CN103111011A - Anti-bile-leakage T-shaped tube - Google Patents
Anti-bile-leakage T-shaped tube Download PDFInfo
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- CN103111011A CN103111011A CN201310040184XA CN201310040184A CN103111011A CN 103111011 A CN103111011 A CN 103111011A CN 201310040184X A CN201310040184X A CN 201310040184XA CN 201310040184 A CN201310040184 A CN 201310040184A CN 103111011 A CN103111011 A CN 103111011A
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Abstract
The invention discloses an anti-bile-leakage T-shaped tube which comprises a T-shaped tube composed of a transverse tube and a vertical tube. The anti-bile-leakage T-shaped tube is characterized in that a plurality of micro cholangiography tubes are arranged on the periphery of the vertical tube, wherein the lengths of the micro cholangiography tubes are smaller than the length of the vertical tube, and both two ends of each micro cholangiography tubes are provided with openings. Because the micro cholangiography tubes are arranged on the anti-bile-leakage T-shaped tube, sinus tract forming conditions can be conveniently observed to provide valid evidence to selection of the T-shaped tube and prevention of bile leakage; and meanwhile, the sinus tract forming process can be integrally observed, and therefore bile leakage is effectively prevented and eliminated.
Description
Technical field:
The present invention relates to a kind of anti-gallbladder and leak T shape pipe, relate to for choledocholithiasis and performing the operation with T shape Manifold technology field.
Background technology:
Choledocholithiasis is commonly encountered diseases, the frequently-occurring disease of Genneral Surgery, according to statistics, accounts for 20.1% of Patients with Cholelithiasis.In the patient of the row gallbladder removal same period, nearly 3%-10% patient is associated with choledocholithiasis.Along with the raising of China's living standards of the people, the formation of cholelithiasis spectrum of disease also varies widely, and the sickness rate of Primary Common Bile Duct Stones slightly descends, but the ratio of Secondary Choledocholithiasis increases gradually.
The clinical characters of choledocholithiasis is that course advancement is fast, and symptom is obvious, easily causes the complication such as cholangitis, pancreatitis.From Tohns in 1898, the T Tube Drain is applied to the common bile postoperative, for the patient of choledocholithiasis, common bile is detected and the T Tube Drain is the operative treatment scheme of standard.Along with the raising of peritoneoscope, endoscopic technic and the renewal of medical imaging equipment and technology, the therapeutic modality of choledocholithiasis is also developing gradually, and peritoneoscope and scope are treated to the master at present, and abdominal is auxiliary.Patient for the Minimally Invasive Surgery failure still must process by abdominal, and is still first-selected Therapeutic Method at basic hospital and economically underdeveloped area hospital abdominal.But laparoscopic common bile duct exploration and open abdomen exploration of common bile duct postoperative and must place the T Tube Drain, the effect of T pipe is bile drainage on the one hand, eliminates biliary tract infection, prevents biliary tract stenosis, prevents biliary tract otch seepage of bile, can manage formed sinus tract by T on the other hand and carry out the treatments such as choledochoscope, greatly reduce the incidence rate of the various complication of exploration of common bile duct postoperative.
Can pull out the T pipe in the medical science teaching material in 2 weeks of regulation exploration of common bile duct postoperative, gallbladder leakage, biliary peritonitis appear in the patient of 4-6% owing to nearly having, in case gallbladder occurs to be leaked, when serious, mortality rate is up to 40-50%, therefore the clinician pulls out the time lengthening of T pipe to January from the chief commander, through the incidence rate that clinical statistics still has the 0.9%-1.5% gallbladder to leak, the time lengthening that will pull out the T pipe in existing clinical position is to February, leaks but still have 0.3% patient gallbladder to occur.Analyze gallbladder leakage reason and mainly contain two classes, a class is that tunnel is not good; Another kind of is that operation technique is improper and postoperative care is not in place.The not good reason of tunnel have following some: (1) T tube material, original T pipe is rubber tube, large to tissue irritation, sinus tract more easily forms and is more firm, is difficult for the gallbladder leakage; Now T pipe is for silica gel material, and is little to tissue stimulation, and sinus tract is difficult for forming, and easily occurs gallbladder after tube drawing and leaks; (2) gerontal patient, malnutrition, hypoproteinemia, jaundice, diabetes, prolonged application hormone etc. all affect formation and the fastness of sinus tract.Improper and the postoperative care reason not in place of operation technique have following some: it is improper that (1) T pipe is selected, and T managed thick, and the cutting of galianconism side opening is large not, causes easily during tube drawing that choledochal wall is torn with sinus tract to break; (2) choledochal wall is sewed up tension, easily tears bile duct wall during tube drawing and causes that gallbladder leaks; With T pipe seam by mistake together, cause during tube drawing that bile duct wall is torn and cause gallbladder to leak when (3) choledochal wall is sewed up; (4) T pipe management after operation is not good at, and T pipe slippage in advance accidentally causes gallbladder to leak.Improper and the postoperative care of operation technique is not in place is anthropic factor, can avoid by technological improvement and intensive care, and the not good non-artificial factor of reason of tunnel can not be avoided fully.
Present clinician can only reduce gallbladder leakage generation by extending T pipe indwelling time, and whether because individual variation causes the sinus tract maturation time different, and it is ripe to there is no the clear and definite sinus tract of technology energy before tube drawing.Therefore nowadays be the blindness tube drawing, extend T pipe indwelling time and not only can not avoid gallbladder to leak fully occuring, and give many sinus tracts early mature patients increased painful and inconvenient with pipe.
Summary of the invention:
The purpose of this invention is to provide a kind of T shape pipe that can prevent effectively that gallbladder from leaking.
The technical scheme that the present invention takes is as follows:
A kind of anti-gallbladder leaks T shape pipe, comprises the T shape pipe that is comprised of transverse tube and vertical tube, it is characterized in that: some miniature shadow pipes that shine are installed on the outer circumference surface of vertical tube, and the miniature length of shadow pipe of shining is less than the length of vertical tube; Miniature two ends according to the shadow pipe all are provided with opening.
Further arrange and be:
The length of transverse tube is 10cm, and the length of vertical tube is 30 cm, and the caliber of transverse tube and vertical tube is 0.8 cm.
The miniature shadow pipe that shines is provided with 4 altogether, and evenly is arranged on the outer circumference surface of vertical tube with space 90 degree.
The miniature shadow pipe that shines is provided with 3, and space 120 degree evenly are arranged on the outer circumference surface of vertical tube respectively.
Described miniature caliber according to the shadow pipe is 0.5-2mm.
Described miniature caliber according to the shadow pipe is preferably 1mm.
Described 4 miniature length according to the shadow pipe are the ladder setting.
Described 4 miniature shadow pipes that shine: the longest one is 20 centimeters, and second is 18 centimeters, and the 3rd is 16 centimeters, and the 4th is 14 centimeters.
Described miniature distance of shining the joint portion of shadow pipe and transverse tube and vertical tube is successively decreased with 2cm.
Further, described 4 miniature lower ends according to the shadow pipe are concordant, and the longest miniature distance of shining the joint portion of shadow pipe top and transverse tube and vertical tube is 2cm.
Described miniaturely be connected according to the bonding mode of employing between shadow pipe and T pipe.
Beneficial effect of the present invention is as follows:
1, by the setting of miniature angiography tube, can conveniently observe sinus tract shaping situation, for T shape pipe is chosen and prevents that the gallbladder leakage from providing effective foundation;
2, the applicant passes through many experiments, caliber, length and the spacing setting of miniature angiography tube have been determined, and the distribution of miniature angiography tube on T pipe vertical tube, and the reasonable distance between miniature angiography tube and transverse tube, thereby can be omnidistance, intactly observe the sinus tract forming process, effectively prevent and stopped the generation that gallbladder leaks.
The present invention is further illustrated below in conjunction with the drawings and specific embodiments.
Description of drawings:
Fig. 1 is structural representation of the present invention;
Fig. 2 is the A-A generalized section of Fig. 1;
Fig. 3 is the structural representation of another embodiment of the present invention.
The specific embodiment:
As shown in Figure 1, anti-gallbladder of the present invention leaks T shape pipe, comprises that the T shape that is comprised of transverse tube 10 and vertical tube 11 manages 1 wherein, and the length of transverse tube 10 is 10cm, and the length of vertical tube 11 is 30 cm, and the caliber of transverse tube 10 and vertical tube 11 is 0.8 cm.
In conjunction with shown in Figure 2, some miniature shadow pipes 2 that shine are installed on the outer circumference surface of vertical tube 11, the miniature length of shadow pipe 2 of shining is less than the length of vertical tube 11; Miniature two ends according to shadow pipe 2 all are provided with opening; In the present embodiment, miniature photograph shadow pipe 2 is provided with altogether 4 and evenly is arranged on the outer circumference surface of vertical tube 11 with space 90 degree, described miniature caliber according to shadow pipe 2 is advisable with 0.5-2mm, when wherein caliber is 1mm, effect for best, can be finely completed according to shadow and observe sinus tract shaping situation with whole process.
As preferred embodiment, described 4 miniature length according to shadow pipe 2 are the ladder setting, and wherein one the longest (being labeled as 21) is 20 centimeters, and second (being labeled as 22) is 18 centimeters, the 3rd (being labeled as 23) is 16 centimeters, and the 4th (being labeled as 24) is 14 centimeters.
The described miniature shadow pipe 2 that shines successively decreases with 2cm with the distance of the joint portion of transverse tube 10 and vertical tube 11, and especially, above-mentioned 4 miniature lower ends according to the shadow pipe are concordant, and the longest miniature distance of shining the joint portion of shadow pipe top and transverse tube 10 and vertical tube 11 is 2cm.Above-described embodiment, that the applicant sums up through many experiments, have the following advantages: 1, miniature length according to the shadow pipe is the ladder setting, can guarantee omnidistancely to observe sinus tract shaping situation at Intraabdominal T shape pipe (approximately 10-15cm), thereby be T shape pipe indwelling time, and tube drawing and prevent that gallbladder from leaking sufficient foundation is provided; 2, miniaturely according to shadow pipe set-up mode on vertical tube, and miniature on vertical tube distance is set according to the shadow pipe, can conveniently shines shadow on the one hand, on the other hand, be conducive to observe the situation of Intraabdominal T shape pipe, thereby for operation provides foundation, the risk of having avoided original blindness tube drawing to cause.
Fig. 3 shows the another kind of embodiment of the present invention, and its basic structure is with Fig. 2 embodiment, and difference is: the miniature shadow pipe 2 that shines is provided with 3, and space 120 degree evenly are arranged on the outer circumference surface of vertical tube 11 respectively.
Be more than several embodiment of the present invention, be used for structure of the present invention is described, but above-mentioned explanation do not consist of limiting the scope of the invention.
The present invention detects at the abdomen common bile+application in the operation of T pipe external drainage.
(1), Therapeutic Method:
Two groups of patients all adopt out the abdomen common bile to detect+operation of T pipe external drainage.
Matched group: the patient adopts general anesthesia, all adopt otch below right costal margin, postoperative is all placed the general T-shaped pipe No. 22, bile duct wall is sewed up afterflush without sepage, all with nearby principle, the T pipe is fixed on outside the abdominal cavity, 2 week of postoperative, row T managed radiography, and postoperative is pulled out the T pipe February, if after the interior retained calculus tube drawing of liver, the row choledochoscope is got stone.
Test group: the patient adopts general anesthesia, all adopt otch below right costal margin, postoperative is all placed with anti-gallbladder of the present invention and is leaked T shape pipe, and bile duct wall is sewed up afterflush without sepage, all will prevent that with nearby principle gallbladder leaks T shape pipe and is fixed on outside the abdominal cavity, 2 week of postoperative, row T managed radiography, 4 of row are miniature according to shadow pipe radiography simultaneously, and clear and definite tunnel situation is every the 2 miniature shadow pipe radiographies that shine of week row, observe the tunnel situation, namely pull out the T pipe in case sinus tract is completed into; If if after the interior retained calculus tube drawing of liver, the row choledochoscope is got stone.
(2), observation of curative effect:
The test group postoperative is every 2 week row T pipe radiographies, the time of viewing test group T pipe tunnel, simultaneously according to radiography as a result two groups of patients of observation and comparison to pull out after T pipe time and tube drawing the data such as gallbladder leakage as follows.
Table 1,
Sequence number | The time of tunnel | Pull out the T pipe time | After tube drawing, gallbladder leaks situation |
Matched group | 60 days | 60 days | 0.3% |
Experimental group | 38 ± 9 days | 42 ± 8 days | 0% |
(3), analyze summary:
As can be seen from the above table, the anti-gallbladder of the present invention leaks T shape pipe, can not only play every effect of general T-shaped pipe, and can monitor after surgery the situation of sinus tract maturation, the blindness tube drawing is become targeted tube drawing, can not only avoid the immature gallbladder that causes of sinus tract to leak fully, and can obviously shorten ripe early patient's the band pipe time of part sinus tract, alleviate the next life inconvenience of T pipe racks and painful.
Claims (10)
1. an anti-gallbladder leaks T shape pipe, comprises the T shape pipe that is comprised of transverse tube and vertical tube, it is characterized in that: some miniature shadow pipes that shine are installed on the outer circumference surface of vertical tube, and the miniature length of shadow pipe of shining is less than the length of vertical tube; Miniature two ends according to the shadow pipe all are provided with opening.
2. a kind of anti-gallbladder according to claim 1 leaks T shape pipe, and it is characterized in that: the length of transverse tube is 10cm, and the length of vertical tube is 30 cm, and the caliber of transverse tube and vertical tube is 0.8 cm.
3. a kind of anti-gallbladder according to claim 1 leaks T shape pipe, it is characterized in that: the miniature shadow pipe that shines is provided with 4 altogether, and evenly is arranged on the outer circumference surface of vertical tube with space 90 degree.
4. a kind of anti-gallbladder according to claim 1 leaks T shape pipe, it is characterized in that: the miniature shadow pipe that shines is provided with 3, and space 120 degree evenly are arranged on the outer circumference surface of vertical tube respectively.
5. a kind of anti-gallbladder according to claim 1 leaks T shape pipe, it is characterized in that: described miniature caliber according to the shadow pipe is 0.5-2mm.
6. a kind of anti-gallbladder according to claim 5 leaks T shape pipe, it is characterized in that: described miniature caliber according to the shadow pipe is 1mm.
7. a kind of anti-gallbladder according to claim 1 leaks T shape pipe, it is characterized in that: described 4 miniature length according to the shadow pipe are the ladder setting.
8. a kind of anti-gallbladder according to claim 7 leaks T shape pipe, it is characterized in that: described 4 miniature shadow pipes that shine: the longest one is 20 centimeters, and second is 18 centimeters, and the 3rd is 16 centimeters, and the 4th is 14 centimeters.
9. a kind of anti-gallbladder according to claim 1 leaks T shape pipe, it is characterized in that: described miniature distance of shining the joint portion of shadow pipe and transverse tube and vertical tube is successively decreased with 2cm.
10. a kind of anti-gallbladder according to claim 9 leaks T shape pipe, it is characterized in that: described 4 miniature lower ends according to the shadow pipe are concordant, and the longest miniature distance of shining the joint portion of shadow pipe top and transverse tube and vertical tube is 2cm.
Priority Applications (1)
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CN201310040184.XA CN103111011B (en) | 2013-02-01 | 2013-02-01 | Anti-bile-leakage T-shaped tube |
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CN201310040184.XA CN103111011B (en) | 2013-02-01 | 2013-02-01 | Anti-bile-leakage T-shaped tube |
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CN103111011B CN103111011B (en) | 2014-12-17 |
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CN201310040184.XA Expired - Fee Related CN103111011B (en) | 2013-02-01 | 2013-02-01 | Anti-bile-leakage T-shaped tube |
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Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4569335A (en) * | 1983-04-12 | 1986-02-11 | Sumitomo Electric Industries, Ltd. | Fiberscope |
CN2518468Y (en) * | 2002-04-22 | 2002-10-30 | 黄林平 | Bile duct decompression and fistulography device |
CN2808189Y (en) * | 2005-06-18 | 2006-08-23 | 杨海龙 | Multifunctional T shape catheter |
CN202070007U (en) * | 2011-04-13 | 2011-12-14 | 由法平 | T tube having capability of monitoring forming of sinus and provided with cholangiographic tube |
CN203075442U (en) * | 2013-02-01 | 2013-07-24 | 绍兴市人民医院 | Anti-bile-leakage T-shaped tube |
-
2013
- 2013-02-01 CN CN201310040184.XA patent/CN103111011B/en not_active Expired - Fee Related
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4569335A (en) * | 1983-04-12 | 1986-02-11 | Sumitomo Electric Industries, Ltd. | Fiberscope |
CN2518468Y (en) * | 2002-04-22 | 2002-10-30 | 黄林平 | Bile duct decompression and fistulography device |
CN2808189Y (en) * | 2005-06-18 | 2006-08-23 | 杨海龙 | Multifunctional T shape catheter |
CN202070007U (en) * | 2011-04-13 | 2011-12-14 | 由法平 | T tube having capability of monitoring forming of sinus and provided with cholangiographic tube |
CN203075442U (en) * | 2013-02-01 | 2013-07-24 | 绍兴市人民医院 | Anti-bile-leakage T-shaped tube |
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