WO2012007045A1 - Dispositif et procédé de détournement sous-cutané de la bile - Google Patents

Dispositif et procédé de détournement sous-cutané de la bile Download PDF

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Publication number
WO2012007045A1
WO2012007045A1 PCT/EP2010/060269 EP2010060269W WO2012007045A1 WO 2012007045 A1 WO2012007045 A1 WO 2012007045A1 EP 2010060269 W EP2010060269 W EP 2010060269W WO 2012007045 A1 WO2012007045 A1 WO 2012007045A1
Authority
WO
WIPO (PCT)
Prior art keywords
proximal
distal
catheter
end portion
abdominal wall
Prior art date
Application number
PCT/EP2010/060269
Other languages
English (en)
Inventor
James W. Voegele
Thomas Edward Albrecht
Christopher J. Hess
Mark S. Zeiner
Mark Steven Ortiz
Alessandro Pastorelli
Michele D'arcangelo
Federico Bilotti
Original Assignee
Ethicon Endo-Surgery, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ethicon Endo-Surgery, Inc. filed Critical Ethicon Endo-Surgery, Inc.
Priority to CN201080068087.6A priority Critical patent/CN103002832B/zh
Priority to PCT/EP2010/060269 priority patent/WO2012007045A1/fr
Publication of WO2012007045A1 publication Critical patent/WO2012007045A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2002/041—Bile ducts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/80—Suction pumps

Definitions

  • the present invention relates, in general, to devices and methods for surgically influencing the digestion of a patient with the aim to treat metabolic disorders, such as morbid obesity and related co-morbidities, such as diabetes, heart disease, stroke, pulmonary disease, and accidents.
  • metabolic disorders such as morbid obesity and related co-morbidities, such as diabetes, heart disease, stroke, pulmonary disease, and accidents.
  • a known minimally invasive bypass system and method for modifying the location at which bile and pancreatic secretions interact with nutrients in a gastrointestinal tract has been discussed in US 2005085787 A1.
  • the known system comprises a conduit having a first end which diverts bile and pancreatic secretions from the ampulla of Vater to a location downstream in the gastrointestinal tract and a second end attached to the ampulla of Vater.
  • the known conduit catheters tend to bundle up and to be displaced by the peristalsis of the intestinal tract so that the distal end of the catheter is frequently relocated far away from the target position intended by the surgeon. Moreover, the known conduit can divert only the amount of bile which has been released through the sphincter of ODDI and the flow rate of bile through the known conduit would not be sufficient to obtain a significant acceleration of the bile cycling compared to the natural entero- hepatic bile cycling velocity.
  • a method for diverting biliary fluid from a biliary fluid flow path to a point distal to a duodenal papilla of Vater comprising the steps of creating a flow path in an abdominal wall and extending a catheter from the biliary fluid flow path through the abdominal wall flow path to a location in the gastrointestinal tract distal to the duodenal papilla of Vater.
  • a proximal end of the catheter is arranged within a gallbladder and the gallbladder is anastomosed to a layer of the abdominal wall.
  • a proximal end of the catheter is arranged within a hepatic duct (right or left or common hepatic duct), thereby obviating the risk of trauma to the common bile duct which is very delicate and fragile.
  • a pump is arranged in the biliary fluid flow path in the abdominal wall and connected with the catheter to accelerate a bile flow to the location in the gastrointestinal tract distal to the duodenal papilla of Vater.
  • a device for diverting biliary fluid from a biliary fluid flow path to a point distal to a duodenal papilla of Vater comprising:
  • a catheter having a proximal end portion and a distal end portion and a conduit section extending between the proximal end portion and the distal end portion,
  • proximal end portion is adapted for percutaneous placement, across an abdominal wall, in a biliary fluid flow path
  • distal end portion is adapted for transcutaneous tunnelization, through the abdominal wall, and for percutaneous insertion, across the abdominal wall, in a target section of small intestine,
  • - distal fixating means connected to the distal end portion and adapted to immobilize the target section of small intestine with respect to the abdominal wall and to the catheter distal end portion.
  • the device comprises proximal fixating means connected to the proximal end portion and adapted to immobilize the biliary fluid flow path with respect to the abdominal wall and to the catheter proximal end portion.
  • the biliary fluid flow path can be the gallbladder or a hepatic duct.
  • the device comprises a pump for accelerating a bile flow in the catheter, the pump being connected to the conduit section and adapted to be arranged in a subcutaneous space in the abdominal wall.
  • FIG. 1 illustrates a device and method for a subcutaneous diversion of bile in accordance with an embodiment of the invention
  • FIG. 2 illustrates a surgical procedure and method for a subcutaneous diversion of bile in accordance with a further embodiment
  • FIG. 3 illustrates a device and method for a subcutaneous diversion of bile in accordance with a further embodiment of the invention
  • FIG. 4 illustrates a detail of the device and method step for a subcutaneous diversion of bile in accordance with a further embodiment of the invention
  • FIG. 5 illustrates a detail of the device in figures 1 to 3 in accordance with an embodiment
  • FIG. 6 illustrates a pump for accelerating bile in accordance with an embodiment
  • FIG. 7 illustrates a pump for accelerating bile or clearing the device in accordance with a further embodiment
  • FIG. 8 illustrates a method in accordance with a yet further embodiment of the invention
  • figure 1 is a partial view of the abdominal cavity of a patient, depicting the abdominal wall 1 with the following layers (from superficial to deep): skin - fascia - muscle - fascia transversalis - peritoneum, the stomach 2, duodenum 3, jejunum 4, ileum 5, colon 6, as well as the biliary tree 7 with gall bladder 8, the pancreatic duct 9 and the mayor duodenal papilla of Vater 10 through which the bile and pancreatic fluid normally enter the duodenum 3.
  • Figure 1 shows further a method and a device 11 for diverting biliary fluid from the biliary fluid flow path, particularly from the gall bladder 8, to a target location in the intestine distal of the papilla of Vater 10.
  • the method comprises the steps of creating a flow path 12 in the abdominal wall 1 and extending a catheter 13 from the biliary fluid flow path 7, 8 through the abdominal wall flow path 12 to a location in the gastrointestinal tract distal to the duodenal papilla of Vater 10.
  • a proximal end portion 14 of the catheter 13 is arranged within the gallbladder 8 and the gallbladder 8 may be anastomosed to an internal layer of the abdominal wall 1.
  • a possible procedure for deploying the subcutaneous catheter 13 may include the selection and marking of a proximal abdominal wall site "A” and a distal abdominal wall site “B” and local anesthetization of proximal site "A” and distal site “B”. Then, visualization of the gallbladder 8 is gained by abdominal ultrasonic imaging, radiography or fluoroscopy. Once the position and orientation of the gallbladder 8 is known, the abdominal wall 1 is opened at the proximal site "A” and a percutaneous cholecystostomy of the gallbladder 8 is performed through the abdominal wall 1 at the proximal site "A".
  • the proximal end portion 14 of the catheter 13 is inserted through the abdominal wall 1 and the cholecystostomy into the gallbladder 8 and fixated with respect to the gallbladder 8 and with respect to the abdominal wall 1 at the proximal site "A".
  • the fixation of the proximal end portion 14 of the catheter 13 can involve a first proximal expandable collar 15 connected to the proximal end portion 14 and inserted together with the proximal end portion 14 through the abdominal wall and through the gallbladder wall inside the gallbladder 8.
  • the first proximal expandable collar 15 may comprise an inflatable balloon collar or an elastically or temperature dependent expandable collar.
  • the collar 15 is expanded, e.g. by insufflating a balloon collar, thereby covering and possibly sealing the previously created cholecystotomy from inside the gallbladder 8. Then the catheter 13 is pulled distally so that the proximal catheter end portion
  • a second proximal collar 16 connected to the proximal end portion 14 distal to the first collar
  • the second proximal collar 16 may comprise an inflatable balloon collar or an elastically or temperature dependent expandable collar or an annular disk shaped collar.
  • the second proximal collar 16 is adapted to slide along the catheter 13 and can be locked to the catheter 13 in a desired position to prevent further relative translation between the catheter 13 and the collars 15, 16, thereby assuring the intended compression between the gallbladder 8 wall and the abdominal wall 1 as well as the fixation of the catheter 13 at the proximal abdominal wall site "A".
  • a distal end portion 17 of the catheter 13 is subcutaneously “tunnelized” from the proximal site "A” to the distal site "B", that means the distal end portion 17 is pierced in a subcutaneous layer of the abdominal wall 1 at proximal site "A” and advanced beneath the patient's skin to the distal site "B", at which a distal end 18 of the distal end portion 17 is brought outside the body ("externalization" of the catheter end).
  • the device 1 1 may comprise a needle (not illustrated) securely fixed to the distal catheter end 18 and intended to be separated from the latter after "tunnelization".
  • the abdominal wall 1 is opened at the distal site "B” and a percutaneous enterostomy (e.g. a jejunostomy) is performed through the abdominal wall 1 at the distal site "B".
  • a percutaneous enterostomy e.g. a jejunostomy
  • the distal end portion 17 of the catheter 13 is inserted through the abdominal wall 1 and the enterostomy into the small intestine, e.g. in the jejunum 4, and fixated with respect to the intestine and with respect to the abdominal wall 1 at the distal site "B".
  • the fixation of the distal end portion 17 of the catheter 13 can involve a first distal expandable collar 19 connected to the distal end portion 17 and inserted together with the distal end portion 17 through the abdominal wall 1 and through the enterostomy inside the intestine 4.
  • the first distal expandable collar 19 may comprise an inflatable balloon collar or an elastically or temperature dependent expandable collar.
  • the collar 19 is expanded, e.g. by insufflating a balloon collar, thereby covering and possibly sealing the previously created enterostomy from inside the intestine. Then the distal end portion 17 of catheter 13 is pulled proximally so that the intestine 4 is approximated to and pressed against an internal layer, i.e. the peritoneum, of the abdominal wall 1 to allow anastomosis therebetween.
  • an internal layer i.e. the peritoneum
  • the compression between the intestine and the abdominal wall 1 at the distal site “B" can be maintained by a second distal collar 20 connected to the distal end portion 17 proximal to the first distal collar 19 and adapted to hold the intestinal wall (particularly the enterostomy of the jejunum wall) and at least an internal layer (e.g. peritoneum or peritoneum and muscle layer) of the abdominal wall 1 between the first and second distal collars 19, 20.
  • a second distal collar 20 connected to the distal end portion 17 proximal to the first distal collar 19 and adapted to hold the intestinal wall (particularly the enterostomy of the jejunum wall) and at least an internal layer (e.g. peritoneum or peritoneum and muscle layer) of the abdominal wall 1 between the first and second distal collars 19, 20.
  • the second distal collar 20 may comprise an inflatable balloon collar or an elastically or temperature dependent expandable collar or an annular disk shaped collar.
  • the second distal collar 16 is adapted to slide along the catheter 13 and can be locked to the catheter 13 in a desired position to prevent further relative translation between the catheter 13 and the collars 19, 20, thereby assuring the intended compression between the enterostomy and the abdominal wall 1 as well as the fixation of the catheter 13 at the distal abdominal wall site "B".
  • the skin at the proximal site "A" and at the distal site “B” can be sutured.
  • the catheter comprises only one expandable proximal collar 15 and only one expandable distal collar 19 adapted to approximate the gallbladder and the intestine to the abdominal wall, wherein the position and compression is assured by additional sutures and/or by the longitudinal tensional resistance of the catheter 13.
  • a proximal end 23 of the catheter 13 is arranged within a hepatic duct 21 , i.e. within the right or left or common hepatic duct.
  • the abdominal wall 1 is opened at the proximal site "A” and a percutaneous transhepatic cholangiography (PTC) is performed with deployment of the proximal catheter end portion 14 through the abdominal wall 1 at the proximal site "A".
  • PTC percutaneous transhepatic cholangiography
  • a thin needle is inserted through the skin (percutaneous) at the proximal site "A" and through the liver 22 (transhepatic) into a bile duct 7.
  • contrast media is injected, and the bile duct system is outlined, wherein imaging may be performed by fluoroscopy.
  • a small guide wire is guided through the needle, into the hepatic duct 21 and possibly but not necessarily into the common bile duct ( Figure 4) while watching the wire and ducts on x-ray.
  • the proximal catheter end portion 14 is then inserted and fixated in the hepatic duct 21 to allow the bile to be drained from the liver, thereby avoiding manipulation of the very delicate and fragile common bile duct.
  • the proximal catheter end 23 may be fixated in the hepatic duct 21 by means of an anchoring member 24 connected to the proximal catheter end portion 14, such as for example a metal stent, an inflatable balloon or a barbed anchoring portion ( Figure 3).
  • the proximal catheter end 23 may be fixated in the biliary duct 7 by means of the same anchoring member 24 connected to the proximal catheter end portion 14.
  • the catheter 13 may be "tunnelized” and extended intramurally in the abdominal wall 1 , i.e. between the parietal pleuramembrane and the fascia (preferably closer to the pleuramembrane), rather than subcutaneously.
  • a pump 25 is arranged in the biliary fluid flow path in the abdominal wall 1 and connected with the catheter 13 to accelerate the bile flow to the location in the gastrointestinal tract distal to the duodenal papilla of Vater 10.
  • the pump 25 is connected to a conduit section 26 of the catheter 13 and can be preferably arranged in a subcutaneous space.
  • the pump 25 may comprise an onboard power source 27 with an inductive recharging unit 28 adapted to be energized by an extracorporeal charging station 29 configured to operate a transcutaneous energy transfer (Figure 6).
  • the pump 25 comprises a pumping member 30, e.g. an elastically deformable hollow bulb or bellows, adapted to be deformable by muscular contractions of the abdominal wall, which occur for instance during standing up, sitting down and walking.
  • a pumping member 30 e.g. an elastically deformable hollow bulb or bellows, adapted to be deformable by muscular contractions of the abdominal wall, which occur for instance during standing up, sitting down and walking.
  • one way valves 31 can be arranged in the pump 25 or in the catheter 13 proximal and distal to the pumping member 30.
  • Such a muscle powered valve is completely independent from any external energy source.
  • the pumping operation is automatically or manually controlled and activated by means of an extracorporeal magnetic pump controller 36 which may be integrated in the above described charging station 29 or distinct from the latter.
  • the pump controller 36 is adapted to generate and transmit to the pump 25 a control signal by magnetic induction in a near-field propagation mode and the pump 25 is adapted to pump the bile in
  • an additional therapeutic agent is delivered to the distal target location in the intestine by injecting or dispensing the additional therapeutic agent into the catheter 13.
  • the device 1 1 may comprise an injection port 32 adapted to be deployed in a subcutaneous space.
  • the injection port 32 comprises a proportioning device 33 which is fluid connected with the catheter 13 and an injection septum 34 adapted to be pierced through by a syringe to receive the therapeutic agent.
  • the injection port 32 may be integrated in the valve 25.
  • a flushing agent such as physiological saline solution
  • manual clearing of the catheter 13 can be accomplished, e.g. by manually pressing the pumping member 30.
  • the pump 25 may contain radio-opaque material and the pump position may be marked by means of a surface tattoo on the patient's abdominal skin.
  • FIG. 8 illustrates a further exemplary embodiment, in which a harvested tubular organ 35, such as a saphenous vein is used instead of the catheter 13.
  • a harvested tubular organ 35 such as a saphenous vein
  • the device 1 1 comprises a hollow external needle 37 having a sharp pointed proximal end 38 adapted to penetrate through the abdominal wall 1 and a blunt tip portion 39 connected to the proximal end 38 and movable between a first position in which the blunt tip portion 39 exposes the pointed distal end 38 and a second position in which the blunt tip portion 39 covers the pointed distal end 38, thereby protecting the surrounding tissue from trauma.
  • a suction device 40 is slidably received inside the hollow external needle 37 and movable distally out of the hollow needle proximal end 38.
  • the suction device 40 comprises a suction tube 41 and a suction cap 42 connected to a proximal end of the suction tube 41 and adapted to hold an organ, particularly the gallbladder 8, by suction.
  • the device 1 1 may further comprise a tubular perforation needle 43 attached to the suction device 40 and adapted to perforate the organ, especially the gallbladder 8, held by the suction cap 42.
  • the perforation needle 43 may be received slidably, and possibly rotatably, inside the suction tube 41 or suction cap 42 and operable to advance proximally, and possibly rotate, to perforate the wall of the organ held by the suction cap 42.
  • the catheter 13 can be slidingly delivered through an internal channel 44 of the tubular perforation needle 43 or through the suction tube 41 , so that the proximal end portion 14 of the catheter 13 emerges inside the held and perforated organ, particularly gallbladder 8.
  • the catheter 13 may comprise the above described first proximal expandable collar 5 connected to the proximal end portion 14 and insertible together with the proximal end portion 14 through the tubular perforation needle 43 or through the suction tube 41 inside the gallbladder 8.
  • the first proximal expandable collar 15 may comprise an inflatable balloon collar or an elastically or temperature dependent expandable collar.
  • the collar 15 is expanded, e.g. by insufflating a balloon collar, thereby covering and possibly sealing the previously created cholecystotomy from inside the gallbladder 8. Then the catheter 13 is pulled distally (i.e. towards the abdominal wall 1 ) so that the proximal catheter end portion 14 together with the gallbladder 8 is approximated to and pressed against an internal layer, i.e. the peritoneum, of the abdominal wall 1 to allow anastomosis therebetween.
  • an internal layer i.e. the peritoneum
  • the compression between the gallbladder 8 and the abdominal wall 1 at the proximal site "A" can be maintained by a second proximal collar 16 connected to the proximal end portion 14 distal to the first collar 15 and adapted to hold the gallbladder wall and at least an internal layer (e.g. peritoneum or peritoneum and muscle layer) of the abdominal wall 1 between the first and second proximal collars 15, 16.
  • a second proximal collar 16 connected to the proximal end portion 14 distal to the first collar 15 and adapted to hold the gallbladder wall and at least an internal layer (e.g. peritoneum or peritoneum and muscle layer) of the abdominal wall 1 between the first and second proximal collars 15, 16.
  • the second proximal collar 16 may comprise an inflatable balloon collar or an elastically or temperature dependent expandable collar or an annular disk shaped collar. As best seen in figure 16, the first and second proximal collars can also be configured to seal the interstice between the catheter and the gallbladder wall to avoid leakage of bile into the abdominal space.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Pulmonology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Ophthalmology & Optometry (AREA)
  • Otolaryngology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un dispositif (11) destiné à détourner le fluide biliaire d'une voie de circulation du fluide biliaire (7, 8, 21) vers une zone cible dans l'intestin (4), comprenant un cathéter (13) comprenant une section de conduite (26) s'étendant entre une partie d'extrémité proximale (14) et une partie d'extrémité distale (17), la partie d'extrémité proximale (14) étant conçue pour un placement percutané dans la voie de circulation du fluide biliaire (7, 8, 21) et la partie d'extrémité distale (17) étant conçue pour une tunnélisation transcutanée, à travers la paroi abdominale (1), et pour une insertion percutanée dans une section cible de l'intestin grêle. Le dispositif comprend un autre moyen de fixation distale (19, 20) connecté à la partie d'extrémité distale (17) et conçu pour immobiliser la section cible de l'intestin grêle par rapport à la paroi abdominale (1) et à la partie d'extrémité distale du cathéter (17).
PCT/EP2010/060269 2010-07-16 2010-07-16 Dispositif et procédé de détournement sous-cutané de la bile WO2012007045A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CN201080068087.6A CN103002832B (zh) 2010-07-16 2010-07-16 一种用于胆汁皮下转移的装置和方法
PCT/EP2010/060269 WO2012007045A1 (fr) 2010-07-16 2010-07-16 Dispositif et procédé de détournement sous-cutané de la bile

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/060269 WO2012007045A1 (fr) 2010-07-16 2010-07-16 Dispositif et procédé de détournement sous-cutané de la bile

Publications (1)

Publication Number Publication Date
WO2012007045A1 true WO2012007045A1 (fr) 2012-01-19

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PCT/EP2010/060269 WO2012007045A1 (fr) 2010-07-16 2010-07-16 Dispositif et procédé de détournement sous-cutané de la bile

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WO (1) WO2012007045A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013004269A1 (fr) * 2011-07-01 2013-01-10 Ethicon Endo-Surgery, Inc. Dispositif et procédé pour acheminer de la bile vers un emplacement cible dans l'intestin
US20170165458A1 (en) * 2015-12-15 2017-06-15 Steven Sounyoung Yu Biliary Diversion Catheter

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB201420829D0 (en) * 2014-11-24 2015-01-07 Imp Innovations Ltd Lymph node replacement construct
CN106073954A (zh) * 2016-06-14 2016-11-09 广州市番禺区中心医院 肝内外胆管体外互联装置
CN106943136B (zh) * 2017-05-02 2023-09-15 温州市中心医院 一种胆道测压管
CN114082001B (zh) * 2021-10-27 2024-03-26 浙江清华柔性电子技术研究院 植入式液体转运装置及液体转运控制系统

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050020963A1 (en) * 2003-07-26 2005-01-27 Gabal Abdelwahab M. Implantable duct system connecting the intrahepatic portal vein to the femoral vein for establishing a subcutaneous porto-systemic shunt and simultaneously providing a durable access to the portal vein
US20050085787A1 (en) 2003-10-17 2005-04-21 Laufer Michael D. Minimally invasive gastrointestinal bypass

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN85204796U (zh) * 1985-12-11 1987-05-06 江苏省江浦县人民医院 胆肠内引流“三通管”
CN201263833Y (zh) * 2008-09-27 2009-07-01 中国人民解放军第二军医大学 一种可防止腹液外渗和导管滑脱的胆道t形引流管
CN201469862U (zh) * 2009-07-06 2010-05-19 邹晓玫 胰管引流导管

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050020963A1 (en) * 2003-07-26 2005-01-27 Gabal Abdelwahab M. Implantable duct system connecting the intrahepatic portal vein to the femoral vein for establishing a subcutaneous porto-systemic shunt and simultaneously providing a durable access to the portal vein
US20050085787A1 (en) 2003-10-17 2005-04-21 Laufer Michael D. Minimally invasive gastrointestinal bypass

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013004269A1 (fr) * 2011-07-01 2013-01-10 Ethicon Endo-Surgery, Inc. Dispositif et procédé pour acheminer de la bile vers un emplacement cible dans l'intestin
US20170165458A1 (en) * 2015-12-15 2017-06-15 Steven Sounyoung Yu Biliary Diversion Catheter
US10449075B2 (en) 2015-12-15 2019-10-22 Steven Sounyoung Yu Biliary diversion catheter

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Publication number Publication date
CN103002832B (zh) 2015-09-23
CN103002832A (zh) 2013-03-27

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