JPH0336365Y2 - - Google Patents

Description

[Detailed description of the device] This device can be inserted into the biliary tract to transfer bile from the biliary tract to the duodenum when it becomes difficult to circulate body fluids within the body cavity, such as when the opening from the biliary tract to the duodenum is narrowed. This invention relates to a drainage tube that is inserted into a stenotic site to allow body fluids to flow therethrough.

Taking the case of stricture in the biliary tract as an example, the common bile duct, which carries bile from the liver, and the great pancreatic duct, which carries splenic fluid from the spleen, merge and open into the duodenum.
If a tumor develops in the papilla of Fuerter located at this opening, the opening will become narrowed and bile and pancreatic juice will no longer flow into the duodenum. Furthermore, when a tumor occurs in the common bile duct or pancreatic duct, which is an enlarged part of the biliary tract, the common bile duct or pancreatic duct is narrowed by the tumor, and bile or pancreatic juice cannot flow out into the duodenum. In these cases, it is desirable to remove the tumor by surgery, as it not only affects digestion but also sometimes causes jaundice and pancreatitis. However, some people, such as the elderly, those prone to anemia, or those with heart disease, cannot tolerate surgery to remove tumors. For patients who cannot undergo such surgery,
As a temporary measure until yellowing is reduced, pancreatitis is removed, and physical strength is restored to endure surgery, a drainage tube is passed through the site of the stricture using an endoscope, thereby draining body fluid. Commercialized treatments have been attempted in recent years.

FIG. 1 shows a conventional drainage tube used for such treatment inserted into the biliary duct a. In Figure 1, the upper part 1 of the drainage tube is inserted up to the common bile duct b, and the lower part 2
shows a state in which it protrudes into the duodenum c. In this case, bile in the common bile duct b flows into the tube through a plurality of small holes 3 provided in the peripheral wall of the upper part 1,
From the small hole 3 provided in the peripheral wall of the lower part 2 to the duodenum c
This will lead to leakage. The drainage tube is made of a synthetic resin such as tetrafluoroethylene resin, polyethylene resin, or polyurethane resin used for vascular catheters, and the distal end side of the tube is cut off, and the upper part is cut off to prevent withdrawal after insertion. 1 curved into a hook shape is used. In such a conventional drainage tube, the lower part 2 protrudes into the duodenum c when inserted into the bile duct a, so when the duodenum c is deformed due to a change in the patient's position, the end of the lower part 2 Not only does the corner of the intestine slide into contact with the inner wall of the duodenum c, causing discomfort to the patient, but repeated sliding contact causes ulcers on the intestinal wall, and as this ulcer progresses, it perforates the duodenal wall, causing peritonitis. I had a problem when I woke up.

The present invention solves these problems by adding flexibility to the lower part of the drainage tube, so that it does not cause discomfort to the patient after insertion and eliminates the risk of ulcers, etc. The present invention provides a drainage tube with no drainage tube.

Hereinafter, according to the preferred embodiment shown in the attached drawings,
The present invention will be explained in detail.

FIG. 2 shows an embodiment of the present invention inserted into the biliary tract. The drainage tube of this embodiment has an upper part 11 which is an inflow part through which body fluids flow in and is located in the common bile duct b, an intermediate part 12 which is inserted into the narrowed bile duct a, and an outflow part through which body fluids flow out. It consists of a lower part 13 that projects into the duodenum c, and the upper part 11 and the lower part 13 communicate through an intermediate part 12. In order to prevent the tube from coming out after insertion, the upper part 11 is curved into a hook shape, and the lower part 13 has a plurality of cuts along the axis of the tube that reach the opening to form a band-shaped part. By forming a band-shaped part between these cuts and expanding them radially outward, and then narrowing their ends, a tea whisk-shaped swelling with inherent elasticity is created. Music section 14
is provided. In addition, the peripheral wall of the upper part 11 and the lower part 1
A plurality of small holes 15 are bored in the peripheral wall of 3 for the circulation of body fluids.

FIG. 3 is a diagram showing another embodiment of the present invention inserted into the biliary tract. In this example, the lower part 13
The bulging portion 14 provided in this embodiment is the same as in the embodiment described above, but there is a difference in the overall shape of the drainage tube in which the bulging portion is provided. In this case, instead of curving the upper part 11 into a hook shape, the upper part 11 has a check piece 16 projecting obliquely like the so-called barb of a fishhook.
is provided to prevent the tube from being removed once inserted. This check piece 16 has almost no effect on the force when inserting the drainage tube, as it only slides into contact with the inner wall of the tube.
In response to a force that attempts to pull out the tube, it acts in a direction that locks the tube to the inner wall and prevents the tube from being pulled out. This check piece 16 may be formed by making a cut in the drainage tube itself to raise it, or may be bonded or welded to the peripheral wall of the drainage tube afterwards. On the other hand, the lower part 13
This is curved into a hook shape to prevent its end from coming into direct contact with the inner wall of the duodenum c.
Further, in this embodiment, the shape of the intermediate portion 12 is gently bent into a dogleg shape to match the shape of the biliary tract through which it is inserted.

In the embodiment shown in FIG. 3, the lower part 13 protruding into the duodenum c does not irritate the intestinal wall because the smooth circumferential wall of the hooked tube normally comes into contact with the intestinal wall. Even if the end of the lower portion 13 comes into contact with the intestinal wall due to deformation of the duodenum c, the expanded portion 14 deforms to accommodate the force and absorbs the force, so that the intestinal wall will not be stimulated. do not have.

Hereinafter, an example of a method of inserting a drainage tube according to the present invention into a site where stenosis has occurred will be explained with reference to FIGS. 4 and 5.

FIG. 4 is a diagram showing a state in which a guide wire is inserted into the narrowed common bile duct using an endoscope, and FIG. FIG. 3 is a longitudinal sectional side view showing a state in which it is placed over the outer periphery of the tip.

First, the endoscope 17 is inserted into the vicinity of the site where the stenosis has occurred, and a treatment tool channel 18 provided on the endoscope is used to insert treatment tools such as forceps and incision tools.
A guide wire 19 for inserting a drainage tube is inserted into the tube, and one end of the guide wire 19 is inserted toward the opening of the site where the stenosis has occurred, as shown in FIG. 4, under observation using the endoscope 17. Insert. Next, the drainage tube 20 is inserted through the guide wire 19. Drainage tube 20
normally has the shape shown by the broken line in FIG. 5, but when inserted into the guide wire 19, it is stretched linearly as shown by the solid line due to the rigidity of the guide wire 19. After that, following the drainage tube 20, a push-in tube 21 having approximately the same diameter as the drainage tube 20 is inserted into the guide wire 19, and the push-in tube 21 allows the drainage tube 20 to be inserted along the guide wire 19. Push it into the bile duct a. In this pushing process, each band-shaped portion forming the bulging portion 14 is crushed between the treatment instrument channel 18 and the guide wire 19, the diameter of the bulging portion 14 is reduced, and the treatment instrument channel 1
It is possible to smoothly insert the drainage tube 20 into the tube 8. Drainage tube 20
When pushed in further, the bulging portion 14 passes through the treatment instrument channel 18, and the bulging portion 14 after passing through the treatment instrument channel 18.
Each part expands radially due to its own unique restoring elasticity. After the drainage tube 20 is inserted into the biliary tract a to a predetermined position, the push tube 21, guide wire 19, and endoscope 17 are pulled out from the body cavity, and the drainage tube 20 is left in the stenotic duct.

According to the drainage tube according to the present invention,
The bulging part provided at the lower part exhibits flexibility against both axial and circumferential forces and absorbs the force that comes into contact with it, so even if the lower part comes into contact with the intestinal wall, it will not damage the inner wall. No pressure or irritation. Therefore,
It does not cause discomfort to the patient or cause ulcers in the intestinal lining. Further, since the diameter of the bulging portion is easily reduced, it does not become an obstacle when inserting the tube.

[Brief explanation of the drawing]

FIG. 1 is a diagram showing a conventional drainage tube inserted into the biliary tract, FIG. 2 is a diagram showing an embodiment of the drainage tube according to the present invention inserted into the biliary tract, and FIG. 3 is a diagram showing a conventional drainage tube inserted into the biliary tract. FIGS. 4 and 5, which show other embodiments in the inserted state, are diagrams for explaining a method of inserting the drainage tube according to the embodiment shown in FIG. 3. 11... Upper part, 12... Middle part, 13... Lower part, 14... Swelling part, 15... Small hole, 16... Check piece, 17... Endoscope, 19... Guide wire,
20...Drainage tube, 21...Pushing tube.

Claims (1)

[Scope of utility model registration request] A drainage tube that is inserted into a stenosed area in a body cavity to allow body fluids to flow through the area, and has a plurality of cuts along the axis at one end of the tube that reach the opening. A drainage tube in which each band-shaped part between the cuts bulges radially outward, and each part has a tea whisk-like bulging part that is concave at the end and has inherent elasticity.