Method for introducing transhepatic drainage for intrahepatic bile ducts

FIELD: medicine.

SUBSTANCE: method involves conducting bougie through the liver. Flexible tube is attached to its end and set in bile ducts. Flexible radio-opaque conductor is introduced through the flexible tube. The tube is removed. Draining tube is introduced along the conductor from porta hepatis to its diaphragmatic surface into the ducts to be drained.

EFFECT: reduced risk of traumatic complications.

 

The invention relates to medicine, namely to liver surgery, and ways of conducting transretinoic drains.

A known method lies in the fact that for transperceneige drainage use clamp-type collets, which together with the drainage tube put on the end of the uterine probe wire after tunnelling liver (1).

The disadvantages of this method of conducting drainage through the liver is high traumatism due to the risk of serious complications, especially wound large vascular trunks liver, rupture of its parenchyma.

There is a method of conducting transretinoic drainage through the use of bogey of different diameters having the form paladugu with olive on the end. Conducting bougie is carried out in the course of intrahepatic duct up to his end of the division with the subsequent release of the diaphragmatic surface of the liver. The olive tree onto a PVC drain with side holes, retrograde movement extends into the lumen of the common hepatic duct with subsequent reduction of the end of the drainage lumen of the intestine (2).

The disadvantage of this type of drainage through the liver is high trauma (damage to the liver parenchyma), because the bougie with drainage are carried out from the surface of the liver to its goal, which is more than the op is sny option rather than holding them in the opposite direction.

The aim of the invention is to reduce the trauma of holding transretinoic drains.

This goal is achieved by the fact that through the elastic tube passes a flexible radiopaque guidewire, remove the tube and the conductor from the hilus of the liver to its diaphragmatic surface is performed in the bile ducts drain tube.

The method is implemented as follows.

Through discovered the proximal end of the common hepatic duct in equity ducts is thin pugachy bougie of soft metal, with a diameter of not more than 2 mm At its distal end, which has a conical thickening and ring grinding, firmly attached thin (2-2 .5 mm) plastic tube. Metal bougie is modeled in the form of a semicircle, is conducted through the tissue of the liver on its diaphragmatic surface. Behind him stretches a thin plastic tube. Then through its lumen spend a flexible radiopaque wire. The tube removed. Pick transitory drainage - plastic tube of the required diameter (usually 5-6 mm) with multiple side holes for drainage of bile. Models its proximal end in the form of a cone, which is placed on flexible metallic conduit located in the bile ducts of the liver. Gradually using Windows Explorer as a marker, not what we spend transitory drainage through the intrahepatic bile ducts.

The positive effect from the use of the proposed method is that it decreases the invasiveness of holding respecting drains through the liver parenchyma.

The proposed method is feasible and appropriate to use in operations concerning injuries and scar strictures of extrahepatic bile ducts.

Sources of information:

1. Eigenpair, Umetered “non-standard situations during operations on liver and biliary tract”. - M., 1987.

2. VNIIM, POS, Vfetaa. Bulletin of surgery №7. - 1992. - P.36-39.

Method of making drainage for intrahepatic bile duct by passing through the liver of bougie, fastening on his distal end of the drainage tube and install it in the bile ducts, characterized in that, to reduce the morbidity, through the elastic tube passes radiopaque guidewire, remove the tube and the conductor from the hilus of the liver to its diaphragmatic surface is performed in the bile ducts drain tube.



 

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