CN100475163C - Biliary duct jejunum anastomotic scaffold - Google Patents
Biliary duct jejunum anastomotic scaffold Download PDFInfo
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- CN100475163C CN100475163C CN 200510061559 CN200510061559A CN100475163C CN 100475163 C CN100475163 C CN 100475163C CN 200510061559 CN200510061559 CN 200510061559 CN 200510061559 A CN200510061559 A CN 200510061559A CN 100475163 C CN100475163 C CN 100475163C
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Abstract
The invention relates to a biliary tract support, which comprises tubular main body made from the material matched with body; the first protruded ring, the second protruded ring, and the extending part far away the second protruded ring, wherein the invention can avoid stitching match open, to save time, avoid directly function biliary tract match open with bile, without leakage, confirm enough blood supply, confirm successful flow of bile, and improve treatment effect.
Description
(1) technical field
The present invention relates to a kind of biliary duct jejunum anastomotic scaffold.
(2) background technology
The method of execution cholangio-jejunostomy is two kinds at present: manual suture method and anastomat stitching method; The former is time-consuming, and difficulty is big, especially abdominal cavity arthroscopic diagnosis; The latter is quick, definite, but the expense costliness, and the bile duct that is only applicable to expand.In addition, existing gallbladder intestinal anastomosis can not fundamentally be avoided the generation of complication such as the leakage of anastomotic stoma gallbladder, anastomotic stricture.
(3) summary of the invention
In order to overcome the manual suture method execution deficiency that cholangio-jejunostomy is time-consuming, difficulty is big in the prior art, and anastomat stitching method is carried out cholangio-jejunostomy expense costliness, the deficiency that the scope of application is little, and aforementioned two weighing methods easily cause the deficiency of complication, the invention provides a kind of biliary duct jejunum anastomotic scaffold, easy and simple to handle when carrying out the bile duct jejunum, cost is low, the scope of application is big, can avoid causing all kinds of complication.
The technical scheme that the present invention solves its technical problem is:
A kind of biliary duct jejunum anastomotic scaffold comprises the tubular body of being made by the acceptable material of human body, has first bulge loop, second bulge loop on the described tubular body, and described tubular body has the tubular body extension at the first bulge loop place away from second bulge loop, one end.Here the acceptable material of said human body recommends to select for use the absorbable material of human body, as: the macromolecular material of Nondegradable: PE, PP, PS, PVC, polyacrylate, politef, polypropylene nitrile, polyformaldehyde, polysiloxanes, aromatic polyester etc.; Natural degradable macromolecular material: collagen, alginic acid, cellulose, chitin, gelatin, hyaluronic acid, polypeptide, agarose etc.; The synthesized degradable macromolecular material: the copolymer (PLGA) of polylactic acid (PLA), polyglycolic acid (PGA), lactic acid and glycolic, polyvinyl alcohol (PVA), polyamide, polyurethane, polycaprolactone, poly butyric ester, poly-fumaric acid are third rare, mucopolysaccharide etc.; Bio-vitric and pottery: hydroxyapatite, tricalcium phosphate, Gypsum Fibrosum, Al
2O
3
Between the sidewall of described first bulge loop and the described tubular body in obtuse angle, between the sidewall of described second bulge loop and the described tubular body in obtuse angle.Can avoid the hydrops of junction between the sidewall of first, second bulge loop and the described tubular body in obtuse angle.
Described first bulge loop, second bulge loop all become centrosymmetry with the axis of described tubular body.
Described first bulge loop, second bulge loop all become annulus.
Described second bulge loop is positioned at the end of described tubular body.
Obtuse angle between the sidewall of described first bulge loop and the described tubular body is 130 °～150 °, and the obtuse angle between the sidewall of described second bulge loop and the described tubular body is 110～120 °.
Described first bulge loop is triangular in shape at the radial section of tubular body portion, and described second bulge loop is trapezoidal at the radial section of tubular body portion.
Further, the wall thickness of described tubular body and tubular body extension is 0.3～0.8mm, the internal diameter of described tubular body and tubular body extension is 3～15mm, the bottom width degree of described first bulge loop in the radially triangular-section of tubular body portion is 2～6mm, first bulge loop, tubular body length between second bulge loop is 4～10mm, second bulge loop is 0.5～3.0mm at the width of going to the bottom of the radially trapezoid cross section of tubular body portion, the height of projection of described first bulge loop is 1～5mm, the height of projection of described second bulge loop is 1～10mm, and the upper base width of described second bulge loop in the radially trapezoid cross section of tubular body portion is 0.2～1.5mm.
Further, the length of described tubular body extension is 3～5mm.
The intestinal wall that coincide during operation cuts one and the corresponding otch of bile duct opening, does a purse string suture with absorbable thread along the parameatal bile duct wall of bile duct, wouldn't tighten up purse wire; Do a purse string suture with absorbable thread respectively along parameatal seromuscular layer of jejunum and mucous layer, wouldn't tighten up purse wire.Described biliary duct jejunum anastomotic scaffold end is inserted jejunum from the jejunum opening, and the bulge loop of support end is close to the jejunum wall, tightens up jejunal mucous membrane layer purse string suture and ligation on the tubular body between first, second bulge loop.The support front end is sent into the bile duct opening, tighten up the bile duct wall pocket, on the tubular body between first, second bulge loop, and make bile duct inner membrance and jejunal mucous membrane close apposition with the same ligation of jejunal mucous membrane pocket.On draw the jejunum seromuscular layer, after it covered bile duct inner membrance and jejunal mucous membrane apposition position (tubular body between first, second bulge loop), tighten up the pocket ligation on the tubular body extension, avoid the ligation tension.Ligation one absorbable thread outside the last jejunum seromuscular layer between first, second bulge loop, ligation can not tensions, make the jejunum seromuscular layer paste the bile duct inner membrance and the jejunal mucous membrane apposition position gets final product.
Beneficial effect of the present invention is: 1. anastomotic stoma need not be sewed up, and has saved the time greatly.2. support has been isolated bile and gallbladder intestinal anastomotic stoma, has avoided the direct effect of bile to the gallbladder intestinal anastomotic stoma, closely is coated with the jejunum seromuscular layer at bile duct inner membrance and jejunal mucous membrane apposition position skin simultaneously, thereby has thoroughly stopped the generation that the anastomotic stoma gallbladder leaks.3. the bile duct broken ends of fractured bone need not too much to dissociate, and has guaranteed that not only the bile duct broken ends of fractured bone has sufficient blood confession, and is suitable for the hilar bile duct and the stones in intrahepatic bile duct of the free difficulty of the bile duct broken ends of fractured bone.4. can absorb support and have support function, guaranteed the unobstructed of anastomotic stoma, can reduce the biliary tract harm that intestinal juice and bile reflux bring, simultaneously, inner support is by the outward force effect and isolate the stimulation of bile to anastomotic stoma, (the anastomotic stoma scar hyperplasia takes place in June usually to suppress, alleviated the hyperplasia of anastomotic stoma cicatrix, and the absorption cycle of inner support is 1.5～2 years), avoid anastomotic stoma because of the anastomotic stricture that scar hyperplasia, cicatricial contracture cause, improved the late result that the gallbladder intestinal coincide.
(4) description of drawings
Fig. 1 is embodiment one a described vertical section structure sketch map of the present invention.
(5) specific embodiment
Below in conjunction with the drawings and specific embodiments the present invention is described in further detail.But protection scope of the present invention is not subjected to the restriction of following embodiment, and for example second bulge loop might not be positioned at the end of tubular body, and the concrete shape of first, second bulge loop is not subjected to the restriction of following embodiment yet.
Embodiment one
With reference to Fig. 1, a kind of biliary duct jejunum anastomotic scaffold, comprise the tubular body of making by human body absorbable material polyglycolic acid (PGA) 1, have first bulge loop 2, second bulge loop 3 on the tubular body 1, the axis that first, second bulge loop is with described tubular body becomes centrosymmetric annulus, and second bulge loop 3 is positioned at the end of described tubular body 1.Tubular body 1 has tubular body extension 4 the first bulge loop place away from second bulge loop, 3 one ends.The sidewall of first bulge loop 2 and tubular body 1 are one 135 ° obtuse angle, are one 115 ° obtuse angle between the sidewall of second bulge loop 3 and the tubular body 1.First bulge loop 2 is triangular in shape at the radial section of tubular body portion, and second bulge loop 3 is trapezoidal at the radial section of tubular body portion.The size of this support is as follows: the wall thickness of tubular body 1 and tubular body extension 4 is 0.5mm, the internal diameter of described tubular body and tubular body extension is 6mm, the length of tubular body extension 4 is 4mm, the bottom width degree of described first bulge loop in the radially triangular-section of tubular body portion is 5mm, first bulge loop 2, tubular body length between second bulge loop 3 is 5mm, second bulge loop is 1mm at the width of going to the bottom of the radially trapezoid cross section of tubular body portion, the height of projection of described first bulge loop 2 is 2mm, the height of projection of second bulge loop 3 is 2.5mm, and second bulge loop is at the upper base width 0.5mm of the radially trapezoid cross section of tubular body portion.
The intestinal wall that coincide during operation cuts one and the corresponding otch of bile duct opening, does a purse string suture with absorbable thread along the parameatal bile duct wall of bile duct, wouldn't tighten up purse wire; Do a purse string suture with absorbable thread respectively along parameatal seromuscular layer of jejunum and mucous layer, wouldn't tighten up purse wire.Described biliary duct jejunum anastomotic scaffold end is inserted jejunum from the jejunum opening, and second bulge loop 3 of support end is close to the jejunum wall, tightens up jejunal mucous membrane layer purse string suture and ligation on the tubular body between first, second bulge loop 1.The support front end is sent into the bile duct opening, tighten up the bile duct wall pocket, on the tubular body between first, second bulge loop 1, and make bile duct inner membrance and jejunal mucous membrane close apposition with the same ligation of jejunal mucous membrane pocket.On draw the jejunum seromuscular layer, after it covered bile duct inner membrance and jejunal mucous membrane apposition position (tubular body between first, second bulge loop), tighten up the pocket ligation on tubular body extension 4, avoid the ligation tension.Ligation one absorbable thread outside the last jejunum seromuscular layer between first, second bulge loop, ligation can not tensions, make the jejunum seromuscular layer paste the bile duct inner membrance and the jejunal mucous membrane apposition position gets final product.
Embodiment two
A kind of biliary duct jejunum anastomotic scaffold, comprise the tubular body of making by hydroxyapatite, have first bulge loop, second bulge loop on the tubular body, the axis that first, second bulge loop is with described tubular body becomes centrosymmetric annulus, and second bulge loop is positioned at the end of described tubular body.Tubular body has the tubular body extension at the first bulge loop place away from second bulge loop, one end.The sidewall of first bulge loop and tubular body are one 130 ° obtuse angle, are one 110 ° obtuse angle between the sidewall of second bulge loop and the tubular body.First bulge loop is triangular in shape at the radial section of tubular body portion, and second bulge loop is trapezoidal at the radial section of tubular body portion.The size of this support is as follows: the wall thickness of tubular body and tubular body extension is 0.3mm, the internal diameter of described tubular body and tubular body extension is 3mm, the length of tubular body extension is 3mm, the bottom width degree of first bulge loop in the radially triangular-section of tubular body portion is 2mm, first bulge loop, tubular body length between second bulge loop is 4mm, second bulge loop is 0.5mm at the width of going to the bottom of the radially trapezoid cross section of tubular body portion, the height of projection of described first bulge loop is 1mm, the height of projection of second bulge loop is 1mm, and the upper base width of second bulge loop in the radially trapezoid cross section of tubular body portion is 0.2mm.Operation method is with embodiment one.
Embodiment three
A kind of biliary duct jejunum anastomotic scaffold, comprise the tubular body of making by cellulose, have first bulge loop, second bulge loop on the tubular body, the axis that first, second bulge loop is with described tubular body becomes centrosymmetric annulus, and second bulge loop is positioned at the end of described tubular body.Tubular body has the tubular body extension at the first bulge loop place away from second bulge loop, one end.The sidewall of first bulge loop and tubular body are one 150 ° obtuse angle, are one 120 ° obtuse angle between the sidewall of second bulge loop and the tubular body.First bulge loop is triangular in shape at the radial section of tubular body portion, and second bulge loop is trapezoidal at the radial section of tubular body portion.The size of this support is as follows: the wall thickness of tubular body and tubular body extension is 0.8mm, the internal diameter of described tubular body and tubular body extension is 15mm, the length of tubular body extension is 5mm, the bottom width degree of first bulge loop in the radially triangular-section of tubular body portion is 6mm, first bulge loop, tubular body length between second bulge loop is 10mm, second bulge loop is 3mm at the width of going to the bottom of the radially trapezoid cross section of tubular body portion, the height of described first bulge loop is 5mm, the height of second bulge loop is 10mm, and the upper base width of second bulge loop in the radially trapezoid cross section of tubular body portion is 1.5mm.Operation method is with embodiment one.
Embodiment four
A kind of biliary duct jejunum anastomotic scaffold, comprise the tubular body of making by polyacrylate, have first bulge loop, second bulge loop on the tubular body, the axis that first, second bulge loop is with described tubular body becomes centrosymmetric annulus, and second bulge loop is positioned at the end of described tubular body.Tubular body has the tubular body extension at the first bulge loop place away from second bulge loop, one end.The sidewall of first bulge loop and tubular body are one 110 ° obtuse angle, are one 150 ° obtuse angle between the sidewall of second bulge loop and the tubular body.First bulge loop is triangular in shape at the radial section of tubular body portion, and second bulge loop is trapezoidal at the radial section of tubular body portion.The size of this support is as follows: the wall thickness of tubular body and tubular body extension is 0.6mm, the internal diameter of described tubular body and tubular body extension is 10mm, the length of tubular body extension is 4mm, the bottom width degree of first bulge loop in the radially triangular-section of tubular body portion is 4mm, first bulge loop, tubular body length between second bulge loop is 7mm, second bulge loop is 2mm at the width of going to the bottom of the radially trapezoid cross section of tubular body portion, the height of described first bulge loop is 2mm, the height of second bulge loop is 3mm, and the upper base width of second bulge loop in the radially trapezoid cross section of tubular body portion is 1mm.Operation method is with embodiment one.
Embodiment five
The biliary duct jejunum anastomotic scaffold of Application Example one is done new gallbladder intestinal anastomosis to experiment pig, and the result is as follows:
The application test group: 10 (new gallbladder intestinal anastomosis) and matched group 10 (manual suture gallbladder intestinal anastomosis) compare:
1. finishing the gallbladder intestinal coincide the time:
Abdominal: every 4-12 of test group minute; Matched group: every 25-40 minute laparoscopic surgery: every 10-25 of test group minute; Every 40-85 of matched group minute
2. peri-operation period complication: gallbladder leaks incidence rate: test group is 0% (0/10), and matched group is 20% (2/10); Two groups are not had other complication.
3. peri-operation period mortality rate: two groups are 0%.
4. two groups of experiment pig body weight of postoperative change there was no significant difference.
Claims (3)
1. a biliary duct jejunum anastomotic scaffold comprises the tubular body of being made by the human body acceptable material, has first bulge loop, second bulge loop on the described tubular body, and described tubular body has the tubular body extension at the first bulge loop place away from second bulge loop, one end; Between the sidewall of described first bulge loop and the described tubular body in obtuse angle, between the sidewall of described second bulge loop and the described tubular body in obtuse angle; Described first bulge loop, second bulge loop all become centrosymmetry with the axis of described tubular body; Described first bulge loop, second bulge loop all become annulus; Described second bulge loop is positioned at the end of described tubular body; Obtuse angle between the sidewall of described first bulge loop and the described tubular body is 130 °～150 °, and the obtuse angle between the sidewall of described second bulge loop and the described tubular body is 110～120 °; It is characterized in that: described first bulge loop is triangular in shape at the radial section of tubular body portion, and described second bulge loop is trapezoidal at the radial section of tubular body portion.
2. biliary duct jejunum anastomotic scaffold as claimed in claim 1, it is characterized in that: the wall thickness of described tubular body and tubular body extension is 0.3～0.8mm, the internal diameter of described tubular body and tubular body extension is 3～15mm, the bottom width degree of described first bulge loop in the radially triangular-section of tubular body portion is 2～6mm, first bulge loop, tubular body length between second bulge loop is 4～10mm, second bulge loop is 0.5～3.0mm at the width of going to the bottom of the radially trapezoid cross section of tubular body portion, the height of projection of described first bulge loop is 1～5mm, the height of projection of described second bulge loop is 1～10mm, and the upper base width of described second bulge loop in the radially trapezoid cross section of tubular body portion is 0.2～1.5mm.
3. biliary duct jejunum anastomotic scaffold as claimed in claim 2 is characterized in that: the length of described tubular body extension is 3～5mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 200510061559 CN100475163C (en) | 2005-11-14 | 2005-11-14 | Biliary duct jejunum anastomotic scaffold |
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| Application Number | Priority Date | Filing Date | Title |
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| CN 200510061559 CN100475163C (en) | 2005-11-14 | 2005-11-14 | Biliary duct jejunum anastomotic scaffold |
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| CN1965767A CN1965767A (en) | 2007-05-23 |
| CN100475163C true CN100475163C (en) | 2009-04-08 |
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Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101390766B (en) * | 2007-09-21 | 2011-05-18 | 蔡秀军 | Bile-duct anastomosis bracket |
| CN101732113A (en) * | 2008-11-27 | 2010-06-16 | 梁向党 | Preparation method of special instant dissolved stent for intestinal adhesion |
| CN101548903B (en) * | 2009-03-03 | 2012-08-22 | 蔡秀军 | Biliary-enteric anastomosis support tube |
| CN104174072B (en) * | 2014-08-07 | 2016-03-23 | 西安科技大学 | A kind of medical polyurethane pancreas intestine anastomat material and preparation method thereof |
| CN110522483A (en) * | 2018-09-14 | 2019-12-03 | 复旦大学附属华山医院 | Ductus pancreaticus is to jejunal mucous membrane anastomosis bracket |
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| 胆肠吻合术的现代应用. 赵辉等.中国现代普通外科进展，第8卷第4期. 2005 |
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