JPH02239875A - Catheter for drug injection - Google Patents

Abstract

PURPOSE:To prevent the leakage of a stone dissolving agent to the duodenal papilla side by providing an outflow preventive member consisting of a material which is swollen and increased in volume by a billary calcule dissolving agent in a part on the front end side of a catheter body to be located in the cystic duct. CONSTITUTION:The stone dissolving agent (MTBE) or the bille can be released through the catheter 11 into the gall bladder or can be recovered by the normal or inverse rotation of a pump 14. The front end side part 18 of the catheter 11 has plural holes 19 for releasing or recovering the MTBE or the bille. The material which is swollen by the MTBE, for example, a sealing member 20 consisting of silicone rubber, etc., is fixed to the part positioned to face the cystic duct in tight contact therewith at the time of using the catheter on the side nearer the operator side than the holes 19. There are plural communicating holes 21 in the peripheral wall part of the catheter 11 to be mounted with a sealing member 20. The respective communicating holes 21 introduce the MTBE passing in the catheter 11 to the sealing member 20 to bring the MTBE into partial contact therewith.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a drug injection catheter for introducing a gallstone dissolving agent into the gallbladder via the duodenal papilla.

[Prior Art] In general, surgical procedures, oral administration of bile acids, etc. have been used to treat gallbladder stones. However, in recent years, drugs that directly act on gallbladder stones and have a dissolving effect, such as M T B E (Methy Te
Drugs such as arybutyl ether) have been developed, and a method of introducing this drug into the gallbladder to dissolve the gallbladder stones has come into use.

Until now, as a means of introducing gallstone dissolving agents into the gallbladder,
Possible methods include percutaneous transhepatic intubation with a catheter or transduodenal papillary intubation using an endoscope.

However, in any of these methods, a means is required to keep the MTBE only within the gallbladder in order to prevent MTBE from flowing out into the duodenum and causing side effects such as inflammation.

[Problems to be Solved by the Invention] Therefore, in the transduodenal papillary injection method, a balloon 2 is provided at the tip of a narrow catheter 1, as shown in FIG. 3 cystic duct 4
It is conceivable to place the MTBE at the mouth 5 of the patient to prevent the MTBE from flowing out into the duodenum.

However, since the cystic duct 4 is generally thin and has a spiral shape, it is not possible to insert a very thick catheter 1 into the cystic duct 4. In addition, it is necessary to provide the occlusion balloon 2 described in "2" and further attach the indwelling balloon 7. Further, since a conduit for supplying air or liquid to the balloons 2 and 7 must be provided within the catheter 1, the outer diameter of the catheter 1 becomes large, and as a result, it is difficult to insert it into the gallbladder 3. In addition, the liquid-feeding conduit for injecting MTBE becomes thinner, making it impossible to efficiently inject or discharge MTBE.

Moreover, the effect of preventing leakage of MTBH by the leakage prevention balloon 2 was not necessarily sufficient because the positioning action of the balloon 2 was unstable.

The present invention has been made in view of the above-mentioned problems, and its purpose is to efficiently inject and discharge a gallstone dissolving agent, even though the cystic duct is difficult to intubate due to its small diameter. An object of the present invention is to provide a drug injection catheter that reliably prevents a solubilizing agent from flowing out from the gallbladder.

[Means for Solving the Problems] In order to solve the above problems, the drug injection catheter of the present invention includes a catheter body made of a tube that is resistant to gallstone dissolving agents, and a drug release catheter provided at the tip of the catheter body. and a sealing part made of an abrasive material that is swollen by a gallstone dissolving agent and provided on the outer periphery of the catheter body at a position corresponding to the cystic duct on the rear end side of the drug release hole.

The catheter body is inserted endoscopically into the gallbladder via the duodenal papilla, and the outflow prevention part made of a material that swells with a gallstone dissolving agent and expands in volume is placed on the distal end of the catheter body located in the cystic duct. Therefore, when a gallstone dissolving agent is injected into the gallbladder after being inserted into the gallbladder, the outflow prevention member swells due to the gallstone dissolving agent. The outer diameter of the catheter portion located in the cystic duct portion is increased, and the catheter portion is brought into close contact with the inner wall of the cystic duct, thereby preventing leakage of a stone-dissolving agent such as MTBE to the duodenal papilla side.

Embodiment FIG. 1 shows a first embodiment of the present invention. 1st
In the figure, 11 indicates a catheter.

The main body of this catheter 11 is made of a flexible tube made of a material such as Teflon that is not changed by a stone dissolving agent such as MTBE. A cap 12 is attached to the proximal end of the catheter 11. Further, the mouthpiece 12 of the catheter 11 is connected to a pump 14 through a tube 13 that is not changed by the MTBE. Further, the tube 13 extending through the pump 14 is branched by a three-way stopcock 15, one of which is led to a drug container 16 containing MTBE. The other end is led to a bile container 17 for temporarily storing the aspirated bile.

The pump 14 can be rotated forward or reverse by a control means (not shown) to discharge or collect MTBE or bile into the gallbladder through the catheter 11.

The distal end portion of the catheter 11 8 is provided with a plurality of holes 19 for releasing or recovering MTBE or bile. On the proximal side of each hole 19, a sealing member 20 made of a material such as silicone rubber, which is swollen by MTBE, is in close contact with a portion located corresponding to the cystic duct 27, which will be described later. Fixed. A plurality of communication holes 21 are provided in the peripheral wall portion of the catheter 11 to which the sealing member 20 is attached. Each communication hole 21
is adapted to guide the MTBE passing through the catheter 11 to the sealing part abutment 20 so as to partially contact it.

Next, how to use this example will be explained. FIG. 2 shows its usage. That is, after the duodenal fiberscope 22 is orally inserted into the duodenum 23, the catheter 11 is introduced from the duodenal papilla 24 through the common bile duct 25 into the gallbladder 26 using a guide wire (not shown) or the like. At this time, the sealing member 20 is located within the cystic duct 27. In this state, the three-way stopcock 15 is operated to allow the tube 13 to communicate only with the bile container 17.

Then, the pump 14 is operated (reversely) and the bile in the gallbladder 26 is temporarily collected into the bile container 17 through the catheter 11. The reason why the bile is temporarily collected into the bile container 17 is to prevent the bile from solidifying into a jelly-like state due to mixing with MTBE.

After bile collection is completed in this manner, the three-way stopcock 15 is switched to connect the tube 13 to the drug container 16, and the pump 14 is rotated in the normal direction. Then, the MTBE in the drug container 16
is injected into the gallbladder 26 through the catheter 11. At this time, the MTBE comes into contact with the sealing member 2o through each communication hole 21 of the catheter 11 provided in the mounting portion of the sealing member 20, so that the sealing member 20 begins to swell. Furthermore, after being injected into the gallbladder 26, MTBE attempts to flow out through the cystic duct 27 and comes into contact with the sealing member 2o from the outside, accelerating the swelling of the sealing member 20.

The outer diameter of the sealing member 20 swollen in this manner expands and comes into close contact with the cystic duct 27, thereby preventing bile from flowing out.

Then, the pump 14 is rotated forward and backward for a required period of time to dissolve the gallstones 28, and then the pump 14 is reversed to discharge the MTBE in the gallbladder 26 into the drug container 16. After that, the three-way stopcock 15 is switched again, and the tube 13
is connected to the bile container 17 and the pump 14 is rotated in the normal direction to return bile into the gallbladder 26. Thereafter, the catheter 11 is pulled from the proximal side and removed from the cystic duct 27, etc. to complete the procedure.

According to this configuration, the sealing member 20 is swollen by the action of MTBE, which is a gallstone dissolving agent, so that its structure can be simplified and the outer diameter of the catheter 11 can be made as thin as possible. Therefore, insertion of the catheter 11 into the cystic duct 27 becomes easy. In addition, because the structure is simple,
The inner diameter of the catheter 11 can be made as large as possible, and the gallstone dissolving agent can be delivered efficiently.

FIG. 3 shows a second embodiment of the invention. In this embodiment, a circumferential groove-like recess 31 is provided in the attachment portion of the catheter 11 to which the sealing member 20 is attached.
It is provided so that the sealing portion 20 is fitted therein.

In general, Teflon, which is the material for forming the catheter 11, does not have very good adhesion to silicon, which is the material for the sealing member 20, so the position of the sealing member 20 may shift depending on the case.

In the case of this second embodiment, the sealing member 20 is fitted and attached to the recess 31, so that it is difficult to shift. Other configurations and effects are similar to those of the first embodiment described above.

Note that the present invention is not limited to the above embodiments. For example, the sealing member 2o is not limited to silicone, and may be made of other materials that swell with the gallstone dissolving agent, such as polyurethane.

[Effects of the Invention] As explained above, according to the present invention, the cystic duct portion can be reliably sealed with a simple and compact structure. Furthermore, the outer diameter of the catheter can be configured to be small, and the catheter can be easily inserted into the gallbladder. Furthermore, since the passageway through which the gallstone dissolving agent is delivered can be made larger inside the catheter, the flow rate of the gallstone dissolving agent can be increased.

[Brief explanation of drawings]

FIG. 1 is a configuration diagram of a system showing a first embodiment of the present invention, FIG. 2 is an explanatory diagram of the state of use of the first embodiment of the present invention, and FIG. 3 is a diagram showing a second embodiment of the present invention. FIG. 4 is a side cross-sectional view of the distal end portion of the catheter of the embodiment, and is a diagram of the prior example in use. 11... Catheter, 20... Sealing member, 21...
・Communication hole, 26... Gallbladder, 27... Cystic duct. Applicant's agent Patent attorney Atsushi Tsuboi

Claims (1)

[Claims] A drug injection catheter that is introduced into the gallbladder via the duodenal papilla and guides a gallstone dissolving agent to the gallbladder, which includes a catheter body made of a tube that is resistant to the gallstone dissolving agent, and a drug release device provided at the tip of the catheter body. A drug injection comprising a hole, and a sealing member made of a material that is provided on the outer periphery of the catheter body at a position corresponding to the cystic duct on the rear end side of the drug release hole and is swollen by a gallstone dissolving agent. catheter.