CN205073075U - Snakelike biliary tract support of integral type glasses - Google Patents

Abstract

The utility model provides a snakelike biliary tract support of integral type glasses comprises biliary tract support, support propelling movement pipe, support guide wire and support protective case, and the support guide wire passes support propelling movement pipe and the biliary tract support is even as an organic whole according to connecting wire ring sum through -hole base, support protective case entangle the top of biliary tract support and support propelling movement pipe can be before using the protective cradle structure. The biliary tract support is the slant S -shaped, and the other end is alpha shape, the middle discharge portion that is. Biliary tract drainage position can be put into through the direct motion of liver and gall way puncture sinus through choledochus incision, T type pipe sinus, percutaneous to biliary tract support even as an organic whole under the seal wire guides, also can drive in the wrong direction through the duodenum mirror and put into biliary tract drainage position. The support can drop by oneself, can select the S -shaped structure of different radians to obtain the different support drainage time according to clinical needs, and the special S -shaped structure of support can not oppressed pancreas pipe opening and aroused the pancreatitis when the discharge bile duct.

Description

The snakelike biliary tract rack of integral eyeglass

Technical field:

The present invention relates to a kind of support for biliary drainage, the snakelike biliary tract rack of a kind of integral eyeglass.

Background technology

At the operative treatment of choledocholithiasis or when getting stone through Sphincterotomy under Inner mirror, normal employing biliary tract rack inserts bile duct for biliary drainage, current clinical conventional biliary tract rack is integral type plastic stent, namely support, stent pushing pipe and guide wire are connected as a single entity, insert duodenum and bile duct by scope by retrograde for support, or insert bile duct and duodenum through the direct motion of bile duct procedure otch.But this kind of integrated plastic support quality is hard, relies on the agnail at its two ends to be fixed in bile duct, therefore can not self falling, need again to be taken out through scope after reaching treatment or prevention object, add patient suffering and medical expense.For this reason, have the report adopting single J support clinically, but because of this support in bile duct without fixture, support easily comes off too early, cannot meet clinical needs.Tian Mingguo once devised " regular self falling biliary tract rack (ZL200920160913.4) ", this support can maintain two weeks in bile duct and self falling is discharged with feces, but its shortcoming is: the fixture of (1) bile duct side is made by absorbable suture line and formed, therefore cannot insert bile duct by endoscopic technic aperture mirror, be only limitted to use in exploration of common bile duct operation; (2) Absorption Line on support is once remain in the core that may form cholelithiasis in bile duct; (3) managing with propelling movement because of support is not unitary design, and support only entangles the pushed pipe of seal wire and advances bile duct, cannot percentage regulation and direction." a kind of soft bile duct support (ZL200920003161.0) " of Tian Mingguo design, its bile duct fixed part twist with C shape, attempt to control support by the different spiral number of degrees of support, helix pitch and C shape radian to come off the time, but its shortcoming is: the helical structure of (1) support may be oppressed ductus pancreaticus opening when discharging bile duct and be brought out acute pancreatitis; (2) bile does not meet adequate drainage principle by the drainage tube of spiral; (3) C shape structure is not smooth arc in bile duct, not only affects adequate drainage, also makes support be increased by the resistance in seal wire and endoscopic technic hole; (4) because of support with push manage be not unitary design support pushed enter bile duct after cannot percentage regulation and direction.

Therefore, the tear-away biliary tract rack of a kind of integral type safe and effective, flexible to operation is lacked at present.

Summary of the invention:

Can not the various defects of deciduous and existing self falling biliary tract rack in order to what solve existing integral type biliary tract rack, the invention provides the snakelike biliary tract rack of a kind of integral eyeglass, it is snakelike that this support is designed to glasses according to human body gallbladder ductus pancreaticus anatomical structure and physiological characteristics, support one end is oblique S shape, the other end is α shape, and centre is Drainage Section.Support guide wire and propelling movement pipe form stent pushing system, biliary drainage position can be inserted through common bile duct otch, T pipe sinus tract or percutaneous through transhepatic cholangiography puncture direct motion after being connected with support under seal wire guides, also can drive in the wrong direction through duodenoscope and insert the drain site of bile duct.Support can self falling, can effectively control support come off the time by selecting the S shape structure of different radian, and the special S shape structure of support can not be oppressed ductus pancreaticus opening when discharging bile duct and be caused pancreatitis.

Technical solution of the present invention is: be made up of support, stent pushing pipe, support guide wire and support protective casing.Support adopts 88% polyurethane elastomer and 12% barium sulfate powder mixed injection molding to become the conduit of external diameter 7F, 8F, 8.5F, 9F, wall thickness 0.3-0.4mm, long 8-12cm, catheter fever is moulded glasses snakelike, its one end is oblique S shape, the other end is α shape, centre is Drainage Section, and S shape and α shape structure are at the homonymy of Drainage Section conduit.The conduit that S shape structure is extended by circular arc, oppositely circular arc and tangent line thereof is formed, the inner arc radius of circular arc conduit is 6-8mm, central angle is respectively 90 degree, 120 degree, 150 degree, 180 degree and 210 degree, one end of circular arc conduit is connected along the tangential direction of circular arc with Drainage Section, the other end extends along reverse circular arc, the center of circle of reverse circular arc conduit on the radius extended line of circular arc conduit central angle, its inner arc radius 10-15mm, central angle is 30 degree, and conduit continues to extend 1cm along the tangent line of reverse circular arc; The circular arc internal diameter of α shape structure is 6mm, and the central angle of circular arc is 330 degree, and circular arc one end is connected along circle tangential direction with Drainage Section, and the other end extends 1cm along circle tangential direction; The inner arc wall median line of S shape conduit and α shape conduit establishes a stringer mark line; Respectively establish 1 drain side opening at Drainage Section and S shape conduit and α shape conduit connection, and on the two side of S shape conduit and α shape conduit, respectively establish 4 drain side openings respectively; Drain segment length 4cm, if centimeter scale labelling; Establish a connection side opening at the inside 2mm place, one end apart from support, do not establish the other end connecting side opening to make sharp mouth shape.

Stent pushing pipe is made up of polyvinyl fluoride, its external diameter is respectively 7F, 8F, 8.5F, 9F, wall thickness 0.3-0.6mm, and length is respectively 50cm and 180cm, 2mm place from the front end is with operation suture thread through and through suture tube wall and make and connect wire loop, connects a through hole base at propelling movement pipe tail end.

Support guide wire is made up of perfluoroethylene-propylene copolymer, and its external diameter is 5F, 5.5F, 6F and 6.5F, wall thickness 0.2mm, and front end is sharp mouth shape, and tail end is connected with a through hole base, and length is respectively 70cm and 200cm.

The tail end base of support guide wire front end through stent pushing pipe is inserted, after propelling movement pipe front end passes, propelling movement pipe front end is connected wire loop from outside to inside through support connecting hole, by guide wire through wire loop and support, the tail end base of guide wire is connected and fixed with propelling movement pipe tail end base, and support, guide wire and propelling movement pipe are connected as a single entity.

Support protective casing is made by clear hard polythene material, wall thickness 1mm, and internal diameter is 7F, 8F, 8.5F, 9F, and one end is oblique S shape, and the other end is α shape, and centre is straight tube, and S shape structure and α shape structure are positioned at the homonymy of straight tube.S shape structure is made up of circular arc, oppositely circular arc and tangent line elongate catheter thereof, the inner arc radius of circular arc conduit is 5-7mm, central angle is respectively 90 degree, 120 degree, 150 degree, 180 degree and 210 degree, one end of arc-shaped structure is connected along the tangential direction of circular arc with straight length, the other end extends along reverse circular arc, the center of circle of reverse circular arc is on the radius extended line of circular arc central angle, and the central angle of reverse circular arc is 30 degree, inner arc radius 9-14mm, and conduit extends 1.5cm along reverse circular arc tangential line direction again; The inner arc wall radius of α shape structure is 5mm, and one end is connected along circle tangential direction with straight length, and the other end extends 1.5cm along circle tangential direction; Straight tube segment length 4cm; One end internal diameter of protective casing expands as 8F, 9F, 9.5F, 10F, long 1cm, to embed be connected with propelling movement pipe top with latex mattress; One sidewall of protective casing establishes a stringer breach, the wide 2mm of breach, so that the handling of support; The inner arc wall median line of S shape conduit with α shape conduit establish a stringer mark line corresponding with the mark line of support.

Adopt protective casing effectively can avoid this soft support recurring structure distortion.During use, sleeve pipe breach is strutted taking-up support.After integrated bracket being entangled seal wire feeding bile duct and duodenal appropriate location under scope, adjusting pole direction, make the right side of the stringer mark line of support one end towards the duodenum section of falling enteric cavity or the right side of bile duct, exit seal wire and guide wire, the wire loop pushing pipe front end loses interconnect function, and support is released.In SJ shape after support launches in common bile duct, S shape structure is fixed in common bile duct according to elastic recovery force, because of common bile duct from top to bottom diagonal enter duodenal left back sidewall, common bile duct is formed by the natural torsion of upper left to bottom right, arc structure trend according to mechanics principle support S shape structure bottom is consistent with choledoch-natural torsion, namely outer arc keeps left, inner arc to the right, and not easily rotates; Because the duodenum section of falling is positioned at choledoch-right side, support α shape structure in vater's papilla opening part enteric cavity must be positioned at the right side of Drainage Section conduit, thus the arc structure maintaining the S shape structure in homonymy direction in bile duct is further consistent with choledoch-natural torsion.Arc structure forms ABC tri-strong points to bile duct wall, and along circular arc extend reverse circular arc and tangent line prolongation because of reverse with circular arc, arc structure is not easily rolled up in bile duct, its end is not easily tangled by cystic duct opening and abnormal structure, ensure that support discharges bile duct smoothly, reduce propelling movement resistance during Stent Implantation to the full extent simultaneously, reverse circular arc because of the little arc length of radian short, pressure and frictional resistance are not produced to bile duct wall; The frictional resistance of support and bile duct wall depends on the central angle of circular arc portion, central angle is larger, and the elastic recovery force of scaffold tube in bile duct is larger, larger to the support force of bile duct wall, result is that frictional resistance is larger, thus the time that support is retained in bile duct is longer; Otherwise central angle is less, its support force is less, then frictional resistance is less, thus the time that support is retained in bile duct is shorter.Therefore, the time arc structure of different central angle can being selected to come off to control support, in support discharge process, support arcuate structure moves down gradually, although may swing be rotated after the α shape structure in enteric cavity is promoted by chyme, but the natural torsion radian of distal part of common bile duct increases, the arcuate structure of support not easily rotates with the swing of α shape structure at the lumen of bile duct of this arc in the same way, first it will pass through vater's papilla to the C point of farthest side in three strong points of bile duct wall formation, because arcuate structure is consistent with the natural torsion of bile duct, the pressure direction of C point points on the right side of nipple, and ductus pancreaticus imports bile duct formation ampulla and Common openings from left side diagonal, therefore, compressing ductus pancreaticus opening can be avoided to bring out acute pancreatitis, after C point discharges bile duct, support loses support force in oblique A, B to bile duct wall at 2 in bile duct, discharges rapidly under enterokinesia, can not form compressing to nipple place ductus pancreaticus opening.The α shape structure of support not only prevents support to Retrograde transposition in bile duct but also under chyme promotes, promote that bile duct discharged by support in duodenum.

When clinical practice, under choledochoscope, seal wire can be inserted through common bile duct otch in duodenum in operation, or in biliary tract and duodenum, insert seal wire through T pipe sinus tract or the direct motion of percutaneous transhepatic cholangiography puncture sinus tract during No operation, or in bile duct, insert seal wire at duodenoscope retrograde, to push to direct motion in bile duct and duodenum by pushing pipe for the integrated bracket of 50cm entangles seal wire maybe to drive in the wrong direction through duodenoscope operating walk way in bile duct, push to the position of applicable biliary drainage by pushing integrated bracket that pipe is 180cm, according to the position adjustment direction of mark line, the S structure of support and choledoch-arc are consistent.Exit releasing bracket after seal wire and guiding catheter, rack elasticity replys its SJ shape structure.

The invention has the beneficial effects as follows, the support of different radian or central angle can be taked according to the needs of clinical biliary drainage, make it different time self falling after surgery.The risk that after application obviously can reduce Primary Closure of Choledochostomy in exploration of common bile duct, gallbladder leaks; Support inserts the alternative existing rigid plastic support of biliary tract and alternative endoscopic pernasal biliary drainage (ENBD) at duodenoscope retrograde, thus bile loss and the discomfort of patient with nose conduit when avoiding the removal surgery of scope again and the per nasal biliary drainage of rigid plastic support.The upper end α of support end being inserted obstruction of bile duct can be used for the palliative treatment of Malignant Obstructive Jaundice.To the patient of exploration of common bile duct T Tube Drain postoperative common bile duct far-end benign stricture, insert this support by T pipe sinus tract thus avoid long-term a large amount of bile loss.

Accompanying drawing explanation

Below in conjunction with drawings and Examples, the present invention is further described.

Fig. 1 is support Design figure of the present invention

Fig. 2 is support diagram of the present invention

Fig. 3 is that of the present invention propelling movement manages the diagram after being connected with guide wire

Fig. 4 be of the present invention push pipe, guide wire be connected with support after diagram

Fig. 5 is the diagram after integrated bracket of the present invention entangles seal wire

Fig. 6 is support protective casing diagram of the present invention

Fig. 7 is bile duct, ductus pancreaticus and duodenal anatomy relationship figure

Fig. 8 is that support of the present invention is inserted after bile duct and duodenum in SJ shape diagram

Fig. 9, Figure 10 are support of the present invention discharge process diagrams in bile duct

The point of contact of 1. circular arc conduits and Drainage Section conduit in figure, the point of contact of circular arc conduit and oppositely circular arc conduit and extension conduit, 2. central angle, 3. drain side opening, 4. connecting hole, 5. the S shape structure of frame, 6. the α shape structure of support, 7. stent drainage section, 8. centimeter scale, 9. inner arc wall stringer mark line, 10. push pipe, 11. wire loops, 12. guide wires, S end or the α end of 13. supports manage with propelling movement the integrated bracket be connected, 14. seal wires, the connecting portion of 15. protective casings, the breach of 16. protective casings, 17. common bile duct, 18. ductus pancreaticus, 19. duodenums, 20. vater's papillies (bile duct and ductus pancreaticus Common openings place).

Detailed description of the invention and application principle

In Fig. 5, seal wire 14 and guide wire 12 are through propelling movement pipe 10 and support 13 and through the wire loop 11 being penetrated rack bore by support connecting hole from outside to inside.When exiting seal wire and guide wire, wire loop loses fixation, and support is released as Fig. 8 in bile duct, and rack elasticity is replied as SJ shape.The S shape structure of support in bile duct produces support force form frictional resistance according to ABC in Fig. 83 to bile duct wall, thus maintain the drainage time of support in bile duct, the reverse circular arc of S shape structure upper and tangent line prolongation thereof can avoid the arcuate structure of bottom elasticity in bile duct to roll up, the little arc length of its radian is short and do not produce frictional resistance, end is that extended configuration is not easily tangled by cystic duct opening and abnormal structure, can ensure that support discharges bile duct smoothly.When chyme in enterokinesia and enteric cavity promotes the α shape structure of support in enteric cavity, support moves down in bile duct, when the vater's papilla in C point arrival Fig. 9 of S shape structure or gallbladder ductus pancreaticus ampulla, because of S shape structure and α shape structure for homonymy design and the circular arc portion of S shape structure consistent with the traveling of bile duct nature radian, C point is just oppressed the right side wall of nipple or ampulla, thus avoids the ductus pancreaticus opening in compressing left side and cause pancreatitis.When support continues to move down, after in Figure 10, C point enters duodenal lumen, the AB in oblique line directions 2 loses support force to bile duct and frictional resistance, and support will enter enteric cavity rapidly under enterokinesia, can not oppress ductus pancreaticus opening and bring out pancreatitis.

Embodiment 1

Stent Implantation in exploration of common bile duct.Take out calculus under choledochoscope after, insert seal wire through choledochoscope handle hole to common bile duct distal openings, then S shape structure in Fig. 4 is entangled seal wire with the integrated bracket that is connected of propelling movement pipe push to common bile duct far-end and duodenum.It is SJ shape in Fig. 8 that seal wire and pusher exit after-poppet elastic recovery, is closed by Primary Closure of Choledochostomy.Postoperative support can after bile drainage a period of time by chyme in enteric cavity or enterokinesia promotion self falling.

Embodiment 2

At duodenoscope retrograde placing rack.Vater's papilla is found under mirror, in biliary tract, seal wire is inserted through handle hole, again the integral type biliary tract rack that α shape structure in Fig. 4 is connected with propelling movement pipe is entangled seal wire to insert through duodenoscope handle hole, with propelling movement pipe, support is pushed in common bile duct, after the Drainage Section of support enters biliary tract, release seal wire and guide wire pipe, stent returns is the SJ shape in Fig. 8.

Embodiment 3

Percutaneous to puncture placing rack through transhepatic cholangiography.Under B ultrasonic location, percutaneous punctures through transhepatic cholangiography, punctures successfully and is inserted to bile duct far-end by puncture hole by seal wire, make seal wire by narrow positions and enter duodenum.Exit puncture needle, dilating catheter is pushed expansion from the external seal wire that entangles to liver parenchyma and stenosis of bile duct, exits dilating catheter.The integral type biliary tract rack that α shape structure in Fig. 4 is connected with propelling movement pipe is entangled seal wire push in common bile duct and duodenum.Exit seal wire, guide wire and pusher, rack elasticity replys its JS shape, because α end is in bile duct above narrow section, and S shape structure in duodenum by enterokinesia and chyme motive force more weak, support difficult drop-off, can be used for the Palliative drain of advanced malignant obstruction jaundice.

Claims (7)

1. the snakelike biliary tract rack of integral eyeglass; it is characterized in that: be made up of biliary tract rack, stent pushing pipe, support guide wire and support protective casing; support guide wire is connected as a single entity according to connection wire loop and through hole base through stent pushing pipe and biliary tract rack, and support protective casing entangles the top of biliary tract rack and stent pushing pipe.

2. the snakelike biliary tract rack of integral eyeglass according to claim 1, it is characterized in that: support is made up of the polyurethane catheter of external diameter 7F, 8F, 8.5F, 9F, wall thickness 0.3-0.4mm, its one end is oblique S shape, the other end is α shape, centre is Drainage Section, homonymy in Drainage Section of S shape structure and α shape structure and be that tangent line is connected with Drainage Section, inside 2mm place, support one end establishes a connection side opening, does not establish the other end connecting side opening to be sharp mouth shape.

3. the snakelike biliary tract rack of integral eyeglass according to claim 2, it is characterized in that: the S shape structure of support is made up of the circular arc conduit be connected, oppositely circular arc conduit and tangent line elongate catheter thereof, stringer mark line is established in inner arc wall center, drain side opening is established in two side, circular arc conduit inner arc radius is 6-8mm, central angle is respectively 90 degree, 120 degree, 150 degree, 180 degree and 210 degree, reverse circular arc conduit inner arc radius is 10-15mm, central angle is 30 degree, the long 1cm of tangent line elongate catheter.

4. the snakelike biliary tract rack of integral eyeglass according to claim 2, it is characterized in that: the α shape structure of support is made up of circular arc conduit and tangent line elongate catheter thereof, stringer mark line is established in inner arc wall center, drain side opening is established in two side, 330 degree, the inner arc radius 6mm of circular arc conduit, central angle, the long 1cm of tangent line elongate catheter.

5. the snakelike biliary tract rack of integral eyeglass according to claim 1, it is characterized in that: stent pushing pipe external diameter is respectively 7F, 8F, 8.5F, 9F, wall thickness 0.3-0.6mm, length is respectively 50cm and 180cm, 2mm place from the front end establishes a connection wire loop, and tail end connects a through hole base.

6. the snakelike biliary tract rack of integral eyeglass according to claim 1, it is characterized in that: support guide wire external diameter is respectively 5F, 5.5F, 6F and 6.5F, wall thickness 0.2mm, its front end is sharp mouth shape, tail end is connected with a through hole base, and length is respectively 70cm and 200cm.

7. the snakelike biliary tract rack of integral eyeglass according to claim 1; it is characterized in that: the structure of support protective casing and internal diameter and the biliary tract rack structure of being inserted in and external diameter match; one sidewall establishes stringer breach; stringer mark line is established in inner arc wall center, and internal diameter expansion in one end is connected with propelling movement pipe top.