CN100450561C

CN100450561C - Anterograde inside duct for choledochus-duodenum

Info

Publication number: CN100450561C
Application number: CNB2006101052070A
Authority: CN
Inventors: 周群; 王克成; 高建宏; 李伟; 吴宁; 张波
Original assignee: NO 451 HOSPITAL PLA
Current assignee: NO 451 HOSPITAL PLA
Priority date: 2006-12-19
Filing date: 2006-12-19
Publication date: 2009-01-14
Anticipated expiration: 2026-12-19
Also published as: CN1973915A

Abstract

The anterograde inside duct for choledochus-duodenum includes one hose with raised ribs and homogeneously distributed holes, one bullet-shaped biliary tract probe in the front end of the hose, and one sacculus or stacked wing in the middle of the hose, and the hose contains barium powder in its material or has barium string embedded in its wall. The anterograde inside duct is set inside choledochus-duodenum for anterograde draining, supporting the sphincter and avoiding inflammatory stenosis. It is soft, safe and reliable, and may be used to dredge choledochus without damaging body tissue and generate treating effect.

Description

Anterograde inside duct for choledochus-duodenum

Affiliated technical field

The present invention relates to a kind of interior drainage of biliary tract and intestine conduit that abdomen or peritoneoscope biliary tract surgery are used of opening, specifically, it is the conduit that drain and sphincter (full name Oddi sphincter) short-term support in a kind of common bile duct-duodenum direct motion.

Background technology

Cholelithiasis is fallen into common bile duct easily and is caused obstruction of biliary tract, needs the excision gallbladder to assist and removes obstruction of common bile duct.Referring to Fig. 6, gallbladder assist 16 cut after, liver 15 excretory bile will enter duodenum 11 by common bile duct 10, because biliary tract is not smooth, bile flow produces fluid pressure to common bile duct, makes the operative incision on the common bile duct be difficult to healing, therefore, need mediation biliary tract and bile drainage, alleviate bile flow, make wound healing choledoch-pressure.In the prior art, be applied to clinical drainage method and generally be divided into two classes, the first kind is a T type pipe external drainage method, it is most widely used clinically at present a kind of, the transverse tube that is T type drainage catheter is inserted in the common bile duct 10, its vertical tube stretches out stomach wall, outside the bile lead body, as: U.S. Pat 5273534.The major defect of this T type external drainage method is: a large amount of biliary drainages go out the disorder that external meeting causes patient's dyspepsia and organismic internal environment, the stomach wall draining wound can increase patient's misery, if mistake is pulled out conduit or conduit and come off and also can cause fatal biliary peritonitis, overall complication is higher.Second class is the interior drainage method of support that drives in the wrong direction, the used drainage catheter of this method is a kind of support tube of hard, it carries by duodenoscope, stretch into duodenum 11 from gastral cavity 17, dispose common bile duct from sphincter 12 again, this kind method need be cut sphincter, inserts this drainage stent pipe again, its main effect is to support common bile duct to go into the intestinal mouth, the oncothlipsis around the prevention and cause obstruction of biliary tract.The problem of this kind method is: cut sphincter and substitute with hard conduit, make sphincteral switching afunction, can cause bleeding simultaneously, complication such as duodenal injury and pancreatitis, moreover, during operation technique, because the hard rack pipe has been carried in gastroscope or duodenoscope, the operation that makes endoscope is difficulty, time-consuming, effort not only very, and it is dangerous big, therefore, the method of being somebody's turn to do the drain of driving in the wrong direction belongs to biliary tract, pancreas tumor palliative therapy method, is not suitable for being used in the treatment of common optimum obstruction of common bile duct disease drain.At present, yet there are no the reported in literature of in common bile duct-duodenum direct motion drainage method or utensil.Drainage method is between common bile duct 10 and duodenum 11 conduit to be set in common bile duct-duodenum direct motion, by this conduit bile is introduced duodenum; When conduit is set, need from otch 9 conduit be inserted in the common bile duct then, stretch to duodenum downwards from common bile duct again at common bile duct 10 upper cuts.Drainage method does not have intubate in this direct motion on stomach wall, and bile does not outflow, and need not cut sphincter, compare with the interior drainage method that drives in the wrong direction with above-mentioned T type pipe external drainage, have the advantage safe, that misery is little, side effect is little and complication is few, simultaneously, operation technique is also much easier than drain in driving in the wrong direction.Though the drainage method tool has an enormous advantage in the direct motion, but the clinical difficulty that implements is bigger, main cause is that sphincteral passage is narrow, and its inner chamber has ductus pancreaticus mouth 14, if at sphincteral slype drainage catheter is set, then be easy to stop up the ductus pancreaticus mouth, thereby cause danger, and the easy slippage of built-in drainage catheter, in the extremely difficult control of choledoch-holdup time, so, in the direct motion up to the present drainage method also have no talent be applied to clinical.

Summary of the invention

The objective of the invention is in order to solve the problem in the prior art, a kind of Anterograde inside duct for choledochus-duodenum is provided, application by this conduit, make the method for drain in common bile duct-duodenum direct motion can be safely, realize reliably, thereby misery and the harmful effect of avoiding T type pipe external drainage to bring to the patient, and this conduit is had concurrently visit logical, expand common bile duct and short-term supports sphincteral therapeutical effect.

For achieving the above object, technical scheme of the present invention is as follows: it comprises a flexible pipe, the front end of this flexible pipe has a warhead shape biliary tract probe, be provided with a ball assists or folds the wing at the middle part of flexible pipe, this ball assist or the radially area of folding the wing greater than the sphincter sectional area less than the common bile duct sectional area, assist or fold on the hose wall between the wing at described biliary tract probe and ball and be provided with vertical convex tendon, this vertical convex tendon is circumferentially evenly arranged at interval along tube wall, on hose wall, also be provided with uniform side opening, contain in the described hose material and be embedded with a barium line on barium powder or the tube wall.This conduit quality bullet is soft, during operation technique, needs a metal probe is through in the conduit, make conduit have certain rigidity, simultaneously probe is bent to required shape, makes its easily through common bile duct, when conduit insert put in place after, its front portion is positioned at duodenum, the ball at its middle part is assisted or is folded the wing and is stuck on the distal common bile duct sphincter, and afterbody is positioned at common bile duct, at this moment, bile can enter conduit by the side opening on the duct wall, and enters duodenum along catheter drainage.

Characteristics of the present invention are as follows:

One, the ball at this conduit middle part is assisted or is folded the wing and is stuck on the distal common bile duct sphincter, prevented the slippage of conduit, simultaneously, one section pipe of the vertical convex tendon of conduit band is positioned at sphincter, make between duct wall and the sphincteral slype and leave the slit, avoid blocking the ductus pancreaticus mouth, a difficult problem that has solved the easy slippage of direct motion drainage catheter and blocked the ductus pancreaticus mouth.

Two, this conduit can be discharged naturally by patient's crude fibre food of eating, if can not discharge naturally, can take out by gastroscope, because this catheter proximal end has a probe, so be easy to entangle and extract with the cover line of gastroscope.Like this, this conduit retention time in vivo can artificially be controlled, thereby has solved a conduit unmanageable difficult problem of holdup time in vivo.

Three, in the process that this conduit is inserted, that the probe of catheter proximal end can be visited is logical, the expansion common bile duct, plays mediation and expands choledoch-therapeutical effect, and simultaneously, after conduit was inserted and put in place, in its holdup time, it also can play short-term and support choledoch-effect.

Four, this conduit quality bullet is soft, can not damage tissue in inserting process, makes inserting of conduit safe, reliable.

Five, contain in this tube material and be embedded with a barium line on barium powder or the tube wall, make the conduit X-ray visual, be detained position convenience is provided for checking it at any time.

Description of drawings

One of Fig. 1, overall structure vertical profile sectional view of the present invention.

The A-A cross-sectional view of Fig. 2, Fig. 1.

Fig. 3, contour structures sketch map of the present invention.

Two of Fig. 4, overall structure vertical profile sectional view of the present invention.

The B-B cutaway view of Fig. 5, Fig. 4.

Fig. 6, common bile duct-duodenum direct motion drain state diagram.

The specific embodiment

Embodiment 1

Referring to Fig. 1～3, this conduit comprises a flexible pipe 1, and the front end of this flexible pipe 1 has a warhead shape biliary tract probe 2, and this probe is used for visiting logical and the expansion common bile duct, also can prevent the up position of moving of flexible pipe simultaneously; Be provided with a ball at the middle part of flexible pipe 1 and assist 3, the radially area that this ball is assisted less than the common bile duct sectional area, makes it can be stuck in sphincter place suitable for reading greater than the sphincter sectional area, prevents the conduit slippage of inserting; For preventing to block the ductus pancreaticus mouth, on assisting tube wall between 3, biliary tract probe 2 and ball be provided with vertical convex tendon 4, and this vertical convex tendon is along the circumferential even layout at interval of tube wall, and this example evenly is provided with 5; Also be provided with uniform side opening 5 on hose wall, bile can flow into and outflow by uniform side opening; This flexible pipe can make its quality bullet soft with silica gel or pvc material injection mo(u)lding; In order to realize checking with x-ray fluoroscopy the delay position of conduit, ginseng has the barium powder or is being embedded with a barium line (such as the barium line is embedded on the convex tendon) on the flexible pipe in described tube material.

Referring to Fig. 6, when operation technique, earlier a metal probe is penetrated in the conduit, make conduit 1 have certain rigidity, simultaneously probe is curved required camber, handle the probe afterbody then and conduit is sent into the abdominal cavity from incision of abdominal wall, and the flexibility by probe with probe 2 direct sendings of catheter proximal end to common bile duct otch 9, and send in the common bile duct 10 by this otch, again along the downward direct motion of common bile duct to duodenum 11, after the probe 2 of catheter proximal end passes through sphincter 12, promptly finish and insert operation.When conduit insert put in place after, the conduit front portion is positioned at duodenum 11, the ball at its middle part assists 3 to be stuck on the distal common bile duct sphincter 12, prevent the slippage of conduit, its afterbody is positioned at common bile duct, at this moment, bile can enter conduit by the side opening on the duct wall, and enters duodenum along catheter drainage.In inserting the process of conduit, logical limit expansion common bile duct is visited on catheter proximal end biliary tract 2 limits of popping one's head in; For the treatment of dredging and expanding, the process of inserting can repeat several times.Insert finish after, withdraw from probe.When conduit insert put in place after, the biliary tract of conduit probe 2 and ball assist the convex tendon on the tube wall between 3 to make between the inwall of conduit outer wall and sphincter slype always to have the slit, therefore, can avoid conduit obstruction ductus pancreaticus mouth 14, be detained in the intravital time, also can playing the sphincteral effect of supporting.After conduit was inserted and finished, liver 15 excretory bile can enter conduit by the mouth of pipe of tail end of conduit and the side opening on the afterbody tube wall, and imported duodenum by conduit, finished the drain task.After the drain task is finished (being the common bile duct wound healing), can conduit be taken out of from common bile duct by patient's raw fiber food of eating, enter intestinal and discharge, it discharges probability can account for 35%; Owing to contain the barium powder or be embedded with the barium line in the conduit, so can check whether conduit discharges with x-ray fluoroscopy, or inspection conduit position, if can not discharge by crude fibre, then available gastroscope stretches into duodenum from gastral cavity 17, to pop one's head in gastroscope cover line and 2 to entangle, take out of by gastroscope again, conduit retention time in vivo can be controlled for the people fully.

Referring to Fig. 3, more smooth in order to make drain, assist at ball also to be provided with side opening 6 on 3.

Embodiment 2

Referring to Fig. 4,5, the ball of last example is assisted also and can be realized with the folded wing, and three spademans 7 promptly are set on the tube wall at flexible pipe 1 middle part, because spademan quality bullet is soft, so, when conduit is pulled out with gastroscope, spademan can fold under sphincteral restriction, thereby smoothly conduit is pulled out.

Claims

1, a kind of Anterograde inside duct for choledochus-duodenum, it is characterized in that: it comprises a flexible pipe (1), the front end of this flexible pipe has a warhead shape biliary tract probe (2), be provided with a ball at the middle part of flexible pipe and assist (3) or the folded wing (7), this ball assist or the radially area of folding the wing greater than the sphincter sectional area less than the common bile duct sectional area, assist or fold on the hose wall between the wing at described biliary tract probe and ball and be provided with vertical convex tendon (4), this vertical convex tendon is circumferentially evenly arranged at interval along tube wall, on hose wall, also be provided with uniform side opening (5), contain in the described hose material and be embedded with a barium line on barium powder or the tube wall.

2, Anterograde inside duct for choledochus-duodenum according to claim 1 is characterized in that: described ball is assisted and is provided with side opening (6).