JP2002200163A - Drainage tube - Google Patents

Abstract

PROBLEM TO BE SOLVED: To device a drainage tube which is inserted into both a bile duct and a pancreatic duct at the same time to be held and in which bile and pancreatic juice are discharged from the system and within the duodenum, respectively. SOLUTION: The first tube portion 4 having the first hollow passage 9 in which the first body fluid introducing port 8 is formed in a distal portion, the second tube portion 6 having the second hollow passage 13 in which the second body fluid introducing port 12 is formed in a distal portion and the first body fluid discharging passage 5 communicating with the first hollow passage 9 without communicating with the second hollow passage 13 are formed inside and in the second tube portion 6 and/or a catheter tube portion 3 which has the catheter tube portion 3 extending from the branch portion 11 of the second tube portion 6 to the distal side, in which the first body fluid discharging port 20 communicating with first body fluid discharging passage 5 is formed in a distal portion and which is situated near the branch portion 11, the second body fluid discharging port 24 communicating with the second hollow passage 13 without communicating with the first hollow passage 9 is formed.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a drainage tube, and more particularly, to a drainage tube used for endoscopic pancreatic cholangiography or endoscopic nasal cholangiopancreatic duct drainage, which is used for both the bile duct and the pancreatic duct simultaneously. The present invention relates to a drainage tube which is inserted and placed therein, and is capable of simultaneously discharging a plurality of body fluids such as bile and pancreatic juice.

[0002]

2. Description of the Related Art When a stenosis occurs in a body cavity such as a bile duct, discharge of secretions, for example, bodily fluid such as bile and pancreatic juice, is inhibited, causing symptoms such as jaundice in patients. Therefore, a treatment (endoscopic retrograde bile duct or pancreatic duct drainage) in which a drainage tube is inserted into a bile duct or a pancreatic duct and placed there to discharge bile and the like is known (for example, Japanese Patent Application Laid-Open No. H11-76412, US Patent No. 517662
No. 6). In addition, a treatment method in which a tube inserted into the body through the nose is inserted and placed in a stenosis site created in a body cavity such as a bile duct, and a contrast medium is injected from outside the body or a body fluid such as bile is discharged (endoscope) Cholangiography) is also known (for example, Japanese Utility Model Laid-Open No. 5-65349).

[0003] Such a drainage tube is designed to be inserted into only one of the bile duct and the pancreatic duct. However, stenosis may occur in both the bile duct and the pancreatic duct, and in such a case, it may be difficult to take appropriate measures. Further, when performing treatment on either the bile duct or the pancreatic duct, there is a case where it is necessary to simultaneously ensure the discharge of body fluid from either the bile duct or the pancreatic duct. In order to respond to such a request, conventionally, it is necessary to insert a separate drainage tube into each of the bile duct and the pancreatic duct, and the operation for that has been complicated.

[0004] In the treatment of the bile duct, there is a case where it is desired to excrete bile and at the same time, inject a contrast agent or an antibiotic into the bile duct to ensure that pancreatic juice is excreted into the duodenum. It has been difficult for the conventional drainage tube to satisfy such requirements.

[0005]

SUMMARY OF THE INVENTION It is an object of the present invention to simultaneously insert and place both the bile duct and the pancreatic duct,
An object of the present invention is to provide a drainage tube capable of discharging bile out of the body and discharging pancreatic juice into the duodenum.

[0006]

In order to achieve the above object, a drainage tube according to a first aspect of the present invention comprises:
A first tube portion having a first hollow passage having a first body fluid inlet formed at a distal end thereof, the first tube portion being a drainage tube inserted into the body and placed in the body to discharge body fluids and the like; A second tube portion having a second hollow passage branching from the first tube portion and having a second bodily fluid inlet formed at a distal end thereof, without communicating with the second hollow passage; A first bodily fluid discharge passage communicating with the first hollow passage is formed therein and extends proximally from a branch of the first tube portion and the second tube portion to a proximal end. Has a catheter tube portion formed with a first body fluid discharge port communicating with a first body fluid discharge passage, and a second tube portion and / or the catheter tube portion located near the branch portion. , Without communicating with the first hollow passage Wherein the second fluid outlet communicating with the second hollow passage is formed.

Preferably, the catheter tube portion and the first tube portion are constituted by a single main hollow tube, and the second tube portion is a sub tube having an outer diameter smaller than that of the first tube portion. It is constituted by a hollow tube, and the sub hollow tube is sealed into the inside of the main hollow tube through a branch through hole formed in a tube wall in the middle of the main hollow tube, and the sub hollow tube is A distal end opening is sealed and joined to an outlet through-hole formed in the tube wall of the main hollow tube separately from the branching through-hole, and constitutes the second body fluid outlet. ing.

Alternatively, the catheter tube portion and the first tube portion are constituted by a single main hollow tube, and the second tube portion is a sub-hollow tube having an outer diameter smaller than that of the first tube portion. The sub hollow tube is sealed into the inside of the main hollow tube through a branching through hole formed in a tube wall in the middle of the main hollow tube, and the inside of the main hollow tube is formed. Extends along the proximal end along the tube wall of the main tube on the proximal end side than the branching through-hole,
The second body fluid discharge port communicating with the inside of the sub-tube is formed.

Alternatively, the catheter tube portion includes:
A multi-lumen tube in which two or more lumens are formed along the axial direction, wherein one of the lumens is the first body fluid discharge passage, and the other one of the lumens is A second body fluid discharge passage is provided, and a proximal end of the first tube portion communicating with the first body fluid discharge passage is joined to a distal end of the multi-lumen tube, and is connected to the second body fluid discharge passage. Said second communicating
The proximal end of the tube portion is joined, and the second body fluid outlet is formed in the tube wall of the multi-lumen tube so as to communicate only with the second body fluid outlet passage.

[0010] The catheter tube portion and the first tube portion are formed of a single main hollow tube, and the second tube portion is a sub-hollow tube having an outer diameter smaller than that of the first tube portion. And the sub hollow tube is joined to the outside of the main hollow tube in the middle of the main hollow tube, and the proximal end side opening of the sub hollow tube is connected to the second body fluid outlet. Make up.

[0011] To achieve the above object, a second aspect of the present invention is provided.
The drainage tube according to the aspect of the drainage tube is placed in the body cavity to discharge body fluids and the like,
A first bodily fluid inlet is formed at the distal end, and a first bodily fluid inlet is formed at the proximal end.
A hollow first tube member having a body fluid outlet formed therein,
A hollow second fluid body is rotatably mounted on the proximal end of the first tube member, a second fluid outlet is formed at the distal end, and a second fluid outlet is formed at the proximal end. And two tube members.

Preferably, the first tube member and the second tube member
The tube member is formed integrally from, for example, a single tube.

[0013] Preferably, the drainage tube of the present invention is deformed in a direction in which an angle between the axis of the first tube member and the axis of the second tube member approaches 180 degrees when no external force is applied. Have the restoring power to try.

[0014]

The drainage tube according to the first aspect of the present invention is used, for example, for endoscopic nasal bile duct pancreatic drainage. When the treatment of the bile duct and the pancreatic duct (expansion of a stenosis site, etc.) is simultaneously performed using this drainage tube, for example, it is performed as follows. First, one first guidewire is inserted into a bile duct, and the other second guidewire is inserted into a pancreatic duct. Next, the guide wires are passed through the first tube portion and the second tube portion, and the drainage tube is pushed along the guide wires, and the distal ends of the tube portions are inserted into the bile duct and the pancreatic duct, respectively.

After that, when the guide wire is pulled out, the first tube portion and the second tube portion of the drainage tube remain in the bile duct and the pancreatic duct, respectively, and the first tube portion expands the stenosis site of the bile duct, and The tube portion expands the stenosis site of the pancreatic duct. Bile from the bile duct,
Through the first hollow fluid passage and the first extracorporeal discharge passage from the first bodily fluid inlet of the first tube portion, the fluid is discharged out of the body from the first bodily fluid outlet located outside the body. Pancreatic juice from the pancreatic duct passes through the second hollow passage from the second body fluid inlet of the second tube portion, and is discharged into the duodenum from the second body fluid outlet.

When a contrast agent or an antibiotic is injected into the bile duct during treatment of the bile duct, the contrast agent or the antibiotic may be injected from the first body fluid outlet located outside the body. These fluids are injected into the bile duct from the first bodily fluid inlet through the first bodily fluid discharge passage of the catheter tube portion and the first hollow passage of the first tube portion. Also at this time, the pancreatic juice from the pancreatic duct passes through the second hollow passage from the second body fluid inlet of the second tube portion, and is discharged into the duodenum from the second body fluid outlet.

In the first aspect of the present invention, since the second hollow passage is completely independent of the first hollow passage and the first bodily fluid discharge passage, pancreatic juice from the pancreatic duct flows back to the bile duct. Never.

The drainage tube according to the second aspect of the present invention is placed in the bile duct and the pancreatic duct at the same time, and can simultaneously treat the bile duct and the pancreatic duct (such as dilation of a stenosis site). For example, this is performed as follows. First, one first guidewire is inserted into a bile duct, and the other second guidewire is inserted into a pancreatic duct. Next, each guide wire is passed through the first tube member and the second tube member, the proximal end of the drainage tube is pushed in by a pushing tube or the like, and the distal end of each tube member is inserted into the bile duct and pancreatic duct, respectively.

Thereafter, when the guide wire and the pushing tube are pulled out, the drainage tube remains at the bifurcation of the bile duct and the pancreatic duct. For example, the first tube member expands a stenosis site of the bile duct, and the second tube member extends the pancreatic duct. Dilate the stenosis site. Bile from the bile duct passes through the inside of the tube member from the first body fluid inlet of the first tube member,
It is discharged into the duodenum from the first body fluid outlet. Pancreatic fluid from the pancreatic duct passes through the inside of the tube member from the second body fluid inlet of the second tube member, and is discharged into the duodenum from the second body fluid outlet.

At the bifurcation between the bile duct and the pancreatic duct, the bile duct and the pancreatic duct intersect at an acute angle. Therefore, by giving the drainage tube a restoring force that tends to deform in a direction in which the angle between the axis of the first tube member and the axis of the second tube member approaches 180 degrees, the drainage tube can Does not come off easily. In the conventional drainage tube, it is necessary to form a projection for preventing the drainage tube from coming off, such as a flap, at both ends of the drainage tube in order to prevent the drainage tube from coming off. However, the drainage tube of the present invention does not necessarily need to be provided with a retaining projection or the like. Therefore, in the present invention,
It is possible to effectively prevent inflammation of the inner wall of the bile duct or pancreatic duct, which may be caused by a retaining projection such as a flap.

[0021]

DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below based on embodiments shown in the drawings. First Embodiment As shown in FIG. 1, a drainage tube 2 according to the present embodiment has a catheter tube portion 3, a first tube portion 4, and a second tube portion 6. The catheter tube portion 3 is constituted by a double lumen tube having two lumens along the axial direction. The double lumen tube is integrally molded by extrusion molding, etc.
The present invention is not limited to this, and may be manufactured by another manufacturing method. For example, a double lumen tube may be manufactured by inserting a relatively small outer diameter single lumen tube inside a relatively large outer diameter single lumen tube and joining them. . The catheter tube portion 3 according to the present embodiment includes a first bodily fluid discharge passage 5 and a second
And a body fluid discharge passage 7.

At the distal end of the catheter tube section 3, the proximal end of the first tube section 4 and the proximal end of the second tube section 6 are joined so as to form a branch 11. It is. A first hollow passage 9 is formed in the inside of the first tube portion 4 along the axial direction, and a first bodily fluid introduction which is one open end of the first hollow passage 9 is provided at a distal end thereof. A mouth 8 is formed. The other open end 1 of the first hollow passage 9
0 is the first bodily fluid discharge passage 5 of the catheter tube portion 3
Communicates with the distal end opening of the

Inside the second tube portion 6, a second hollow passage 13 is formed along the axial direction, and a distal end of the second hollow passage 13 is provided with one open end of the second hollow passage 13. A one-body fluid inlet 12 is formed. The other open end 14 of the second hollow passage 13 communicates with the distal end opening of the second bodily fluid discharge passage 7 of the catheter tube portion 3.

At the proximal end of the catheter tube section 3,
A first body fluid outlet 20 which is a proximal end opening of the first body fluid discharge passage 5 and a proximal end opening 22 of the second body fluid discharge passage 7 are formed.

In the present embodiment, a second body fluid outlet 24 is formed in the tube wall on the proximal end side at a predetermined distance L3 from the distal end branch portion 11 of the catheter tube portion 3, and
The bodily fluid outlet 24 communicates with the second bodily fluid discharge passage 7.
In the present invention, the proximal end opening 22 of the second body fluid discharge passage 7 is
It may be plugged with a plug or the like. The plug may be located anywhere in the passage 7 between the second body fluid outlet 24 and the proximal end opening 22. However, in the present invention, the plug does not necessarily have to be provided.

The outer diameter D0 of the catheter tube portion 3 is
Although not particularly limited, it is preferably 1.5 to 4.0 mm. The axial length L0 of the catheter tube portion 3 is not particularly limited, but is preferably 2000 to 3
000 mm. The predetermined distance L3 is not particularly limited, but is preferably 10 to 50 mm. In addition,
As shown by the two-dot chain line in FIG. 1, the second hollow passage is provided in the tube wall of the second tube portion 6 located near the branch portion 11 without providing the second body fluid outlet 24 in the catheter tube portion 3. Second body fluid outlet 24 'communicating with 13
May be provided.

In the present embodiment, the outer diameter D1 of the first tube portion 4 is preferably designed in accordance with the inner diameter of the bile duct, and is, for example, 1.5 to 4.0 mm. In the present embodiment, the outer diameter D2 of the second tube portion 6 is preferably designed according to the inner diameter of the pancreatic duct.
0 to 3.0 mm. These outer diameters D1 and D2 are
It is preferable that the size be different depending on the size of the body cavity to be inserted, but from the viewpoint of facilitation of manufacture, the same size may be used.

The axial length L1 of the first tube portion 4 is
It is preferably 50 to 120 mm, and the second tube portion 6
Has an axial length L2 of preferably 30 to 80 mm.
These axial lengths L1 and L2 may be the same or different. The wall thickness of these tube sections 4 and 6 is preferably 0.1-0.4 mm.

In this embodiment, the cross-sectional shape of each of the tube portions 4 and 6 is circular. However, in the present invention, the cross-sectional shape of each of the tube portions 4 and 6 is not particularly limited, and is semicircular, elliptical, or other. Shape.

The material of the catheter tube portion 3, the first tube portion 4, and the second tube portion 6 constituting the drainage tube 2 according to the present embodiment is not particularly limited, but may be, for example, polytetrafluoroethylene (PTF).
E), tetrafluoroethylene-perfluoroalkylvinyl ether copolymer (PFA), tetrafluoroethylene-hexafluoropropylene copolymer (FE
P), tetrafluoroethylene-ethylene copolymer (E
Fluororesins such as TFE), polyvinylidene fluoride (PVDF) and polyvinyl fluoride (PVF), as well as synthetic resin tubes such as polyurethane, polyvinyl chloride, polyethylene, polyamide and polyimide, or metal spring reinforced tubes, stainless steel tubes, etc. It consists of. Stainless steel wire, nickel
A titanium alloy wire or the like may be used. Further, a biocompatible film or the like may be formed on the surface of the drainage tube 2.

When the treatment of the bile duct and pancreatic duct of a patient (expansion of a stenosis site and the like) is simultaneously performed using the drainage tube 2 of the present embodiment, the treatment is performed, for example, as follows. First, as shown in FIG. 2, the distal end of the endoscope 30 is passed to the duodenum 32, one first guide wire 40 is inserted into the bile duct 34 through the endoscope 30, and the other second guide wire is inserted. 42 is inserted into the pancreatic duct 36. Next, outside the body, the proximal ends of each guide wire 40 and 42 are passed through each of the body fluid inlets 8 and 12 of the first tube portion 4 and the second tube portion 6 shown in FIG. Pull out from 24.

As shown in FIG. 3, the drainage tube 2 is pushed inside the endoscope 30 along the guide wires 40 and 42, and the distal ends of the tube portions 4 and 6 are respectively connected to the bile duct. 34 and into the pancreatic duct 36.

Thereafter, the guide wires 40 and 42 are
When the tube is pulled out of the patient's mouth together with the endoscope 30, as shown in FIG.
And the second tube portion 6 remains near the bifurcation 38 in the bile duct 34 and pancreatic duct 36, respectively. as a result,
The first tube portion 4 expands the stenosis site of the bile duct 34, and the second tube portion 6 expands the stenosis site of the pancreatic duct 36 at the same time. Bile from the bile duct 34 is discharged from the first bodily fluid inlet 8 of the first tube portion 4 through the first hollow passage 9 and the first bodily fluid discharge passage 5 to the outside from the first bodily fluid outlet 20. In addition, pancreatic juice from the pancreatic duct 36 is discharged from the second body fluid inlet 12 of the second tube portion 6 through the second hollow passage 13 and the second body fluid discharge passage 7 and into the duodenum 32 from the second body fluid outlet 24. You.

When a contrast agent or an antibiotic is injected into the bile duct 34 during treatment of the bile duct 34, the first outside of the body is located.
What is necessary is just to inject a contrast agent or an antibiotic from the body fluid outlet 20.
These fluids pass through the first body fluid discharge passage 5 of the catheter tube portion 3 and the first hollow passage 9 of the first tube portion 4 and are injected into the bile duct 34 from the first body fluid inlet 8.
Also at this time, the pancreatic juice from the pancreatic duct 36 passes through the second hollow passage 6 from the second body fluid inlet 12 of the second tube portion 6, and is discharged into the duodenum from the second body fluid outlet 24.

In the present embodiment, since the second hollow passage 13 and the second body fluid discharge passage 7 are completely independent of the first hollow passage 9 and the first body fluid discharge passage 5, The pancreatic juice does not flow back to the bile duct 34 side.

Second Embodiment As shown in FIG. 5A, a drainage tube 2a according to the present embodiment is a modified example of the drainage tube 2 shown in FIG. The part to be performed will be described in detail.

In this embodiment, the catheter tube portion 3a and the first tube portion 4a are constituted by a single main hollow tube. The second tube portion 6a is constituted by a sub hollow tube having an outer diameter smaller than that of the first tube portion 4a. The secondary hollow tube is sealed into the inside of the main hollow tube through the branch through hole 11a formed in the tube wall in the middle of the main hollow tube, and extends to the proximal end side along the inside of the main hollow tube. Exist.

The proximal end opening 22a of the secondary hollow tube is
It is located at the same position in the axial direction as the proximal end opening of the main hollow tube serving as the first body fluid outlet 20a. Branch through hole 11a
In the tube wall of the main hollow tube located on the proximal end side of the main hollow tube, a through hole communicating with the inside of the sub hollow tube is formed, and this through hole becomes the second body fluid outlet 24a.
From the proximal end opening 22a of the sub hollow tube to the position of the through hole 11a for branching, the sub hollow tube is bonded to the inner wall of the main hollow tube by means such as adhesion, and the inside of the sub hollow tube located therebetween. The passage is the second body fluid discharge passage 7a
Becomes A plug or the like is packed in any position between the second body fluid discharge port 24a and the proximal end opening 22a in the second body fluid discharge passage 7a, and the flow path is blocked.

The branch through hole 11a and the first body fluid outlet 20
The inside of the main hollow tube located between the main hollow tube and the main hollow tube becomes the first body fluid discharge passage 5a, and the main hollow tube located on the distal end side from the through-hole 11a for branching becomes the first tube portion 4a. One hollow passage 9a is formed, and its distal end opening serves as the first body fluid inlet 8a.

The sub-hollow tube located on the distal end side from the branching through hole 11a becomes the second tube portion 6a, in which a second hollow passage 13a is formed, and the distal end opening is formed in the second body fluid. It becomes the inlet 12a. Branch hole 11
In (a), an adhesive or a sealing material is filled to seal a gap with the sub hollow tube.

The drainage tube 2a according to the present embodiment
In this case, the same operation and effect as those of the drainage tube 2 according to the first embodiment can be obtained, and further, the following operation and effect can be obtained. That is, in this embodiment, the second tube portion 6a having an outer diameter smaller than the outer diameter of the first tube portion 4a is easily formed with respect to the drainage tube 2a, and is branched according to the respective inner diameters of the bile duct and the pancreatic duct. Easy to manufacture tube part. In addition, it is easy to join a branch portion between the first tube portion 4a and the second tube portion 6a.

Third Embodiment As shown in FIG. 5B, a drainage tube 2b according to this embodiment is a modification of the drainage tube 2 shown in FIG. 1, and the description of the common parts is omitted. The part to be performed will be described in detail.

In this embodiment, the catheter tube portion 3b and the first tube portion 4b are constituted by a single main hollow tube. The second tube portion 6b is constituted by a sub hollow tube having an outer diameter smaller than that of the first tube portion 4b. The sub hollow tube is sealed into the main hollow tube through a branch through hole 11b formed in a tube wall in the middle of the main hollow tube. The distal end opening of the auxiliary hollow tube is sealed and joined to an outlet through hole formed in the tube wall of the main hollow tube separately from the branch through hole 11b, and the second body fluid outlet is provided. 24b.

The branch through hole 11b and the second body fluid outlet 24
The internal passage of the sub hollow tube located between the second body fluid discharge passage 7b and the second hollow fluid discharge passage 7b. In addition, the proximal end opening of the main hollow tube becomes the first body fluid outlet 20b, and the branch through-hole 1 is formed.
The inside of the main hollow tube located between 1b and the first body fluid discharge port 20b becomes the first body fluid discharge passage 5b. Furthermore, the main hollow tube located on the distal end side from the branching through-hole 11b becomes the first tube portion 4b, in which a first hollow passage 9b is formed, and the distal end opening is formed in the first body fluid inlet. 8b.

The sub-hollow tube located on the distal end side from the branching through-hole 11b becomes the second tube portion 6b, in which a second hollow passage 13b is formed, and the distal end opening is formed in the second body fluid. It becomes the inlet 12b. Branch hole 11
An adhesive or a sealing material is filled in the outer circumference of the second body fluid outlet 24b to seal the gap with the sub hollow tube.

The drainage tube 2b according to the present embodiment
In addition, in addition to the same operation and effect as the drainage tube 2 according to the first embodiment, the following operation and effect can be obtained. That is, in this embodiment, the second tube portion 6b having an outer diameter smaller than the outer diameter of the first tube portion 4b is easily formed with respect to the drainage tube 2b, and is branched according to the respective inner diameters of the bile duct and pancreatic duct. Easy to manufacture tube part. In addition, it is easy to join the branch portion between the first tube portion 4b and the second tube portion 6b. Further, since the distal end opening of the sub hollow tube becomes the second body fluid outlet 24b as it is, the formation of the second body fluid outlet 24b is also easy.

Fourth Embodiment As shown in FIG. 5C, a drainage tube 2c according to the present embodiment is a modified example of the drainage tube 2 shown in FIG. The part to be performed will be described in detail.

In this embodiment, the catheter tube portion 3c and the first tube portion 4c are constituted by a single main hollow tube. The second tube portion 6c is constituted by a sub hollow tube having an outer diameter smaller than that of the first tube portion 4c. The distal end of the auxiliary hollow tube is joined to the outer periphery of the main hollow tube by a heat-shrinkable tube 26 or the like at a branch portion 11c located in the middle of the main hollow tube. 2 body fluid outlet 2
4c.

The internal passage of the sub hollow tube located between the branch portion 11c and the second body fluid discharge port 24c becomes the second body fluid discharge passage 7c. Also, the proximal end opening of the main hollow tube becomes the first body fluid outlet 20c, and the inside of the main hollow tube located between the branch portion 11c and the first body fluid outlet 20c is connected to the first body fluid outlet passage 5c. Become. Further, the branch unit 11
The main hollow tube located on the distal end side from c is the first tube portion 4c, the first hollow passage 9c is formed therein, and the distal end opening becomes the first body fluid inlet 8c.

The sub-hollow tube located at the distal end side from the branch portion 11c becomes the second tube portion 6c, in which the second hollow passage 13c is formed, and the opening at the distal end thereof is the second body fluid inlet. 12c.

The drainage tube 2c according to the present embodiment
In this case, the same operation and effect as those of the drainage tube 2 according to the first embodiment can be obtained, and further, the following operation and effect can be obtained. That is, in this embodiment, the second tube portion 6c having an outer diameter smaller than the outer diameter of the first tube portion 4c is easily formed with respect to the drainage tube 2c, and is branched according to the respective inner diameters of the bile duct and the pancreatic duct. Easy to manufacture tube part. In addition, it is easy to join the branch portion between the first tube portion 4c and the second tube portion 6c. Further, since the distal end opening of the sub hollow tube becomes the second body fluid outlet 24c as it is, the formation of the second body fluid outlet 24c is also easy. However, in the drainage tube 2c of the present embodiment, the catheter tube portion 3
Since the outer diameter of c tends to be smaller, it is important to reinforce the strength of the catheter tube portion 3c and prevent kink as compared with the drainage tube 2 of other embodiments.

The present invention is not limited to the above-described embodiment, but can be variously modified within the scope of the present invention.

For example, the first tube portion and / or the second tube portion of the drainage tube in the embodiment described above.
Pigtails, flaps, and the like may be formed around the distal end of the tube portion as needed. Further, a plurality of side holes may be formed in the tube wall surface. The inner diameter of the side hole is 0.5 to 1.2 mm, and the number is 10 or less. In addition, the drainage tube of the above-described embodiment can be applied to treatment of other body cavities in addition to treatment of bile ducts and pancreatic ducts.

Fifth Embodiment As shown in FIG. 6A, the drainage tube 102 according to the present embodiment has a first tube member 104 and a second tube member 106. The base end of the first tube member 104 and the base end of the second tube member 106 are rotatably connected via a hinge 105.

The first tube member 104 and the second tube member 106 are respectively formed in the first hollow passage 1 having a semicircular cross section.
09 and a second hollow passage 113. At the distal end of the first tube member 104, a first body fluid inlet 108, which is one open end of the first hollow passage 109, is formed, and at the base end, the other end of the first hollow passage 109 is formed. A first body fluid discharge port 110 which is an open end is formed. At the distal end of the second tube member 106, a second bodily fluid inlet 112, which is one open end of the second hollow passage 113, is formed. At the base end, the other end of the second hollow passage 113 is formed. A second body fluid outlet 114, which is an open end, is formed.

The maximum width D1 of the first tube member 104 is
In the present embodiment, it is preferable to be designed according to the inner diameter of the bile duct, for example, 1.5 to 4.0 mm. Also,
In the present embodiment, the maximum width D2 of the second tube member 106 is preferably designed according to the inner diameter of the pancreatic duct,
For example, it is 1.0 to 3.0 mm. These widths D1 and D2 are preferably different depending on the size of the body cavity to be inserted, but may be the same size from the viewpoint of easy production.

The axial length L1 of the first tube member 104
Is preferably 50 to 120 mm, and the axial length L2 of the second tube member 106 is preferably 30 to 80 mm.
It is. These axial lengths L1 and L2 may be the same or different. The wall thickness of these tube members 104 and 106 is preferably 0.1 to 0.4 mm.

In the present embodiment, the cross-sectional shape of each of the tube members 104 and 106 is semicircular, but in the present invention, the cross-sectional shape of the tube members 104 and 106 is
The shape is not particularly limited, and may be a circle, an ellipse, or another shape. However, it is particularly preferable when the cross-sectional shapes of the tube members 104 and 106 are semicircular. In this case, the drainage tube 102 is bent as much as possible around the hinge 105 as a rotation axis, and the tube members 104 and 106 are made as close as possible to make the cross section of the drainage tube as a whole circular. Therefore, the drainage tube 102 can easily pass through the inside of the endoscope, and the attachment of the drainage tube using the endoscope becomes easy.

To manufacture the drainage tube shown in FIG. 6A, for example, as shown in FIG. 6B, a hollow tube 102a having a semicircular cross section and a predetermined length is prepared.
A cut 10 is made in the longitudinal direction of the hollow tube 102a so as to leave a bottom wall 105a serving as a hinge 105.
Insert 3. After that, the bottom wall 105 which becomes the hinge portion 105
When the tube 2a is bent around the rotation center a, the drainage tube 102 shown in FIG. 6A is completed.

The drainage tube 102 of the present embodiment
Since the single hollow tube 102a is bent and integrally formed, the hinge 105 has a crossing angle of the axis of the first tube member 104 and the second tube member 106 closer to 180 degrees. A restoring force to be deformed acts.

The drainage tube 10 according to the present embodiment
The material of No. 2 is not particularly limited, but is the same as, for example, the drainage tube 2 according to the first embodiment.

When the treatment of the patient's bile duct and pancreatic duct (expansion of a stenosis site or the like) is simultaneously performed using the drainage tube 102 of the present embodiment, the treatment is performed, for example, as follows. First, as shown in FIG. 7, the distal end of the endoscope 30 is passed to the duodenum 32, one first guidewire 40 is inserted into the bile duct 34 through the endoscope 30, and the other second guidewire is inserted. 42 is inserted into the pancreatic duct 36. Next, the proximal end of each guidewire 40 and 42 is
It passes through the hollow passages 109 and 113 of the first tube member 4 and the second tube member 106 shown in FIG. The drainage tube 102 is pushed inside the endoscope 30 along the guide wires 40 and 42 with the pushing tube 44 shown in FIG. 8, and the distal ends of the tube members 104 and 106 are respectively attached to the bile duct 34 and the pancreatic duct 3.
Insert into 6.

Thereafter, when the guide wires 40 and 42 and the pushing tube 44 are pulled out of the patient's mouth together with the endoscope 30, the drainage tube 102 remains at the bifurcation 38 of the bile duct 34 and the pancreatic duct 36. as a result,
The first tube member 104 expands a stenosis site of the bile duct 34, and the second tube member 106 expands a stenosis site of the pancreatic duct 36. Bile from the bile duct 34 is discharged from the first body fluid inlet 108 of the first tube member 104 through the hollow passage 109 into the duodenum 32 from the first body fluid outlet 110. Further, the pancreatic juice from the pancreatic duct 36 passes through the second body fluid inlet 112 of the second tube member 106, passes through the hollow passage 113, and is discharged into the duodenum 32 from the second body fluid outlet 114.

At the junction 38 between the bile duct 34 and the pancreatic duct 36,
The bile duct 34 and the pancreatic duct 36 intersect at an acute angle. The drainage tube 102 has a restoring force that tends to deform in a direction in which the angle between the axis of the first tube member 104 and the axis of the second tube member 106 approaches 180 degrees. In close contact. Therefore, the drainage tube 102 does not easily come off the branch portion 38.

In the conventional drainage tube, in order to prevent the drainage tube from falling out of the bile duct 34 or the pancreatic duct 36, it is necessary to form projections for preventing the drainage tube from coming off, such as flaps, at both ends. However, the drainage tube 2 of the present embodiment does not necessarily need to be provided with a retaining projection or the like. Therefore, in the present embodiment, it is possible to effectively prevent inflammation of the inner walls of the bile duct 34 and the pancreatic duct 36 which may be caused by the retaining projection such as the flap. When removing the drainage tube 102 of the present embodiment, through an endoscope,
The drainage tube 102 may be removed by grasping the drainage tube 102 with the tip of the forceps.

It should be noted that the present invention is not limited to the above-described embodiment, but can be variously modified within the scope of the present invention.

For example, the distal end of the first tube member 4 constituting the drainage tube according to the above embodiment and / or
Alternatively, a pig tail, a flap, or the like may be formed at the base end as needed. Further, the drainage tube of the present invention can be applied to treatment of other bifurcations in addition to bifurcations of bile ducts and pancreatic ducts.

[0068]

As described above, according to the present invention, for example, the bile duct can be inserted and placed in both the bile duct and the pancreatic duct, and bile can be discharged outside the body, and pancreatic juice can be discharged into the duodenum. The drainage tube capable of performing the drainage can be provided.

[Brief description of the drawings]

FIG. 1 is a perspective view of a drainage tube according to an embodiment of the present invention.

FIG. 2 is a schematic view showing a method of attaching the drainage tube shown in FIG. 1 to a bifurcation of a bile duct and a pancreatic duct.

FIG. 3 is a schematic view showing a step that follows the step of FIG. 2; It is.

FIG. 4 is a schematic diagram showing a step that follows the step of FIG. 3;

5 (A) to 5 (C) are schematic cross-sectional views of a drainage tube according to another embodiment of the present invention.

FIG. 6A is a perspective view of a drainage tube according to an embodiment of the present invention, and FIG. 6B is a perspective view showing a process of manufacturing the drainage tube shown in FIG. 6A.

FIG. 7 is a schematic view showing a method of attaching the drainage tube shown in FIG. 6 to a bifurcation of a bile duct and a pancreatic duct.

FIG. 8 is a schematic diagram showing a step that follows the step of FIG. 7;

[Explanation of symbols]

 2, 2a to 2c drainage tube 4, 4a to 4c first tube portion 5, 5a to 5c first body fluid discharge passage 6, 6a to 6c second tube portion 7, 7a to 7c second body fluid discharge passage 8, 8a to 8c first body fluid inlet 9, 9a to 9c first hollow passage 11, 11c branch part 11a, 11b branch through hole 12, 12a to 12c second body fluid inlet 13, 13a to 13c ... second hollow passage 20, 20a-20c ... first body fluid outlet 24, 24a-24c ... second body fluid outlet 30 ... endoscope 32 ... duodenum 34 ... bile duct 36 ... pancreatic duct 38 ... branch 40 ... first Guide wire 42 Second guide wire 102 Drainage tube 104 First tube member 105 Hinge part 106 Second tube member 108 First body fluid inlet 109 First hollow passage 110 ... first fluid outlet 112: Second fluid inlet 113: Second hollow passage 114 ... second fluid outlet

Claims (8)

[Claims] 1. A drainage tube inserted into a body and placed in the body to discharge a body fluid or the like, the first tube having a first hollow passage having a first body fluid inlet formed at a distal end. A second tube portion having a second hollow passage diverging from the first tube portion and having a second body fluid inlet formed at a distal end thereof; Has a first bodily fluid discharge passage formed therein, which communicates with the first hollow passage without communicating with the first hollow passage, and extends proximally from a branch portion of the first tube portion and the second tube portion. A proximal end portion having a catheter tube portion formed with a first bodily fluid outlet communicating with the first bodily fluid discharge passage, a second tube portion located near the bifurcation, and / or
Alternatively, a drainage tube is formed in the catheter tube portion, wherein a second bodily fluid discharge port that communicates with the second hollow passage without communicating with the first hollow passage is formed. 2. The catheter tube portion and the first
The tube portion is constituted by a single main hollow tube, the second tube portion is constituted by a sub hollow tube having an outer diameter smaller than that of the first tube portion, and the sub hollow tube is The main hollow tube is sealed into the inside of the main hollow tube through a branch through hole formed in a tube wall in the middle of the main hollow tube, and the distal end opening of the sub hollow tube is the branch through hole. 2. The drainage according to claim 1, wherein the second body fluid outlet is separately sealed and joined to an outlet through-hole formed in a tube wall of the main hollow tube. 3. tube. 3. The catheter tube portion and the first
The tube portion is constituted by a single main hollow tube, the second tube portion is constituted by a sub hollow tube having an outer diameter smaller than that of the first tube portion, and the sub hollow tube is The main hollow tube is sealed and enters the inside of the main hollow tube through a branch through hole formed in a tube wall in the middle of the main hollow tube, and extends to the proximal end side along the inside of the main hollow tube; 2. The drainage tube according to claim 1, wherein the second body fluid outlet communicating with the inside of the sub tube is formed in a tube wall of the main tube closer to the proximal end than the branching through hole. 3. 4. The catheter tube portion is a multi-lumen tube in which two or more lumens are formed along an axial direction, and one of the lumens serves as the first body fluid discharge passage. The other one of the lumens becomes a second body fluid discharge passage, and a proximal end of the first tube portion communicating with the first body fluid discharge passage is joined to a distal end of the multi-lumen tube. And a proximal end of the second tube portion communicating with the second bodily fluid discharge passage is joined, and a tube wall of the multi-lumen tube is connected to the second bodily fluid discharge passage only with the second bodily fluid discharge passage. The drainage tube according to claim 1, wherein a two-body fluid outlet is formed. 5. The catheter tube portion and the first
The tube portion is constituted by a single main hollow tube, the second tube portion is constituted by a sub hollow tube having an outer diameter smaller than that of the first tube portion, and the sub hollow tube is 2. The drainage according to claim 1, wherein the drainage tube is connected to the outside of the main hollow tube in the middle of the main hollow tube, and a proximal end side opening of the sub hollow tube constitutes the second body fluid discharge port. tube. 6. A drainage tube indwelled in a body cavity to discharge a body fluid or the like, wherein a first body fluid inlet is formed at a distal end, and a first body fluid inlet is formed at a proximal end.
A hollow first tube member having a bodily fluid discharge port formed therein; a first bodily fluid member rotatably mounted at a base end of the first tube member; and a second bodily fluid inlet formed at a distal end portion. A drainage tube having a hollow second tube member having a second body fluid outlet formed at an end thereof. 7. The drainage tube according to claim 6, wherein the first tube member and the second tube member are integrally formed. 8. In a state where no external force is applied, a restoring force tends to be deformed in a direction in which the angle between the axis of the first tube member and the axis of the second tube member approaches 180 degrees. The drainage tube according to claim 6 or 7, wherein: