CN111481808A

CN111481808A - Saccule type nasobiliary tube for preventing duodenal papillary hemorrhage

Info

Publication number: CN111481808A
Application number: CN202010425989.6A
Authority: CN
Inventors: 张�诚
Original assignee: Shanghai East Hospital Tongji University Affiliated East Hospital
Current assignee: Shanghai East Hospital Tongji University Affiliated East Hospital
Priority date: 2020-05-19
Filing date: 2020-05-19
Publication date: 2020-08-04

Abstract

The invention provides a balloon type nasobiliary tube for preventing duodenal papillary hemorrhage, which comprises an elastic loop tube I, a straight tube II, an elastic loop tube II and a straight tube III; a channel I is arranged in the elastic loop pipe I; a channel II is arranged in the straight pipe I; the straight pipe II is attached with a balloon and internally provided with a channel III and a channel IV; the balloon is cylindrical; a channel V and a channel VI are arranged in the elastic loop pipe II; a channel VII and a channel VIII are arranged in the straight pipe III; the joint connected with the tail end of the straight pipe III comprises a nut and a joint body, and an inner cavity of the nut is provided with an internal thread; one end of the joint body is provided with two parallel metal needles, the other side of the two metal needles is connected with a conical structure, and the conical structure is provided with external threads which are matched and connected with the internal threads; the other side of the conical structure is provided with a drainage joint and a pressurization joint. The invention can drain bile and prevent duodenal papilla hemorrhage; in the using process, intestinal juice and chyme cannot reversely flow into the gallbladder main pipe; after the use is finished, the saccule is released and can be pulled out without secondary endoscope operation.

Description

Saccule type nasobiliary tube for preventing duodenal papillary hemorrhage

Technical Field

The invention relates to the technical field of minimally invasive medical technology and surgical instruments, in particular to a balloon type nasobiliary tube for preventing duodenal papillary hemorrhage, which is a minimally invasive surgical instrument for draining bile and preventing duodenal papillary hemorrhage.

Background

The duodenoscope technology (ERCP) is an important measure for treating liver, gallbladder and pancreas diseases at present, and comprises common bile duct stones, bile duct injuries, bile duct stenosis, biliary tract complications after liver transplantation and the like. Compared with the traditional open surgery, the technique has the advantages of small wound, high safety factor, quick recovery and the like, but has complications such as bleeding, acute pancreatitis, perforation, acute cholangitis and the like. With the increase of therapeutic ERCP, the incidence of post-operative complications of ERCP also tends to increase, with the incidence of duodenal papilla bleeding as high as 2.4% to 10.4%.

Bleeding during ERCP can be directly stopped endoscopically, and the stopping method includes such as medicine spraying stopping bleeding, local injection stopping bleeding, electric coagulation stopping bleeding, hemostatic clamp clip stopping bleeding, metal stent compression and the like. Among various measures of endoscope treatment, the placement of the full-coated self-expandable metal stent can generate mechanical compression effect on the whole nipple tissue, has the most thorough hemostatic effect, and is particularly suitable for patients with blood coagulation dysfunction caused by anticoagulant drugs such as poor liver function, jaundice, oral aspirin and the like. However, the application of the full-coated metal stent for preventing bleeding has the following disadvantages: 1. the price of the full-film-covered metal stent is as high as 2 ten thousand yuan, so that the wide clinical application of the full-film-covered metal stent is limited; 2. after the metal bracket is placed across the duodenal papilla, the leakproofness of the duodenal papilla is damaged, intestinal fluid and chyme in the intestinal tract easily flow back into the bile duct through the metal bracket, and cholangitis and bile duct calculi are generated; 3. after the papillary wound surface is healed, the metal bracket needs to be taken out through secondary endoscope operation, and part of patients need to use the saccule to clean regurgitated chyme in the bile duct.

Disclosure of Invention

The price of the fully-coated metal stent proposed by the method is up to 2 ten thousand yuan, so that the wide clinical application of the fully-coated metal stent is limited; after the metal bracket is placed across the duodenal papilla, the leakproofness of the duodenal papilla is damaged, intestinal fluid and chyme in the intestinal tract easily flow back into the bile duct through the metal bracket, and cholangitis and bile duct calculi are generated; after the papillary wound surface is healed, the metal bracket needs to be taken out by secondary endoscope operation, and part of patients need to use the balloon to clean the regurgitated chyme in the bile duct, so that the balloon type nasobiliary duct for preventing duodenal papillary hemorrhage is provided. The anti-skidding type pig tail tube mainly utilizes the elastic loop tube I of the single pig tail tube for skid prevention, utilizes the semi-arc elastic loop tube II for displacement prevention, and is attached with the balloon on the straight tube II, and the tail end of the straight tube III is connected with the joint, so that bile drainage is realized, and duodenal papilla bleeding can be prevented; in the using process, intestinal juice and chyme cannot reversely flow into the gallbladder main pipe; after the use is finished, the saccule is released and can be pulled out without secondary endoscope operation.

The technical means adopted by the invention are as follows:

a balloon-type nasobiliary tube for preventing duodenal papillary hemorrhage, comprising: the elastic loop tube I, the straight tube II, the elastic loop tube II and the straight tube III are sequentially communicated;

the elastic loop pipe I is a single-channel single-pig tail pipe, and a channel I is arranged in the elastic loop pipe I;

the straight pipe I is a single-channel pipe, and a channel II communicated with the channel I is arranged in the straight pipe I;

side holes are formed in the tube walls of the elastic loop tube I and the straight tube I and are used for draining bile;

the straight pipe II is a double-channel pipe and is attached with a balloon, and a channel III and a channel IV which are communicated with the channel II are arranged in the straight pipe II; the head end of the channel IV is a blind end and is communicated with the saccule through a side wall hole formed in the tube wall of the straight tube II; the balloon is positioned on the outer surface of the straight pipe II and is cylindrical, and two ends of the balloon are fixed on the pipe wall of the straight pipe II through metal rings; the attached saccule is that the outer wall of the straight pipe II is sleeved with the saccule;

the elastic loop pipe II is in a semi-arc shape and is a double-channel pipe, and a channel V and a channel VI are arranged in the elastic loop pipe II; the channel V is communicated with the channel III, and the channel VI is communicated with the channel IV;

the straight pipe III is a double-channel pipe, a channel VII and a channel VIII are arranged in the straight pipe III, the channel VII is communicated with the channel V, and the channel VIII is communicated with the channel VI;

the tail end of the straight pipe III is connected with a connector, the connector comprises a nut and a connector body, an inner cavity of the nut is conical, an internal thread is arranged on the surface of the inner cavity, and the diameter of the tail of the nut is equal to the pipe diameter of the straight pipe III; one end of the joint body is provided with two parallel metal needles, one sides of the two metal needles are respectively inserted into the channel VII and the channel VIII, the other side of the two metal needles is connected with a conical structure, the outer surface of the conical structure is provided with an external thread, and the external thread is matched and connected with the internal thread; a drainage joint and a pressurizing joint are arranged on the other side of the conical structure, one sides of the drainage joint and the pressurizing joint are respectively communicated with the channel VII and the channel VIII through the conical structure and the metal needle, and the other sides of the drainage joint and the pressurizing joint are connected with a three-way joint; the pressurizing connector is connected with a pressure pump or an injector, and the drainage connector is connected with a drainage bag to drain bile.

Further, the length of the saccule type nasobiliary tube is 260cm, and the tube diameter is 7Fr or 8.5 Fr.

Further, the balloon has an expanded diameter of 8mm, 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, or 22 mm.

Further, the length of the elastic loop tube II is 4-6 cm.

The blind end refers to the head end of the water injection and air injection channel which is L-shaped and is connected with the sacculus cavity through a side wall hole arranged on the tube wall of the straight tube II.

Compared with the prior art, the invention has the following advantages:

1. the balloon type nasobiliary tube for preventing duodenal papilla hemorrhage provided by the invention can drain bile and prevent duodenal papilla hemorrhage at the same time.

2. The sacculus type nasobiliary tube for preventing duodenal papillary hemorrhage provided by the invention has the advantages that intestinal juice and chyme cannot reversely flow into the biliary trunk in the using process.

3. The balloon type nasobiliary tube for preventing duodenal papillary hemorrhage provided by the invention can be pulled out by releasing the balloon after use, and secondary endoscope operation is not needed.

4. According to the balloon type nasobiliary tube for preventing duodenal papillary hemorrhage, the elastic loop tube I is a single-channel single pig tail tube and can play a role in skid resistance. The elastic loop tube II conforms to the physiological structure, increases the uncertainty of the drainage tube and plays a role in preventing displacement.

5. The balloon type nasobiliary tube for preventing duodenal papilla hemorrhage provided by the invention is characterized in that the balloon is attached to the straight tube II, so that duodenal papilla hemorrhage and duodenal content reflux can be prevented, and duodenal papilla stenosis can be relieved.

6. According to the balloon type nasobiliary tube for preventing duodenal papillary hemorrhage, provided by the invention, the side holes are formed in the elastic loop tube I and the straight tube I, so that the bile drainage effect is better.

In conclusion, the technical scheme of the invention can solve the problem that the price of the full-film-covered metal stent in the prior art is as high as 2 ten thousand yuan, thereby limiting the wide clinical application of the full-film-covered metal stent; after the metal bracket is placed across the duodenal papilla, the leakproofness of the duodenal papilla is damaged, intestinal fluid and chyme in the intestinal tract easily flow back into the bile duct through the metal bracket, and cholangitis and bile duct calculi are generated; after the papillary wound surface is healed, the metal bracket needs to be taken out through secondary endoscope operation, and part of patients need to use the saccule to clean regurgitated chyme in the bile duct.

Based on the reasons, the invention can be widely popularized in the fields of minimally invasive medical technology, surgical instruments and the like.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly introduced below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to these drawings without creative efforts.

Fig. 1 is a schematic structural diagram of a balloon type nasobiliary tube for preventing duodenal papillary hemorrhage according to an embodiment of the present invention.

Fig. 2 is a structural diagram of a balloon type nasobiliary tube for preventing duodenal papillary hemorrhage in an operating state (balloon filling) according to an embodiment of the present invention.

FIG. 3 is a cross-sectional view of a straight pipe III according to the present invention.

FIG. 4 is a schematic view of the inner cavity of the nut of the present invention.

Fig. 5 is a schematic structural view of a joint body according to the present invention.

In the figure: 1, an elastic loop tube I; 2. a straight pipe I; 3. a straight pipe II; 4. an elastic loop pipe II; 5. a straight pipe III; 51. a channel VII; 52. a channel VIII; 6. a side hole; 7. a balloon; 8. a joint; 81. a metal needle; 82. a tapered structure; 83. a pressurized joint; 84. a drainage joint.

Detailed Description

It should be noted that the embodiments and features of the embodiments may be combined with each other without conflict. The present invention will be described in detail below with reference to the embodiments with reference to the attached drawings.

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. The following description of at least one exemplary embodiment is merely illustrative in nature and is in no way intended to limit the invention, its application, or uses. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

It is noted that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of exemplary embodiments according to the invention. As used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, and it should be understood that when the terms "comprises" and/or "comprising" are used in this specification, they specify the presence of stated features, steps, operations, devices, components, and/or combinations thereof, unless the context clearly indicates otherwise.

The relative arrangement of the components and steps, the numerical expressions and numerical values set forth in these embodiments do not limit the scope of the present invention unless specifically stated otherwise. Meanwhile, it should be understood that the sizes of the respective portions shown in the drawings are not drawn in an actual proportional relationship for the convenience of description. Techniques, methods, and apparatus known to those of ordinary skill in the relevant art may not be discussed in detail but are intended to be part of the specification where appropriate. Any specific values in all examples shown and discussed herein are to be construed as exemplary only and not as limiting. Thus, other examples of the exemplary embodiments may have different values. It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, further discussion thereof is not required in subsequent figures.

In the description of the present invention, it is to be understood that the orientation or positional relationship indicated by the directional terms such as "front, rear, upper, lower, left, right", "lateral, vertical, horizontal" and "top, bottom", etc., are generally based on the orientation or positional relationship shown in the drawings, and are used for convenience of description and simplicity of description only, and in the absence of any contrary indication, these directional terms are not intended to indicate and imply that the device or element so referred to must have a particular orientation or be constructed and operated in a particular orientation, and therefore should not be considered as limiting the scope of the present invention: the terms "inner and outer" refer to the inner and outer relative to the profile of the respective component itself.

Spatially relative terms, such as "above … …," "above … …," "above … …," "above," and the like, may be used herein for ease of description to describe one device or feature's spatial relationship to another device or feature as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device in the figures is turned over, devices described as "above" or "on" other devices or configurations would then be oriented "below" or "under" the other devices or configurations. Thus, the exemplary term "above … …" can include both an orientation of "above … …" and "below … …". The device may be otherwise variously oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.

It should be noted that the terms "first", "second", and the like are used to define the components, and are only used for convenience of distinguishing the corresponding components, and the terms have no special meanings unless otherwise stated, and therefore, the scope of the present invention should not be construed as being limited.

As shown in fig. 1 to 5, the present invention provides a balloon type nasobiliary tube for preventing duodenal papillary hemorrhage, comprising: the elastic loop tube I1, the straight tube I2, the straight tube II 3, the elastic loop tube II 4 and the straight tube III 5 are sequentially communicated;

the elastic loop pipe I1 is a single-channel single-pig tail pipe, and a channel I is arranged in the elastic loop pipe I;

the straight pipe I2 is a single-channel pipe, and a channel II communicated with the channel I is arranged in the straight pipe;

the tube walls of the elastic loop tube I1 and the straight tube I2 are both provided with side holes 6 for draining bile;

the straight tube II 3 is a double-channel tube, is attached with a balloon 7, and is internally provided with a channel III and a channel IV which are communicated with the channel II; the head end of the channel IV is a blind end and is communicated with the saccule 7 through a side wall hole formed in the tube wall of the straight tube II 3; the balloon 7 is positioned on the outer surface of the straight pipe II 3, the balloon 7 is cylindrical, and two ends of the balloon 7 are fixed on the pipe wall of the straight pipe II 3 through metal rings;

the elastic loop pipe II 4 is in a semi-arc shape and is a double-channel pipe, and a channel V and a channel VI are arranged in the elastic loop pipe II; the channel V is communicated with the channel III, and the channel VI is communicated with the channel IV;

the straight pipe III 5 is a double-channel pipe, a channel VII 51 and a channel VIII 52 are arranged in the straight pipe III, the channel VII 51 is communicated with the channel V, and the channel VIII 52 is communicated with the channel VI;

the tail end of the straight pipe III 5 is connected with a connector 8, the connector 8 comprises a nut and a connector body, the inner cavity of the nut is conical, internal threads are arranged on the surface of the inner cavity, and the diameter of the tail of the nut is equal to the pipe diameter of the straight pipe III 5; one end of the joint body is provided with two parallel metal needles 81, one sides of the two metal needles 81 are respectively inserted into the channel VII 51 and the channel VIII 52, the other side of the two metal needles 81 is connected with a conical structure 82, the outer surface of the conical structure 82 is provided with external threads, and the external threads are matched and connected with the internal threads; a drainage joint 84 and a pressurizing joint 83 are arranged on the other side of the conical structure 82, the metal needle 81 is a single-channel metal tube, two channels are arranged in the conical structure 82, one sides of the drainage joint 84 and the pressurizing joint 83 are respectively communicated with the channel VII 51 and the channel VIII 52 through the conical structure 82 and the metal needle 81, and the other sides of the drainage joint 84 and the pressurizing joint 83 are connected with a three-way joint; the pressurizing connector 83 is connected with a pressure pump or a syringe through a three-way connector, and the pressurizing connector 83 is connected with the three-way connector and used for closing a channel after pressurization and removing the pressurizing pump. The drainage connector 84 is connected with a drainage bag to drain bile.

The saccule type nasobiliary tube is 260cm in length and 7Fr or 8.5Fr in tube diameter.

The balloon 7 has an expanded diameter of 8mm, 10mm, 12mm, 14mm, 16mm, 18mm, 20mm or 22 mm.

The length of the elastic loop pipe II 4 is 4-6 cm.

During clinical operation, the device is placed into the duodenum through a duodenum forceps channel under the guidance of a guide wire, the balloon 7 is withdrawn after being completely exposed outside a duodenoscope, physiological saline containing a contrast agent is injected through a pressurizing connector 83 to fill the balloon 7, the pressurizing connector 83 is closed, and the drainage connector 84 is connected with a drainage bag. The duodenal papilla is positioned on the cylindrical saccule 7, and the filled cylindrical saccule 7 generates pressure on the inner wall of the duodenal papilla, namely hemostasis by compression. Simultaneously, the duodenal papilla is blocked, so that the reflux of intestinal contents into the bile duct can be prevented.

Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; while the invention has been described in detail and with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; and the modifications or the substitutions do not make the essence of the corresponding technical solutions depart from the scope of the technical solutions of the embodiments of the present invention.

Claims

1. A balloon-type nasobiliary tube for preventing duodenal papillary hemorrhage, comprising: the elastic loop tube I (1), the straight tube I (2), the straight tube II (3), the elastic loop tube II (4) and the straight tube III (5) are sequentially communicated;

the elastic loop pipe I (1) is a single-channel single-pig tail pipe, and a channel I is arranged in the elastic loop pipe I;

the straight pipe I (2) is a single-channel pipe, and a channel II communicated with the channel I is arranged in the straight pipe I;

side holes (6) are formed in the tube walls of the elastic loop tube I (1) and the straight tube I (2) and are used for draining bile;

the straight pipe II (3) is a double-channel pipe, a balloon (7) is attached to the straight pipe II, and a channel III and a channel IV which are communicated with the channel II are arranged in the straight pipe II; the head end of the channel IV is a blind end and is communicated with the saccule (7) through a side wall hole formed in the tube wall of the straight tube II (3); the balloon (7) is positioned on the outer surface of the straight pipe II (3), the balloon (7) is cylindrical, and two ends of the balloon (7) are fixed on the pipe wall of the straight pipe II (3) through metal rings;

the elastic loop pipe II (4) is in a semi-arc shape and is a double-channel pipe, and a channel V and a channel VI are arranged in the double-channel pipe; the channel V is communicated with the channel III, and the channel VI is communicated with the channel IV;

the straight pipe III (5) is a double-channel pipe, a channel VII (51) and a channel VIII (52) are arranged in the straight pipe III, the channel VII (51) is communicated with the channel V, and the channel VIII (52) is communicated with the channel VI;

the tail end of the straight pipe III (5) is connected with a connector (8), the connector (8) comprises a screw cap and a connector body, the inner cavity of the screw cap is conical, internal threads are arranged on the surface of the inner cavity, and the diameter of the tail of the screw cap is equal to the pipe diameter of the straight pipe III (5); one end of the joint body is provided with two parallel metal needles (81), one sides of the two metal needles (81) are respectively inserted into the channel VII (51) and the channel VIII (52), the other side of the two metal needles is connected with a conical structure (82), the outer surface of the conical structure (82) is provided with external threads, and the external threads are matched and connected with the internal threads; a drainage joint (84) and a pressurization joint (83) are arranged on the other side of the conical structure (82), one sides of the drainage joint (84) and the pressurization joint (83) are respectively communicated with the channel VII (51) and the channel VIII (52) through the conical structure (82) and the metal needle (81), and the other sides of the drainage joint (84) and the pressurization joint (83) are connected with a three-way joint; the pressurizing connector (83) is connected with a pressure pump or a syringe, and the drainage connector (84) is connected with a drainage bag to drain bile.

2. The balloon-type nasobiliary duct for preventing duodenal papillary hemorrhage according to claim 1, wherein the balloon-type nasobiliary duct has a length of 260cm and a tube diameter of 7Fr or 8.5 Fr.

3. The balloon-type nasobiliary duct for preventing duodenal papillary hemorrhage according to claim 1 or 2, wherein the balloon (7) has an expanded diameter of 8mm, 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, or 22 mm.

4. The balloon type nasobiliary tube for the prevention of duodenal papillary hemorrhage according to claim 1 or 2, wherein the elastic loop tube II (4) has a length of 4-6 cm.