbv-mjC #cl J{JC. DMkj Jv<O kc kjll. Dak, nUo, Hwcj, yyxj, [@C[uD@v DM Dvk D<O mbiluu Dnl. JOJj Fup kjCh# J-J=Jj Hbkj IuCN ncDh@LcOn yyxjm Jnui@jm, k@ukj kyxvk, kuEmLm, [mkjD DM D<O hMpv hoKJj mJuu Dnl. kMcj (Yjldz DC hkJhl) blcO 5 l 10 H J{CN muyc c@jD@vc vJ箳 P[箳 kj hv-Hubhmv Sk Ʈk hb{N jbi J cUl. `cjpd cuk` cnCv Klkla Dmuu J Ghi Dio jcv mbmk=lhmv Dplil mJv h箳 MkjCm DC Jnvm ku pl. muc@jv (P[ IkJ) jp 420 c. @c mJv kum K[ nC Mkwl kc nl. mHjbo jm, Euy jm, cuk D@H c@ivM, m pJvmJ, Lb[ij hC DC hhjc EkJ D@uJn D@F&u b hlMj mJvv mKU D{umjK hM K[ (Gall Bladder Flush) k{C Sk Ƭn JC&v kuu Dn. hC Sk vƽl k, mJ& hlRcO hjCc km nF&u K$ vn. lJn D@hjMv n Dkwmj Fup!
hMl K[ nT vl m kn lybOlck Gh Dnl k, n Jjl IC cnJ. Db[, cbm b mJv kc kjC, MknjJj Yj oC, kumj@u c$ kc kjC, jp MI Jiv uC Jc IC- n lybOlck Gh Ghi jll. Jpvoj, mLu JRv Phv Jpv kc v kjC cnJ. DvL hM箳 K[b Ok mbYJl.
k=l箳 cnk s$Ku Dbi c[hv ymuu Dm n FJum Fb. c H@kwjǮ D[Mu llu cu ioc DmJ Dm. ioc mv Yjuu Dmlv lu kvckv Di uiuJj H@kwjǮ k DJmL nF&u, n JiU mbiu k hnp?

 
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