CN219071770U - Nasal bile duct with pancreas tube guide wire - Google Patents

Nasal bile duct with pancreas tube guide wire Download PDF

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Publication number
CN219071770U
CN219071770U CN202223315907.6U CN202223315907U CN219071770U CN 219071770 U CN219071770 U CN 219071770U CN 202223315907 U CN202223315907 U CN 202223315907U CN 219071770 U CN219071770 U CN 219071770U
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duct
guide wire
bile duct
bending part
tube
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CN202223315907.6U
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张�诚
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Shanghai East Hospital Tongji University Affiliated East Hospital
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Shanghai East Hospital Tongji University Affiliated East Hospital
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    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02ATECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Abstract

The utility model provides a nasal bile duct retaining a pancreatic duct guide wire, wherein the tube body of the nasal bile duct is provided with a plurality of bending parts, at least comprising a bile duct bending part, a duodenal papilla bending part, a pylorus bending part and a gastric large bending part which are sequentially arranged from beginning to end, and the duodenal papilla bending part is provided with a guide wire passing hole; the tube section from the guide wire passing hole to the head end of the nasolacrimal duct is a first tube section, the tube section from the guide wire passing hole to the tail end of the nasolacrimal duct is a second tube section, the duodenal papilla bending part is a bending part at the joint of the first tube section and the second tube section, the bile duct bending part is positioned at the head part of the first tube section, and the pylorus bending part and the stomach large bending part are positioned on the second tube section; the head end of the nasal bile duct is used for placing a bile duct guide wire, the guide wire passing through the hole is used for placing a pancreatic duct guide wire, the bile duct guide wire penetrates through the whole nasal bile duct, and the pancreatic duct guide wire penetrates through the second pipe section. The utility model can prevent the occurrence rate of pancreatitis after the operation of the small-diameter pancreatic duct or the a-shaped pancreatic duct by reserving the guide wire in the pancreatic duct through the nasal bile duct.

Description

Nasal bile duct with pancreas tube guide wire
Technical Field
The utility model relates to the technical field of minimally invasive medical instruments, in particular to a nasal bile duct with a pancreatic duct guide wire.
Background
Pancreatitis is the most common, most damaging and costly complication following Endoscopic Retrograde Cholangiopancreatography (ERCP). Non-steroidal anti-inflammatory drugs and pancreatic duct stents are currently the main methods for preventing pancreatitis after ERCP surgery, wherein the drug treatment is to reduce pancreatic duct pressure mainly by inhibiting pancreatic juice secretion or to prevent pancreatitis by inhibiting pancreatitis activity; the pancreatic duct bracket drains pancreatic juice in the pancreatic duct to the duodenum to reduce pancreatic duct pressure so as to prevent pancreatitis. Wherein, the pancreatic duct stent has definite curative effect and is a main operation scheme for preventing acute pancreatitis after ERCP operation.
However, the success rate of indwelling pancreatic duct stents is not 100%, and in addition, the indwelling pancreatic duct stent itself may induce pancreatitis. The main reasons are as follows: 1. if the running radian of the pancreatic duct is larger, after the pancreatic duct bracket is placed, the pancreatic duct mucous membrane can block the opening of the pancreatic duct bracket, so that pancreatic juice in the pancreatic duct at the far end of the bracket is not smoothly discharged, and pancreatitis occurs; 2. the pancreatic duct of the pancreatic head is spiral or a-shaped, and the pancreatic duct bracket cannot be placed in; 3. the diameter of a normal pancreatic duct is 2-3mm, the circumference of a common pancreatic duct bracket is 5Fr, and after the pancreatic duct bracket is placed, the pancreatic duct bracket can block branches of a main pancreatic duct so as to induce pancreatitis.
Disclosure of Invention
According to the technical problems, a nasal bile duct for retaining a pancreatic duct guide wire is provided. The utility model adopts the following technical means:
the nasal bile duct with the pancreatic duct guide wire is characterized in that the duct body of the nasal bile duct is provided with a plurality of bending parts, at least comprises a bile duct bending part, a duodenal papilla bending part, a pylorus bending part and a gastric large bending part which are sequentially arranged from beginning to end, and the duodenal papilla bending part is provided with a guide wire passing hole; the tube section from the guide wire passing hole to the head end of the nasal bile duct is a first tube section, the tube section from the guide wire passing hole to the tail end of the nasal bile duct is a second tube section, the bending part of the duodenal papilla is the bending part at the joint of the first tube section and the second tube section, the bile duct bending part is positioned at the head part of the first tube section, and the pylorus bending part and the stomach large bending part are positioned on the second tube section; the head end of the nasal bile duct is used for placing a bile duct guide wire, the guide wire passing through the hole is used for placing a pancreatic duct guide wire, the bile duct guide wire penetrates through the whole nasal bile duct, and the pancreatic duct guide wire penetrates through the second pipe section.
Further, the nasal bile duct is a single channel tube or a non-single channel tube.
Further, when the nasal bile duct is a non-single channel tube, the first tube section is a single channel tube I, the second tube section is a double channel tube, and the double channel tube comprises a bile channel and a guide wire channel.
Further, the bile channel is communicated with the single-channel tube I, and the guide wire channel is communicated with the outside through a guide wire through hole.
Further, the head end of the nasal bile duct is conical.
Further, the length of the nasal bile duct is 200-220cm.
Compared with the prior art, the utility model has the following advantages:
1. the nasal bile duct of the indwelling pancreatic duct guide wire provided by the utility model has the advantages that the guide wire is reserved in the pancreatic duct, pancreatic juice can flow out under the guidance of the guide wire, and the nasal bile duct has the effect of preventing pancreatitis like the pancreatic duct bracket.
2. The nasal bile duct of the indwelling pancreatic duct guide wire provided by the utility model can be placed into a pancreatic duct with normal pipe diameter or abnormal running, so that the incidence rate of pancreatic duct stent placement failure or pancreatitis induced by the pancreatic duct stent itself can be reduced.
3. The nasal bile duct of the indwelling pancreatic duct guide wire provided by the utility model is led out from the nasal bile duct cavity, and the pancreatic duct guide wire can be prevented from shifting under the assistance of the nasal bile duct.
4. The nasal bile duct of the indwelling pancreatic duct guide wire provided by the utility model has double channels, can observe the shape of bile and duodenum at the same time, and judges the infection recovery degree, and has or not duodenal papilla bleeding.
5. The nasal bile duct of the indwelling pancreatic duct guide wire provided by the utility model has double channels, the control of biliary tract infection can be promoted by flushing through a bile channel by using antibiotics, and bleeding can be caused through the guide wire channel by using hemostatic drugs, the hemostatic drugs can be directly sprayed on the nipple, and the incidence rate of postoperative nipple wound bleeding can be reduced.
For the reasons, the utility model can be widely popularized in the fields of medical treatment and the like.
Drawings
In order to more clearly illustrate the embodiments of the present utility model or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described, and it is obvious that the drawings in the following description are some embodiments of the present utility model, and other drawings may be obtained according to the drawings without inventive effort to a person skilled in the art.
Fig. 1 is a schematic view showing the structure of an inserted guide wire according to embodiment 1 of the present utility model.
Fig. 2 is a schematic view of a plurality of curved portions in embodiment 1 of the present utility model.
Fig. 3 is a schematic view of the utility model after insertion of the cannula according to example 1.
Fig. 4 is a schematic structural diagram of embodiment 2 of the present utility model.
Fig. 5 is a schematic view showing the structure of an inserted guide wire according to embodiment 2 of the present utility model.
Fig. 6 is a schematic view of a plurality of curved portions in embodiment 2 of the present utility model.
Fig. 7 is a schematic view of the utility model after cannulation of example 2.
In the figure: 1. a first pipe section; 2. a second pipe section; 3. a guidewire passing hole; 4. bile duct bending part; 5. a duodenal papilla curvature; 6. pylorus curvature; 7. the large curvature of the stomach.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present utility model more apparent, the technical solutions of the embodiments of the present utility model will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present utility model, and it is apparent that the described embodiments are some embodiments of the present utility model, but not all embodiments of the present utility model. All other embodiments, which can be made by those skilled in the art based on the embodiments of the utility model without making any inventive effort, are intended to be within the scope of the utility model.
Example 1
In order to solve the defects in the prior equipment and operation technology, as shown in figures 1-3, the utility model provides a nasal bile duct retaining a pancreatic duct guide wire, namely a nasal bile duct with a guide wire for preventing pancreatitis. A method of operation is also provided.
The nose bile duct with the guide wire for preventing pancreatitis is a single-channel tube, the head end of the nose bile duct is conical, the length of the nose bile duct is 200-220cm, a plurality of bending parts exist on the tube body, and the nose bile duct with the guide wire for preventing pancreatitis is sequentially from beginning to end: bile duct curvature 4, duodenal papilla curvature 5, pylorus curvature 6, and gastric greater curvature 7. The duodenal papilla bending portion 5 is provided with a guide wire passing hole. The pipe section from the guide wire through hole 3 to the head end of the nasal bile duct is a first pipe section 1, the pipe section from the guide wire through hole 3 to the tail end of the nasal bile duct is a second pipe section 2, the duodenal papilla bending part 5 is a bending part at the joint of the first pipe section 1 and the second pipe section 2, the bile duct bending part 4 is positioned at the head part of the first pipe section 1, and the pylorus bending part 6 and the stomach large bending part 7 are positioned on the second pipe section 2. And (3) for patients with difficult bile duct intubation, performing bile duct intubation by adopting a double-guide wire method, finally, placing the bile duct guide wire through the nose bile duct head end, inserting the pancreatic duct guide wire through a guide wire hole on the nose bile duct, fixing the bile duct guide wire and the pancreatic duct guide wire, placing the nose bile duct head end into a right hepatic duct, closing the guide wire hole to the duodenal papilla, withdrawing the bile duct guide wire, and retaining the pancreatic duct guide wire in the nose bile duct. The utility model can prevent the occurrence rate of pancreatitis after the operation of the small-diameter pancreatic duct or the a-shaped pancreatic duct by reserving the guide wire in the pancreatic duct through the nasal bile duct.
The operation method of the nasal bile duct comprises the following steps:
1. double guide wire bile duct intubation: the double-guide-wire bile duct intubation method is a common method for difficult bile duct intubation, a cutter is used for carrying out bile duct intubation with a guide wire, and after the guide wire enters a pancreatic duct, the pancreatic duct guide wire is reserved. After the bile duct intubation is successful, operations such as cutting, expanding and stone removal of the duodenal papilla sphincter are completed, guide wires are reserved in the pancreas duct and the bile duct, the bile duct guide wires are inserted through the nose bile duct head end, the pancreas duct guide wires are inserted through the guide wire holes, the nose bile duct head end is inserted into the right liver duct under the guidance of the two guide wires, after the guide wire holes on the nose bile duct are close to the duodenal papilla, the bile duct guide wires are withdrawn, the pancreas duct guide wires and the nose bile duct are reserved, and finally the tail of the nose bile duct is connected with a drainage bag through a connector.
2. Single guide wire bile duct cannula: cutting the catheter with the guide wire, enabling the guide wire to smoothly enter the bile duct, and completing operations such as cutting, expanding, stone extraction and the like of the duodenal papilla sphincter. If the conditions of longer intubation time or operation time, bleeding of the duodenal papilla, papilla edema and the like exist, the conditions are determined to be high risk factors of pancreatitis after ERCP operation. And (3) withdrawing the bile duct guide wire, carrying out pancreatic duct intubation by using the incision knife with the guide wire, and after the intubation is successful, retaining the pancreatic duct guide wire and withdrawing the incision knife. The pancreas duct is inserted into the nasal bile duct through hole, the nasal bile duct is inserted under the guide of the guide wire, after the head end of the nasal bile duct is exposed, the nasal bile duct is inserted into the bile duct without the assistance of the guide wire, the nasal bile duct is inserted into the intrahepatic bile duct until the nasal bile duct guide wire hole is close to the duodenal papilla, the pancreas duct guide wire and the nasal bile duct are reserved, and finally the tail of the nasal bile duct is connected with the drainage bag through the connector.
The utility model has the advantages that the guide wire is reserved in the pancreatic duct, pancreatic juice can flow out under the guidance of the guide wire, and the pancreatic juice has the effect of preventing pancreatitis like the pancreatic duct bracket.
The pancreatic duct guide wire can be placed into a pancreatic duct with normal pipe diameter or abnormal running, so that the occurrence rate of pancreatic duct stent placement failure or pancreatitis induced by the pancreatic duct stent can be reduced.
The pancreas duct guide wire is led out through the nasal bile duct cavity, and the pancreas duct guide wire can be prevented from shifting under the assistance of the nasal bile duct.
Example 2
Pancreatitis is a major complication after Endoscopic Retrograde Cholangiopancreatography (ERCP), and is a major impediment factor limiting the wide development of ERCP techniques to a great extent. Non-steroidal anti-inflammatory drugs and pancreatic duct stents are currently the primary method for preventing pancreatitis after ERCP surgery, wherein pancreatic duct stents cannot reduce the incidence and severity of pancreatitis after ERCP surgery. Although the ERCP postoperative indwelling pancreatic duct stent plays an important role in preventing pancreatitis, the pancreatic duct stent is difficult to put in, and if the indication of the pancreatic duct stent is inaccurately mastered, the pancreatic duct stent can even induce pancreatitis. The main reasons are as follows: 1. if the running radian of the pancreatic duct is larger, the pancreatic duct mucous membrane can block the opening of the pancreatic duct bracket, so that pancreatic juice in the pancreatic duct at the far end of the bracket is not smoothly discharged, and pancreatitis occurs; 2. the pancreatic duct of the head part of the pancreas is in a spiral line or a shape and the like, a pancreatic duct bracket cannot be placed, and the forced placement of the pancreatic duct bracket can lead to the rupture of branch pancreatic ducts and induce acute severe pancreatitis; 3. the diameter of a normal pancreatic duct is 2-3mm, the circumference of a common pancreatic duct bracket is 5Fr, and the inserted pancreatic duct bracket can block branches of a main pancreatic duct so as to induce pancreatitis.
Duodenal papilla hemorrhage is another major complication of ERCP, such as untimely discovery, which can lead to hypovolemic shock, which endangers patient life. The hemostatic clip used prophylactically in operation can obviously reduce the incidence rate of postoperative bleeding, but the hemostatic clip has great operation difficulty, and is easy to cause papillary hyperplasia and even cause papillary sphincter scar stenosis. The bleeding rate can be reduced by using the hemostatic drug for nasal bile duct irrigation, but the hemostatic drug injected through the nasal bile duct can be diluted by bile, and has limited hemostatic effect.
In order to solve the defects in the prior equipment and operation technology, the utility model provides a nasal bile duct retaining a pancreatic duct guide wire and an operation method as shown in figures 4-7.
The head end of the nasal bile duct of the indwelling pancreatic duct guide wire is conical, the length of the nasal bile duct is 200-220cm, the tube body is bent, and the nasal bile duct is sequentially from beginning to end: bile duct curvature 4, duodenal papilla curvature 5, pylorus curvature 6, and gastric greater curvature 7. The duodenal papilla bending portion 5 is provided with a guide wire passing hole 3. The front end pipe section (namely the first pipe section) of the guide wire passing hole 3 is a single-channel pipe, the rear end pipe section (namely the second pipe section) is a double-channel pipe, and the guide wire passing hole comprises a bile channel and a guide wire channel, wherein the bile channel is communicated with the single-channel pipe of the first pipe section, and the guide wire channel is communicated with the outside through the guide wire passing hole 3. The guide wire remained in the pancreatic duct can be led out by the utility model, so that the displacement probability of the guide wire in the pancreatic duct can be reduced, and the postoperative pancreatitis can be prevented. The utility model can simultaneously observe the shapes of bile and duodenal fluid, judge whether the bleeding of biliary tract and duodenal papilla exists, and prevent postoperative delayed bleeding by flushing through a bile channel or a guide wire channel.
The operation method of the nasal bile duct comprises the following steps:
1. double guide wire bile duct intubation: the double-guide-wire bile duct intubation method is a common method for difficult bile duct intubation, a cutter is used for carrying out bile duct intubation with a guide wire, and after the guide wire enters a pancreatic duct, the pancreatic duct guide wire is reserved. After the bile duct intubation is successful, operations such as cutting, expanding and stone removal of the duodenal papilla sphincter are completed, guide wires are reserved in the pancreas duct and the bile duct, the bile duct guide wires are inserted through the nose bile duct head end, the pancreas duct guide wires are inserted through the guide wire holes, the nose bile duct head end is inserted into the right hepatic duct under the guidance of the two guide wires, after the guide wire holes on the nose bile duct are close to the duodenal papilla, the bile duct guide wires are withdrawn, the pancreas duct guide wires and the nose bile duct are reserved, and finally the tail of the nose bile duct is connected with two drainage bags through the connector.
2. Single guide wire bile duct cannula: cutting the catheter with the guide wire, enabling the guide wire to smoothly enter the bile duct, and completing operations such as cutting, expanding, stone extraction and the like of the duodenal papilla sphincter. If the intubation time or operation time in the operation is longer, and the conditions of bleeding, nipple edema and the like exist in the duodenal papilla, the high risk factor of pancreatitis after ERCP operation is determined. And (3) withdrawing the bile duct guide wire, carrying out pancreatic duct intubation by using the incision knife with the guide wire, and after the intubation is successful, retaining the pancreatic duct guide wire and withdrawing the incision knife. The pancreas tube guide wire is inserted into the nasal bile duct guide wire passing hole, the nasal bile duct is placed under the guide of the guide wire, after the head end of the nasal bile duct is exposed, the nasal bile duct is inserted into the bile duct without the assistance of the guide wire, the nasal bile duct is placed into the intrahepatic bile duct until the nasal bile duct guide wire hole is close to the duodenal papilla, the pancreas tube guide wire and the nasal bile duct are reserved, and finally the tail of the nasal bile duct is connected with a plurality of drainage bags through a connector.
The utility model has the advantages that the guide wire is reserved in the pancreatic duct, pancreatic juice can flow out under the guidance of the guide wire, and the pancreatic juice has the effect of preventing pancreatitis like the pancreatic duct bracket.
The pancreatic duct guide wire can be placed into a pancreatic duct with normal pipe diameter or abnormal running, so that the incidence rate of pancreatic duct stent placement failure or pancreatitis induced by the pancreatic duct stent can be reduced;
the pancreas duct guide wire is led out through the nasal bile duct cavity, and the pancreas duct guide wire can be prevented from shifting under the assistance of the nasal bile duct.
The utility model has double channels, can observe the shape of bile and duodenum at the same time, judge the infection recovery degree, and has or not duodenal papilla bleeding;
the utility model has double channels, uses antibiotics to wash through bile channel, can promote the control of biliary tract infection, uses hemostatic medicine to bleed through guide wire channel, can directly spray hemostatic medicine onto nipple, and can reduce the incidence of postoperative nipple wound bleeding.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present utility model, and not for limiting the same; although the utility model has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some or all of the technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit of the utility model.

Claims (6)

1. The nasal bile duct retaining the pancreas duct guide wire is characterized in that the duct body of the nasal bile duct is provided with a plurality of bending parts, and at least comprises a bile duct bending part (4), a duodenal papilla bending part (5), a pylorus bending part (6) and a gastric large bending part (7) which are sequentially arranged from beginning to end, wherein the duodenal papilla bending part (5) is provided with a guide wire passing hole (3); the tube section from the guide wire passing hole (3) to the head end of the nasal bile duct is a first tube section (1), the tube section from the guide wire passing hole (3) to the tail end of the nasal bile duct is a second tube section (2), the duodenal papilla bending part (5) is a bending part at the joint of the first tube section (1) and the second tube section (2), the bile duct bending part (4) is positioned at the head part of the first tube section (1), and the pylorus bending part (6) and the stomach large bending part (7) are positioned on the second tube section (2); the head end of the nasal bile duct is used for placing a bile duct guide wire, the guide wire passing hole (3) is used for placing a pancreatic duct guide wire, the bile duct guide wire penetrates through the whole nasal bile duct, and the pancreatic duct guide wire penetrates through the second pipe section (2).
2. The nasogastric tube of an indwelling pancreatic duct guidewire of claim 1, wherein said nasogastric tube is a single channel tube or a non-single channel tube.
3. The nasal bile duct of an indwelling pancreatic duct guidewire according to claim 2, wherein when said nasal bile duct is a non-single channel tube, the first tube segment (1) is a single channel tube i and the second tube segment (2) is a dual channel tube comprising a bile channel and a guidewire channel.
4. A nasal bile duct with an indwelling pancreatic duct guidewire according to claim 3, in which the bile channel is in communication with a single channel tube i, and the guidewire channel is in communication with the outside through a guidewire passage hole (3).
5. The nasogastric tube of an indwelling pancreatic duct guidewire of claim 1, wherein a head end of said nasogastric tube is conical.
6. The nasogastric tube of an indwelling pancreatic duct guidewire of claim 1, wherein said nasogastric tube has a length of 200-220cm.
CN202223315907.6U 2022-12-09 2022-12-09 Nasal bile duct with pancreas tube guide wire Active CN219071770U (en)

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Application Number Priority Date Filing Date Title
CN202223315907.6U CN219071770U (en) 2022-12-09 2022-12-09 Nasal bile duct with pancreas tube guide wire

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202223315907.6U CN219071770U (en) 2022-12-09 2022-12-09 Nasal bile duct with pancreas tube guide wire

Publications (1)

Publication Number Publication Date
CN219071770U true CN219071770U (en) 2023-05-26

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