JPS6142615Y2 - - Google Patents

Description

[Detailed description of the device] This device can be inserted into the biliary tract to divert bile from the biliary tract to the duodenum when fluid circulation within the body cavity becomes difficult, such as when the opening from the biliary tract to the duodenum becomes narrowed. The present invention relates to a drainage tube used to pass body fluid through a site where stenosis occurs such as outflow.

To explain a case in which stricture occurs in the biliary tract, the common bile duct, which carries bile from the liver, and the great pancreatic duct, which carries pancreatic juice from the pancreas, merge into the duodenum and open into the duodenum. When a tumor develops in a certain papilla of Fuerter, the opening becomes narrowed and bile and pancreatic juice cannot drain 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 into the duodenum. In these cases, it is desirable to remove the tumor by surgery because it not only affects digestion but also sometimes causes jaundice or pancreatitis. However, some people, such as the elderly, those prone to anemia, or those with heart disease, cannot tolerate surgery to remove the tumor. If such surgery is not possible, or as a temporary treatment until surgery to reduce the yellow color, remove pancreatitis, and restore physical strength to withstand surgery, an endoscope may be used to diagnose the above-mentioned stenosis. In recent years, treatment methods have been attempted in which a drainage tube is passed through the site and body fluids are circulated through the drainage tube.

FIG. 1 shows a state in which a conventional drainage tube used for such treatment is inserted into the biliary duct a. In FIG. 1, the distal end 1 of the drainage tube is inserted up to the common bile duct b, and the rear end 2 of the drainage tube protrudes into the duodenum c. 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 distal end 1, and flows out into the duodenum c through small holes 3 provided in the peripheral wall of the rear end 2. The drainage tube is made by cutting off the distal end of a synthetic resin tube such as tetrafluoroethylene resin, polyethylene resin, or polyurethane resin used in vascular catheters, and cutting the distal end 1 to prevent withdrawal after insertion. They used something curved into a hook shape. Such conventional drainage tubes have the following problems.

(1) Because the tip 1 is hook-shaped, the duodenum c
It is difficult to insert a drainage tube into the biliary duct a through the opening of the bile duct a.

(2) Since the distal end 1 is hook-shaped, when the drainage tube is inserted into the bile duct a, the restoring elasticity of the distal end 1 allows the distal end 1 to connect to the common bile duct b.
distal end 1, causing discomfort to the patient by compressing the inner wall of the
If the tube is in contact with the inner wall of the tube for a long period of time, the inner wall of the tube may become inflamed.

(3) Due to changes in the patient's position, the duodenum c is also deformed, and at that time, when the drainage tube is inserted into the bile duct a, the terminal corner of the rear end 2 protruding into the duodenum c becomes the duodenum c. The terminal corner of the rear end 2 that protrudes inward slides against the inner wall of the duodenum c, and as this is repeated, the inner wall develops an ulcer, and as the ulcer progresses, it may perforate the duodenal wall and cause peritonitis.

(4) Since the diameter of the small holes 3 made in the distal end 1 and the posterior end 2 are small, mucous membranes, bile sand (microscopic gallstones), bile sludge (bile containing bile sand), etc. that have detached from the inner wall of the body cavity can be removed. While a sticky substance or a solid substance such as a calculus flows through the small hole 3, the sticky substance or solid substance may adhere to the small hole 3 and block the small hole 3. Even if it is attempted to increase the diameter of the small hole 3 in order to prevent such blockage, it is difficult because the diameter of the drainage tube itself is small.

(5) If the drainage tube is inserted too deeply or if the drainage tube is no longer needed and you try to pull it out, the hook-shaped part of the distal end 1 may touch the inner wall of the lumen into which it has been inserted. It is difficult to pull out because it digs in. In addition, the drainage tube does not have a portion that can securely grip the drainage tube, which makes it even more difficult to pull out the drainage tube.

The present invention was made to solve the above-mentioned problems, and by providing the drainage tube with a bulging part, which will be described in detail later, it can be easily inserted and can be left in the body cavity for a long period of time. To provide a drainage tube that does not become obstructed. Further, the drainage tube according to the present invention does not cause discomfort to the patient after insertion, there is no risk of causing ulcers, etc., and in addition, it can be pulled out as necessary.

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

FIG. 2 is a plan view showing an embodiment of the present invention. The drainage tube according to the present invention consists of a distal end 11 which is an inflow part through which body fluids flow in, an intermediate part 12 which is inserted into a site where stenosis has occurred, and a rear end part 13 which is an outflow part through which body fluids flow out. , the distal end portion 11 and the rear end portion 13 communicate with each other through the intermediate portion 12. A bulge 14 is provided at the rear of the distal end 11, that is, at a portion closer to the intermediate portion 12, for restricting movement of the tube within the body cavity. The bulging portion 14 is formed by forming a plurality of band-shaped portions along the axis line at the same position in the circumferential direction of the tube, as shown in the cross-sectional elevation taken along the line A-A in FIG. , are formed by bulging and expanding radially outward with respect to the central axis of the tube to impart inherent elasticity. A plurality of small holes 1 are provided in the peripheral wall of the tip portion 11.
5.

It is desirable that the shape of the intermediate portion 12 is made to match the shape of the body cavity through which it is inserted, and in this embodiment, it is shaped like a dogleg to match the shape of the biliary tract.

The rear end portion 13 is curved in a hook shape, and a bulge portion 16 similar to the bulge portion 14 provided at the distal end portion 11 is provided at the front portion thereof, that is, the portion closer to the intermediate portion 12. Rear end 1
A plurality of small holes 17 are bored in the peripheral wall of 3.

When the drainage tube having the above-described configuration is inserted into the bile duct a as shown in FIG. Musical parts 14, 16
movement within the body cavity is regulated by In addition, the bile in the common bile duct b flows into the drainage tube through the slit in the swollen part 14 of the distal end 11 and the small hole 15, as shown by the arrow in FIG. It flows out into the duodenum c through the cut in the bulge 16 of the end 13 and the small hole 17. duodenum c
The inwardly protruding rear end 13 does not irritate the intestinal wall because the smooth peripheral wall curved in a hook abuts against the intestinal wall. Posterior end 1 to protect the intestinal wall
Methods such as rounding the end of 3 or attaching a spherical protective member to the end may be adopted, but in the case of this embodiment, it is advantageous when pulling out the drainage tube described later, and it is easy to process. It also has the advantage of being easy.

In this embodiment, the bulging portions 14 and 16 are
However, if there is no fear that the drainage tube will penetrate deeper than the insertion position after insertion, the bulging portion may be provided only at the distal end portion 11.

Further, although there is a possibility that the drainage tube may penetrate deeper than the inserted position, if there is no risk of it falling out, the bulging portion may be provided only at the rear end portion 13.

In this embodiment, the small holes 15 and 17 were formed in each of the distal end 11 and the rear end 13, but the swollen part 1
If body fluids can sufficiently flow through only the holes 7 and 16, the small holes 15 and 17 may not be provided.

An example of a method for inserting the drainage tube according to the present invention into a site where stenosis has occurred will be described below.

First, an endoscope is inserted to the vicinity of the site where the stenosis has occurred, and a drainage tube is inserted into the channel provided in the endoscope for inserting treatment tools such as forceps and incision tools. Insert the guide tube. The guide tube has a thickness that allows the drainage tube to be inserted thereinto, and has a length that is at least twice as long as the treatment instrument channel of the endoscope. The guide tube is inserted into the opening of the perforation site under observation using the endoscope. In this state, only the endoscope is removed from the body cavity, being careful not to dislodge the guide tube from the opening. Next, the drainage tube according to the present invention is inserted into the guide tube. The drainage tube may be rounded at its end as shown in Figure 6 or tapered to reduce its diameter as shown in Figure 7 to facilitate insertion into the punctured site. It is preferable to keep it small. Therefore, FIG. 8 shows the state when the drainage tube is inserted. First, a push wire 19 is prepared which has a locking portion 18 having an outer diameter larger than the diameter of the distal end of the drainage tube and smaller than the diameter of the other portion of the drainage tube. Next, press wire 1
9 into the drainage tube, and insert the drainage tube into the biliary duct a using the push wire 19.
Push it inside. At this time, the distal end portion 11 of the drainage tube is pushed by the locking portion 18 of the push wire 19, and the locking force due to friction between the intermediate portion 12 and the guide tube (not shown) and the pushing force are combined. As a result, the bulging portion 14 is pulled in its axial direction and reduced in diameter, making it possible to smoothly insert it into the biliary tract a.
Push the drainage tube further until the swelling part 14
When the tube passes through the distal end a, each part of the bulging part 14 expands radially due to its unique restoring elasticity, thereby preventing the drainage tube from falling out.

According to the drainage tube according to the present invention,
Since the drainage tube is locked by the bulging portion provided at the distal end, there is no fear that it will move within the body cavity into which it is inserted.

Moreover, since the diameter of the bulging portion is easily reduced by an external force in the axial direction, it is easy to insert the drainage tube into the body cavity.

In addition, even if the small hole is obstructed by a sticky substance or a solid substance, body fluids can flow through the cut, so that the function of the drainage tube is maintained and there is no problem in long-term use.

Furthermore, the diameter of the swollen portion is easily reduced, and the treatment instrument can be inserted through the curved portion of the rear end or the cut in the swelled portion of the rear end using the treatment instrument channel of the endoscope. Since the rear end of the drainage tube can be reliably grasped by hooking the drainage tube onto the tube, the drainage tube can be easily pulled out from the body cavity into which it has been inserted, if necessary.

Furthermore, since the bulging portion exhibits flexibility against forces in both the axial direction and the circumferential direction, even if the tip or rear end comes into contact with the inner wall of the body cavity, it will not press the inner wall. .

[Brief explanation of the drawing]

Fig. 1 is a view showing a conventional drainage tube inserted into the biliary tract, Fig. 2 is a plan view showing an embodiment of the present invention, and Fig. 3 is a second view of the bulging portion of the same embodiment. - A cross-sectional elevational view taken along line A; FIG. 4 is a diagram showing the same embodiment inserted into the biliary tract; FIG. 5 is a diagram showing the flow of body fluid to the bulge; FIGS.
The figure is a vertical cross-sectional plan view showing an enlarged tip of the same example.
FIG. 8 is a diagram illustrating the insertion method of the same embodiment. 11... Tip part, 12... Middle part, 13... Rear end part, 14, 16... Swelling part, 15, 17... Small hole.

Claims (1)

[Claims for Utility Model Registration] A distal end and a rear end that are the inflow and outflow parts of body fluids, and an intermediate portion that communicates with the distal end and the rear end and is inserted into a constricted area in the body cavity. A tube consisting of a plurality of band-shaped sections formed by making a plurality of cuts along the axis at the same position in the circumferential direction of the tube, each of which is expanded outward radially with respect to the central axis of the tube. A drainage tube having a swollen portion that imparts unique elasticity by expanding and expanding at least one of the distal end portion and the rear end portion.