CN100413473C

CN100413473C - Stent used for cholangiojejunostomy

Info

Publication number: CN100413473C
Application number: CNB2005100227181A
Authority: CN
Inventors: 吕毅
Original assignee: Xian Jiaotong University
Current assignee: Xian Jiaotong University
Priority date: 2005-12-23
Filing date: 2005-12-23
Publication date: 2008-08-27
Anticipated expiration: 2025-12-23
Also published as: CN1792336A

Abstract

The present invention relates to a gall-intestine anastomosing scaffold which comprises a conic head and a conic seat connected with the conic head, wherein the conic head with magnetism has conic structure with thin top end and larger middle upper part and is provided with a through hole. The conic head is connected with one end of a cylindrical duct by the through hole, and the conic seat forms a magnetic hollow cone. The conic seat can be sheathed on the duct, and the inner diameter of the conic seat is slightly larger than the outer diameter of the duct of the cone. The present invention uses the magnetic attraction to complete the anastomosis without suture between a gall duct and an intestine duct and can be left at an anastomotic stoma to play the role of fixed supporting, and phenomena of anastomotic stoma fistula and narrow anastomotic stoma are reduced under the condition that the gall-intestine anastomosis can not be completed in a process after an acute bile duct is damaged. When the anastomotic stoma does not need supporting, the gall-intestine anastomosing scaffold can be conveniently extracted with a drainage duct together. The gall-intestine anastomosing scaffold has the advantages of accurate anastomosis and simple and practical design. The operation difficulty is obviously reduced, and the operation is greatly simplified.

Description

A kind of biliary duct jejunum anastomotic scaffold

Technical field

The present invention relates to a kind of surgical operation anastomosis bracket, particularly a kind of bile duct small intestinal that carries out does not have the biliary duct jejunum anastomotic scaffold of sewing up anastomosis and playing the biliary tract rack effect.Also be applicable to bile duct end to end anastomosis or biliary enteric anastomosis in the transplantation of liver.

Background technology

Traditional biliary enteric anastomosis is to carry out manual suture biliary tract and small intestinal with suture, because of biliary tract and small intestinal bore differ greatly, many employing end-to-side anastomosis so coincide, the difficulty of coincideing is big, specification requirement height, the incidence rate height of coincide back fistula of operative incision and anastomotic stricture, and the existence of anastomotic stoma suture can cause mucosa erosion and tissue inflammation edema, strengthen the stimulation of bile, impel scar hyperplasia, easily form anastomotic stricture scar tissue.Anastomotic stoma needs support tube more and supports the long period to reduce the generation of anastomotic stricture.Especially after biliary duct injury because the surrounding tissue inflammatory reaction makes traditional sewing coincide to be difficult to guarantee once success, thereby most cases is biliary tract external drainage in advance only, solves leak and peritonitis, parturients having undergone elective biliary enteric anastomosis then.The biliary duct injury iatrogenic factors is more, and repeatedly surgical patient is painful big, and complication is many, and cost is high, and the patient is beyond affordability, often causes conflict between doctors and patients.

The intestinal that a kind of alloy material-magnet ring that had the people that thulium is made in the last few years is applied to after vascular anastomosis and gastrointestinal anastomosis and the colorectal cancer excision coincide, the result shows that the suction utilize magnetic material can safety finishes between human vas, coincideing and need not silk suture between gastrointestinal, between intestinal tube, and has reduced the generation of anastomotic stricture and fistula of operative incision.People such as Saveliev in 1993 report identically can be used as a kind of palliative treatment way for what the patient of far-end obstruction of bile duct used that magnet ring carries out gallbladder stomach function regulating or small intestinal.After this there is the magnetic pressure utilized to compel principle successively and carries out report identical between the gallbladder small intestinal, utilize gallbladder to carry out a kind of palliative therapy that the gallbladder intestinal coincide when the bile duct far-end blocks but all be limited to basically.What often adopt in clinical then is cholangiojejunostomy.China improves in the Qu Heng field GF anastomat voluntarily and carries out the gallbladder intestinal and coincide, reduced of the influence of manual suture technology to anastomotic stoma, but its application foundation is the common bile duct diameter must be expanded and reach that the person could put into bile duct with nail supporting base more than 2 centimetres, has limited its extensive use in clinical.

Though the generation that the long-term placement of biliary enteric anastomosis after-poppet pipe can alleviate anastomotic stricture, because the existence of suture and suturing skill and rubber standoff Guan Junke commonly used influence the healing of anastomotic stoma, anastomotic stricture still is difficult to avoid.The application of magnet ring in little blood vessel and intestinal tube anastomosis at present demonstrated good promotion prospect.And there are some researches show metal rack to the influence of anastomotic healing less than the rubber standoff pipe.Therefore magnetic material might be applied to fully during the gallbladder intestinal coincide, utilize magneticaction and need not use conventional suture and finish coincideing of gallbladder intestinal.But the end to end anastomosis that the gallbladder intestinal coincide and to be different between the blood vessel and to wait bore between the intestinal tube, its anastomotic stoma both sides caliber size differs greatly, and anastomotic stoma still needs the generation of stent support long period with the minimizing anastomotic stricture.Also there are the both sides of two Magnet being put into stenosis of bile duct by interventional method to treat the report of stenosis of bile duct in recent years, but have different significantly with present technique.This law can provide disposable successful gallbladder intestinal anastomosis, and can support anastomotic stoma and avoid anastomotic stricture, has very outstanding and positive social benefit again.

Summary of the invention

The objective of the invention is to overcome the shortcoming of above-mentioned prior art, a kind of identical effect of not having stitching that not only has is provided, and have a bile drainage, and support the effect of biliary tract, needing behind the bile duct injury to be particularly useful for the biliary duct jejunum anastomotic scaffold of the capable biliary enteric anastomosis of first phase.

For achieving the above object, the technical solution used in the present invention is: comprise conehead and be attached thereto the awl seat that connects, be characterized in, said conehead has magnetic, is that cone structure and top are thin, slightly expand the middle and upper part, offers a through hole on the conehead, conehead is connected with an end of cylindrical conduit by this through hole, said awl seat is for having the cone that is hollow of magnetic, and the awl seat can be sleeved on the conduit, and the internal diameter of awl seat is slightly larger than the external diameter of conduit.

Another characteristics of the present invention are to be coated with the titanium or the Parylene biological coating that strengthen biocompatibility on conehead, conduit and the awl seat respectively.

The nothing that the present invention utilizes magnetic attracting force to finish bile duct and intestinal tube is sewed up and is coincide, can keep somewhere in anastomotic stoma again and play fixed supporting role, reduced the generation of fistula of operative incision and anastomotic stricture, when not needing to support, anastomotic stoma can together extract with drainage tube very easily, not only involutory accurate, simple and easy to do, and can obviously reduce operating difficulty, simplify operation technique greatly.

Description of drawings

Fig. 1 is an overall structure sketch map of the present invention;

Fig. 2 is a cutaway view of the present invention;

Fig. 3 is a use ideograph of the present invention.

The specific embodiment

Below in conjunction with accompanying drawing the present invention is described in further detail.

Referring to Fig. 1,2, the present invention includes conehead 1 and be attached thereto the awl seat 4 that connects, said conehead 1 has magnetic, be cone structure and the top is thin, slightly expand the middle and upper part, the shape and structure of conehead 1 is easy to insert bile duct and expands and partly can play fixation, offer a through hole 3 on the conehead 1, conehead 1 is connected with an end of cylindrical conduit 2 by this through hole 3, said awl seat 4 is for having the cone that is hollow of magnetic, and awl seat 4 can be sleeved on the conduit 2, and the internal diameter of awl seat 4 is slightly larger than the external diameter of conduit 2, awl seat 4 lower ends are connected with drainage tube, be easy to extract with drainage tube, promptly form a magnetic biliary tract rack when magnetic support 4 is complete by conduit 2 and conehead 1 after involutory, the present invention is also at conehead 1, be coated with titanium or the Parylene biological coating that strengthens biocompatibility respectively on conduit 2 and the awl seat 4.This device can be made into the model of different-diameter size.

The present invention at first should measure the internal diameter of bile duct in use, selects then and the corresponding a pair of anastomosis bracket of conehead 1 top external diameter, and the conduit 2 of hand-held cone inserts bile duct with conehead 1 gently, the ligation bile duct broken ends of fractured bone fixedly bile duct on conduit 2; To bore seat 4 is inserted by the small intestinal broken ends of fractured bone and to plan to implement gallbladder intestinal anastomosis, the intestinal wall acanthopore, the conduit 2 of guide cone penetrates in the awl seat 4, ajust anatomical position, involutory cone and awl seat 4, the through hole 3 that is connected with conduit 2 that is opened on the conehead 1 can make bile flow in the enteric cavities through conduit 2, and conduit 2 is drawn and passed fixing through stomach wall from intestinal wall.

The present invention can keep somewhere in the body, and the bile duct broken ends of fractured bone and intestinal wall are sandwiched between cone and the awl seat 4, and intermediate structure is downright bad gradually, and bile duct wall and intestinal wall heal gradually along support.Left and right sides anastomotic stoma can form in 10 days, and can continue as required to keep somewhere the 1-3 month this moment, supported anastomotic stoma, avoided biliary tract stenosis.If will take out support, need only extract in the lump together with drainage tube.

Outstanding feature of the present invention be this anastomosis bracket both can utilize magnetic attracting force finish bile duct and The nothing of intestinal tube is sewed up and is coincide, and can keep somewhere in previous anastomotic again play fixed supporting role, reduce anastomotic leakage and The generation of anastomotic stricture can together be pulled out with drainage tube when previous anastomotic does not need to support very easily Go out. Previous anastomotic need not to sew up, and is involutory accurate, simple and easy to do. At courage intestines anastomosis operation, especially at courage Be difficult for after the pipe damage can obviously reducing operating difficulty when reparation or first phase carry out biliary enteric anastomosis, greatly subtract Change operation technique, the anastomotic stricture that the scar healing that minimizing suturing skill and suture cause causes falls The incidence of low anastomotic leakage, making first phase repair courage intestines continuity becomes possibility. Thereby the patient is avoided Repeated Operation hits, and alleviates biliary duct injury patient's misery. Also be applicable to the bile duct end in the transplantation of liver End coincide or biliary enteric anastomosis. He has significantly with identical the comparing of stapler with traditional craft is identical Advantage is carried out the alimentary tract anastomosis art with the magnetic compression method of external report and is compared and also have significant progress.

Claims

1. biliary duct jejunum anastomotic scaffold, comprise conehead [1] and be attached thereto the awl seat [4] that connects, it is characterized in that: said conehead [1] has magnetic, be that cone structure and top are thin, slightly expand the middle and upper part, offer a through hole [3] on the conehead [1], conehead [1] is connected by the end of this through hole [3] with cylindrical conduit [2], and said awl seat [4] is for having the cone that is hollow of magnetic, awl seat [4] can be sleeved on the conduit [2], and the internal diameter of awl seat [4] is slightly larger than the external diameter of conduit [2].

2. biliary duct jejunum anastomotic scaffold according to claim 1 is characterized in that: be coated with titanium or the Parylene biological coating that strengthens biocompatibility respectively on said conehead [1], conduit [2] and the awl seat [4].