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WO2020171493A1 - Endoprothèse comportant des rainures à double bord pour des biopsies de cancer du canal cholédoque et des voies biliaires - Google Patents

Endoprothèse comportant des rainures à double bord pour des biopsies de cancer du canal cholédoque et des voies biliaires Download PDF

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Publication number
WO2020171493A1
WO2020171493A1 PCT/KR2020/002188 KR2020002188W WO2020171493A1 WO 2020171493 A1 WO2020171493 A1 WO 2020171493A1 KR 2020002188 W KR2020002188 W KR 2020002188W WO 2020171493 A1 WO2020171493 A1 WO 2020171493A1
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WIPO (PCT)
Prior art keywords
stent
bile duct
wall
biliary tract
tract cancer
Prior art date
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Ceased
Application number
PCT/KR2020/002188
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English (en)
Korean (ko)
Inventor
이종찬
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Seoul National University Hospital
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Seoul National University Hospital
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Filing date
Publication date
Application filed by Seoul National University Hospital filed Critical Seoul National University Hospital
Publication of WO2020171493A1 publication Critical patent/WO2020171493A1/fr
Anticipated expiration legal-status Critical
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy

Definitions

  • the present invention relates to a medical stent, and more particularly, to a stent for biliary discharge and biliary cancer biopsy that can conveniently obtain bile duct epithelial tissue for a biopsy to determine whether or not biliary tract cancer.
  • Bile is made in the liver and sent to the duodenum, and the path connecting the liver and duodenum is called the bile duct.
  • the part that passes through the liver is called the intrahepatic bile duct, and the part from the outside of the liver to the part connected to the duodenum is also classified as an extrahepatic bile duct.
  • Biliary duct cancer or bile duct cancer refers to a malignant tumor that occurs in the epithelium of the biliary tract. In the early stages, most patients have no symptoms, but when the bile duct is blocked due to a tumor, painless jaundice and jaundice urine symptoms appear. Biliary duct obstruction progresses slowly and there are no initial symptoms, so when biliary tract cancer is clinically diagnosed, it is already quite advanced.
  • the operator can perform a biopsy while directly viewing the lesion on the endoscopic screen.
  • Bory duct cancer is located inside the bile duct so that the lesion is not viewed directly, but is almost entirely on a two-dimensional screen through fluoroscopy.
  • a tissue biopsy should be performed as in a nearly blinded experiment.
  • biopsy using a general endoscope can obtain tissue while looking at the lesion in front, but in the case of biopsy of biliary tract cancer, biopsy forceps and biliary wall are arranged at about 90 degrees, so the amount of tissue that can be obtained is very small. . Because of this, in the case of biliary tract cancer, the diagnostic yield according to the traditional biopsy is only about 50%. In most cases, when the tumor is diagnosed only by imaging without histological confirmation, and then a treatment policy such as surgery is determined. There are many.
  • the stent for biliary cancer biopsy is a stent inserted into the bile duct for biliary cancer biopsy: a zigzag-shaped groove is formed on the outer wall of the insertion tube made of synthetic resin.
  • the groove portion includes a bottom portion, a first sidewall connecting one side of the bottom portion and the outer wall, and a second sidewall connecting the other side of the bottom portion and the outer wall, and consisting of the first sidewall and the outer wall.
  • the first corner portion collects the bile duct epithelial tissue when the stent is inserted into the bile duct
  • the second corner portion composed of the second side wall and the outer wall stores the bile duct epithelial tissue collected when the stent is withdrawn from the bile duct
  • an artificial polymer used as an extracellular matrix for three-dimensional cell culture of the collected bile duct epithelial tissue and a cell growth inducing agent for inducing cell growth may be formed.
  • the first and second corners are disposed to face each other in the longitudinal direction of the insertion tube, and each corner may have an acute angle.
  • the artificial polymer may be a hydrogel, a scaffold, or a decellularized extracellular matrix (dECM).
  • dECM decellularized extracellular matrix
  • the cell growth inducing agent may be a cytokine.
  • Biliary duct cancer biopsy stent has a dual edge groove (dual edge groove), specifically, the groove formed in the outer wall of the cannula consists of two corners.
  • the first corner part serves to scrape the bile duct epithelial tissue when inserting the stent into the bile duct, and the second corner part securely holds the cell cultured epithelial tissue in the groove when the stent is pulled out from the bile duct so that it can be extracted to the outside.
  • the stent for bile duct cancer biopsy according to the present invention is maintained for about 2 to 3 days after being inserted into the bile duct, during which the bile duct epithelial tissue collected from the lesion using an artificial polymer and a cell growth inducing agent provided in the groove 3D cell culture. Therefore, since a sufficient amount of cells can be obtained, the diagnosis rate of biliary tract cancer can be increased.
  • biliary tract obstruction may be solved.
  • FIG. 1 is a human anatomy diagram showing a process of inserting a stent for biliary cancer biopsy according to an embodiment of the present invention.
  • FIG. 2 is a perspective view showing a stent for biliary cancer biopsy according to an embodiment of the present invention.
  • FIG. 3 is a cross-sectional view of the stent of FIG. 2 taken along line AA′.
  • FIG. 1 is a human anatomy diagram showing a process of inserting a stent for bile discharge and biliary cancer biopsy according to an embodiment of the present invention.
  • the stent for biliary tract cancer biopsy of the present invention is inserted into the bile duct 342 using an endoscopic system.
  • the endoscope system includes an endoscope 40 inserted into the body, a control device that receives photographic information from the endoscope 40 and performs image processing, and a monitor that displays image-processed image information from the control device.
  • the endoscope 40 is inserted into a tube in the insertion part through an opening formed on the side of the handle and a handle part that controls the movement of the endoscope by hand, an insertion part connected to the handle part and inserted into the body. It may include a catheter 42 protruding from the tip.
  • the endoscope 40 of the present invention may include a sideoscope for observing and examining the duodenum 320, the duodenal papilla 322, the bile duct 342, and the pancreatic duct 332. That is, in the case of using a sideoscope with a photographing unit, an illumination unit, and a catheter 42 installed on the distal end of the endoscope 40, the catheter 42 is conveniently inserted into the bile duct 342 while observing the duodenal papilla 322 in the front. can do. After the catheter 42 is inserted into the bile duct 342, a contrast agent is injected to observe the stricture or expansion of the bile duct 342, gallstones, tumors, etc., and a fluoroscopic picture may be taken.
  • the stent of the present invention is compressed and inserted into the catheter 42, and a guide wire may be located inside the stent and the catheter 42.
  • the stent may be introduced into the lesion 344 in the bile duct 342 in the following manner. First, through the endoscope 40, when the guide wire passes through the duodenal papilla 322 and passes through the lesion 344 in the bile duct 342, the catheter 42 with the stent attached along the guide wire is the lesion 344 ) To pass. When the catheter 42 is retracted from the lesion 344, the stent is exposed and expands to expand the constricted lesion 344.
  • the stent of the present invention collects the bile duct epithelial tissue in the process of being installed in the lesion 344 and maintains the collected bile duct epithelial tissue for several days at the lesion 344, for example, for 2 to 3 days. Cells are cultured and used for later biliary cancer biopsy.
  • FIGS. 2 and 3 are perspective views showing a stent for biliary cancer biopsy according to an embodiment of the present invention.
  • 3 is a cross-sectional view of the stent of FIG. 2 taken along line AA′.
  • the stent 100 of the present invention is composed of a tube-shaped insertion tube 101 as a whole and a groove portion 110 formed in a zigzag shape on the outer wall 102 of the insertion tube 101.
  • the insertion tube 101 is made of an elastic synthetic resin, for example, a silicone material. Therefore, when the insertion tube 101 is inserted into the catheter 42 in a compressed state and then exposed to the outside of the catheter 42, it is restored to its original shape, and the path of movement of the bile 10 is secured to solve biliary tract obstruction. have.
  • the stent 100 of the present invention has a special structure for biopsy of biliary tract cancer in the process of being inserted into the bile duct 342.
  • the groove portion 110 includes a bottom portion 114, a first side wall 113 connecting one side of the bottom portion 114 and the outer wall 102, and the other side and the outer wall 102 of the bottom portion 114. It includes a second sidewall 115 connecting.
  • the first corner part 112 made of the first side wall 113 and the outer wall 102 is collected by scratching the bile duct epithelial tissue when the stent 100 is inserted into the bile duct 342.
  • the second edge portion 116 consisting of the second side wall 115 and the outer wall 102 safely stores the previously collected bile duct epithelial tissue in the bottom portion 114 when the stent 100 is withdrawn from the bile duct 342. It acts as a fence.
  • the first edge portion 112 and the second edge portion 116 may be disposed to face each other in the longitudinal direction of the insertion tube 101.
  • the first corner portion 112 is preferably made of a sharp reservation to effectively collect tissue from the lesion.
  • the second corner portion 116 is preferably made of an acute angle so that the tissue collected when the stent 100 is pulled out is not swept to the outside and is well stored.
  • the practitioner maintains the stent 100 in the state of being inserted into the bile duct for a biopsy of biliary tract cancer for several days, and performs three-dimensional cell culture on the collected bile duct epithelial tissue.
  • an artificial polymer 200 and a cell growth inducer 202 are formed in the bottom portion 114 of the groove portion 110.
  • the artificial polymer 200 is used as an extracellular matrix for 3D cell culture, and may be formed of, for example, a hydrogel, a scaffold, or a decellularized extracellular matrix (dECM).
  • the cell growth inducing agent 202 is a substance that induces cell growth of the bile duct epithelial tissue, and may be made of, for example, cytokines.
  • the size of the groove portion 110 it is preferable to design the size of the groove portion 110 so that the inner wall of the bile duct 342 can physically contact the artificial polymer 200 while the stent 100 is inserted into the bile duct 342, in this case More effectively, three-dimensional cell culture can be performed.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Endoscopes (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne une endoprothèse pour des biopsies de cancer du canal cholédoque et des voies biliaires, avec laquelle une biopsie pour le cancer des voies biliaires peut être effectuée de façon pratique. Cette endoprothèse comporte une partie de rainure en forme de zigzag qui est formée sur la paroi externe d'un tube d'insertion constitué de résine synthétique. La partie de rainure comprend une partie inférieure, une première paroi latérale reliant un côté de la partie inférieure à la paroi externe, et une deuxième paroi latérale reliant l'autre côté de la partie inférieure à la paroi externe. Une première partie de bord formée par la première paroi latérale et la paroi externe collecte un tissu épithélial de canal cholédoque lorsque l'endoprothèse est insérée dans un canal cholédoque, et une deuxième partie de bord formée par la deuxième paroi latérale et la paroi externe stocke le tissu épithélial de canal cholédoque collecté lorsque l'endoprothèse est retirée du canal cholédoque. En outre, un polymère artificiel, qui est utilisé en tant que matrice extracellulaire pour la culture de cellules tridimensionnelle du tissu épithélial de canal cholédoque collecté, et un inducteur de croissance cellulaire pour induire une croissance cellulaire sont formés dans la partie inférieure.
PCT/KR2020/002188 2019-02-19 2020-02-17 Endoprothèse comportant des rainures à double bord pour des biopsies de cancer du canal cholédoque et des voies biliaires Ceased WO2020171493A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR1020190018946A KR102242357B1 (ko) 2019-02-19 2019-02-19 이중 모서리 홈을 가진 담즙배출 및 담도암 조직검사용 스텐트
KR10-2019-0018946 2019-02-19

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WO2020171493A1 true WO2020171493A1 (fr) 2020-08-27

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PCT/KR2020/002188 Ceased WO2020171493A1 (fr) 2019-02-19 2020-02-17 Endoprothèse comportant des rainures à double bord pour des biopsies de cancer du canal cholédoque et des voies biliaires

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KR (1) KR102242357B1 (fr)
WO (1) WO2020171493A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5394887A (en) * 1994-01-14 1995-03-07 Haaga; John R. Biopsy needle
US5486191A (en) * 1994-02-02 1996-01-23 John Hopkins University Winged biliary stent
US20050049608A1 (en) * 2003-06-12 2005-03-03 Aznoian Harold M. Stent delivery catheter
US20050113933A1 (en) * 2003-11-24 2005-05-26 Checkmed Systems, Inc. Stent
US20060129229A1 (en) * 2003-03-10 2006-06-15 Kohei Fukaya Stent
KR20150116689A (ko) * 2014-04-08 2015-10-16 주식회사 파인메딕스 초음파 유도 세침 흡인생검용 바늘

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1995017847A1 (fr) 1993-12-30 1995-07-06 Boston Scientific Corporation Prelevement d'echantillon corporel
US5535756A (en) * 1994-01-06 1996-07-16 Parasher; Vinod K. Catheter with simultaneous brush cytology and scrape biopsy capability
ES2665307T3 (es) * 2011-05-26 2018-04-25 Adn International, Llc Dispositivo expansible para la recogida de tejidos de una luz corporal aerodigestiva
IL270674B2 (en) 2017-05-19 2024-12-01 Shalon Tidhar Instruments and methods for collecting samples from the digestive system

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5394887A (en) * 1994-01-14 1995-03-07 Haaga; John R. Biopsy needle
US5486191A (en) * 1994-02-02 1996-01-23 John Hopkins University Winged biliary stent
US20060129229A1 (en) * 2003-03-10 2006-06-15 Kohei Fukaya Stent
US20050049608A1 (en) * 2003-06-12 2005-03-03 Aznoian Harold M. Stent delivery catheter
US20050113933A1 (en) * 2003-11-24 2005-05-26 Checkmed Systems, Inc. Stent
KR20150116689A (ko) * 2014-04-08 2015-10-16 주식회사 파인메딕스 초음파 유도 세침 흡인생검용 바늘

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KR102242357B1 (ko) 2021-04-20

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