JPS63181771A - Catheter for bile duct - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION (1) Industrial Application Field This invention relates to medical catheters and biliary catheters, and more specifically to indwelling intrabiliary catheters used for obstructive yellow scars; More specifically, the present invention relates to an indwellable biliary catheter that can be implanted in the body or exposed outside the body.

(2), Conventional technology Recently, non-invasive biliary endostomy has been developed for obstructive yellow scars that are judged to be impossible to completely cure or remove. It has become widely practiced because it has the same yellow-reducing effect as endoscopic surgery.

Conventionally, various catheters have been proposed for use in such biliary endostomy, but all of them have an opening at one end, which is the insertion tip of the catheter tube, and this opening is the main cause of oily formation. It did not have a structure that could prevent the regurgitation of certain intestinal contents.

(3) Problems to be Solved by the Invention In the conventional biliary fistula catheter, the opening at one end does not have a backflow prevention function as described above, so that the intestinal contents may be lost 1 to 2 months after the catheter is indwelled. Problems include the possibility that objects may flow backwards and the catheter tube becomes obstructed by oily substances, leading to serious complications such as acute cholangitis and bile abscess.

Therefore, in order to eliminate the problems associated with the conventional catheters, the technical object of the present invention is to prevent intestinal contents from flowing back into the catheter tube, which is the main cause of oily formation.

(4) Means for Solving the Problems In order to achieve the above-mentioned technical problem, a biliary catheter according to the first aspect of the present invention has a slit at one end through which a guide wire can pass, and a slit that opens by internal pressure. A second invention characterized by comprising a catheter tube having a stop valve, or a catheter tube having a radial cut at one end that opens when a guide wire passes therethrough, and a slit-like check valve that opens by internal pressure near the one end. A biliary catheter includes a catheter tube having a slit-like check valve at one end through which a guide wire can pass and which opens by internal pressure, or a radial slit at one end that opens by passage of the guide wire, and a catheter tube that opens by internal pressure near the one end. a catheter tube having a slit-like check valve;
The inside of the catheter tube in the axial direction is formed into two channels from one end to the other by a partition wall, and one end of the one channel is closed with a closing member, and the other end is a channel for subcutaneous implantation. A pump for subcutaneous implantation, which is connected to a reservoir in a removable manner and communicates with the reservoir, and the other flow path is open at one end, and the other end is connected to the reservoir through a slit-shaped check valve. It is characterized by being connected in communication and detachably.

(5) Effect: By adopting the technical means described above, the backflow of intestinal contents into the catheter tube is prevented by the slit-shaped check valve provided at or near one end of the catheter tube, which prevents the intestinal contents from flowing back into the catheter tube. The catheter tube is no longer obstructed by oily substances.

(6), Embodiment FIG. 1 shows a first embodiment implemented in a biliary waxing catheter, and the biliary waxing catheter 1 has a catheter tube 2° of a predetermined length made of silicone rubber with little biological abnormality. It has 3. A slit-shaped check valve 5 is attached to one end of the tube 2, through which a guide wire (not shown) can pass, and which is opened by internal pressure. Check valve 5 is 2
Two silicone rubber sheets 6.7 are stacked one on top of the other, and both edges are glued together, and the tip of the sheet 6.7 is flattened so that the tip of the crushed portion is not glued. It is formed in the slit 8.

Reference numeral 10 denotes a hollow connector made of Teflon, through which the other end of the tube 2 and one end of the tube 3 communicate and are detachably connected. A glue reservoir 12 for subcutaneous implantation is connected to the other end of the tube 3 in communication. The reservoir 12 has a needle receiver part 14 made of a stainless steel plate that prevents the injection needle from penetrating the bottom part 13 containing the Tetron mesh, and a needle receiver that allows the injection needle to penetrate into the side opposite to the part 14. It has a dome-shaped needle insertion part 15 made of an elastic material with good self-closing properties that naturally closes the hole formed by the puncture when the injection needle is pulled out, and the lower peripheral edge of the needle insertion part 15 is It is constructed by being glued onto the bottom part 13 via the other end of the tube 3. The one end side of the tube 2 where the check valve 5 is located is not limited to the one described above, but has a structure as shown in FIG. 2, that is,
One end of the tube 2 is closed in a substantially hemispherical shape, and a radial cut 20 is formed at this closed end, which opens when the guide wire passes through.
It is also possible to have a structure in which a slit-shaped check valve 21 that opens due to internal pressure is provided near one end of the tube 2.

It goes without saying that the number of cuts 20 can be selected as appropriate and is not limited to the number shown.

Next, an example of a non-invasive biliary fistula using the biliary fistula catheter 1 shown in FIG. 1 will be described with reference to FIG. 3.

In Figure 3, A indicates the liver, the mouth indicates the pancreas, C indicates the gallbladder, II indicates the duodenum, E indicates the papilla of Vater, and H indicates the skin, but the positions of these internal organs are merely to show their relative positions. Please acknowledge that

First, the right intrahepatic bile duct was inserted using the Seldingo method with two internal and external double needles.
A puncture is performed using a puncture device 23 consisting of 3a and 23b (Fig. 3A). Next, the inner needle 23b of the puncture device 23 is removed, and the guide wire 25 is inserted into the remaining outer needle 23b until its tip passes beyond Vater's nipple (FIG. 3B). After inserting the guide wire 25,
The outer needle 23a is removed while leaving the outer needle 23a as it is, and after removal, a dilator (not shown) is inserted along the guide wire 25 if necessary to dilate the fistula.

Next, when you insert the dilator, after removing it,
Place the tube 2 with the check valve 5 side at the top and guide wire 25.
The check valve 5 is inserted through the slit 8 of the check valve 5 to the target site, and left in place. At this time, the length of the tube 2 is determined based on the length of the patient's bile duct by looking at an X-ray photograph before the surgery, and the tube 2 is cut to a predetermined length if necessary. In addition, a through hole 26 is made in the tube 2, which will be located at the desired target site, using circular forceps or the like before the surgery (FIG. 3C).

Next, after removing the guide wire 25, the reservoir 1
One end of the tube 3 with 2 is cut to a predetermined length, inserted under the skin, and the one end is connected to the other end of the tube 2 via the connector 10. After this connection, the bottom 13 of the reservoir 12 is sewn and fixed to the fascia, and then the epidermis is sutured to complete the surgery. (Figure 3D).

The reservoir 12 of the catheter 1 embedded in the body as described above is filled with anti-cancer drugs and physiological saline by inserting a 25-27G injection needle into the needle insertion part 15 as needed. , a contrast agent, etc. are injected. The injected anti-cancer agent passes through the tubes 3 and 2, passes through the slit 8 of the check valve 5, enters the duodenum 2, and passes through the through hole 26, leading to the blockage between the bile duct and the tube 2. Flows into the bile duct upstream from the position where the bile duct is located.

On the other hand, even if the intestinal contents try to flow back into the bile duct, that is, into the catheter tube 2 placed in the bile duct, the back flow is prevented by the check valve 5 provided at one end of the tube 2, and the inside of the tube 2 is filled with oil and other substances. There is no possibility that food residue will enter and block the tube 2.

FIG. 4 shows a second embodiment implemented on an external biliary waxing catheter, and to explain the differences from the first embodiment in the external biliary waxing catheter 31, a tube fixing cuff 32 is bonded to the tube 3. The tube 3 is slidably inserted so that it can be fixed at an appropriate position in the tube 3 with an adhesive. The other end of the tube 3, which is fixed by the cuff 32 and exposed outside the body, is connected by a band 36 to an injection luer connector 35 to which an injection site 33 as a needle insertion part can be removably connected. A cap 37 is provided that is attached to the connector 35 when the injection site 33 is not in use. In this embodiment, an anticancer agent or the like is injected outside the body from a syringe inserted into the connector 35 or from an injection needle inserted into the injection 33 connected to the connector 35.

FIG. 5 shows a third embodiment implemented in an intrabiliary waxing catheter. Tube 4 of this intrabiliary waxing catheter 41
The axial interior of 2.43 has two flow passages 46, 47, 48 extending from one end to the other by partition walls 44, 45, respectively.
．． 49 and the other end of the tube 42 with the passage 46.47 and the other end of the tube 42 with the passage 48.49.
It is connected to one end of 3 by means of connectors 51 and 52 formed to fit into the flow path. tube 4
One end of the flow path 46 of the tube 43 is closed with a closing member 53, and the other end of the flow path 48 of the tube 43 is connected in communication with a glue reservoir 55 for subcutaneous implantation. In the reservoir 55, 56 is a needle receiver part similar to that of the first embodiment, and 57 is a needle insertion part. A pump 61 for subcutaneous implantation is provided in the reservoir 55 and communicated with the other end of the channel 49 of the tube 43 via a short tube 60 fixed by the fixing part 58 . The pump 61 also has the function of a reservoir, and therefore the same needle receiver as described above has a section 62 and a needle insertion section 63. A check valve 6 similar to the check valve 5 of the first embodiment is provided at the end of the short pipe 60 that protrudes into the pump 61.
5 is provided. Incidentally, 66 is a supporting bottom part containing Teflon mesh for supporting the reservoir 55 and pump 61 so that they do not bend.

In the case of the catheter 41 of this third embodiment, the tube 42
A through hole as described above is formed on the flow path 46 side. In use, an anticancer agent or the like is injected into the reservoir 55 as necessary in the same manner as described above, and the injected anticancer agent or the like is transferred to the channel 48 of the tube 43, 42.
46 and flows from the through hole, and from the pump 61 entering from the reservoir 55 through the slit of the check valve 65, by pressing the pump 61, it passes through the channel 49.47 of the tube 43.42. and flows through the slit 8 of the check valve 5. At this time, when it is desired that the anti-cancer agent etc. mainly flow through the through hole, the pump 61 is pressed and crushed to prevent the anti-cancer agent etc. from flowing to the pump 61 side from the slit of the check valve 65.

Further, the bile in the bile duct that enters the flow path 46 of the tube 42 through the through hole is stored in the reservoir 55 through the flow path 48 of the tube 43, and then passes through the slit of the check valve 65 to be pumped into the pump 61. Therefore, by pressing the pump 61, the fluid flows from the slit 8 of the check valve 5 to the duodenum 2.

It goes without saying that this embodiment can also be used to inject an anticancer agent or the like into the pump 61 by inserting an injection needle into the needle insertion portion 63.

(7) Effects of the Invention This invention is as described above, and the slit-shaped check valve provided at or near one end of the catheter tube reliably prevents intestinal contents from flowing back into the catheter tube. This makes it possible to eliminate occlusion of the catheter tube due to oil, thereby eliminating complications that were previously feared, and making it possible to maintain extremely safe indwelling of the catheter for a long period of time. Also,
In the second aspect of the invention in which the catheter tube is formed into two channels, an excellent effect can be expected in that bile can be absorbed and discharged downstream from the occluded position between the bile duct and the tube.

[Brief explanation of the drawing]

FIG. 1 shows a first embodiment of the present invention, in which (A) is a longitudinal sectional front view with a part of the catheter tube omitted, (B) is a partially enlarged perspective view of the tube with a slit-shaped check valve, and FIG.
The figures show a modification of the same tube as above, (A) is a partial front view of the tube with a slit check valve, (B) is (A)
3(A) to 3(D) are schematic diagrams showing an example of the use of the catheter of the first embodiment, and FIG. 4 is a partial enlarged perspective view of the catheter tube of the second embodiment. FIG. 5 is a longitudinal sectional front view with a part of the catheter tube omitted, showing the third embodiment. 1.31.41...catheter 2, 3.42.43...catheter tube 5.2
1.63...Slit-shaped check valve 8...Slit
10... Connector 12.55... Reservoir 13... Bottom part 14.56.62...
Needle guard is part 15, 57, 63...needle insert part 20.
... Cut 25 ... Guide wire -1
5 =

Claims (1)

[Scope of Claims] 1. A catheter tube having a slit-like check valve at one end through which a guide wire can pass and which opens due to internal pressure, or a radial cut at one end that opens when the guide wire passes through, and an internal pressure valve near the one end. A biliary catheter, comprising a catheter tube having a slit-like check valve that opens by. 2. A catheter tube with a slit-shaped check valve at one end through which a guide wire can pass and which opens by internal pressure, or a radial cut at one end that opens by passage of the guide wire, and a slit-shaped check valve near the one end that opens by internal pressure. The biliary catheter according to claim 1, comprising a catheter tube having a valve, and a reservoir for subcutaneous implantation communicating with and detachably connected to the other end of the catheter tube. 3. A catheter tube with a slit-shaped check valve at one end through which a guide wire can pass and which opens by internal pressure, or a radial cut at one end that opens by passage of the guide wire, and a slit-shaped check valve near the one end that opens by internal pressure. a catheter tube having a valve, the axial interior of the catheter tube is formed into two flow paths from one end to the other end by a partition wall, and one end of the one flow path is closed with a closing member. In addition, the other end communicates with and is removably connected to a reservoir for subcutaneous implantation, and one end of the other flow path is open, and the other end communicates with the reservoir through a slit-shaped check valve. A biliary catheter characterized in that the biliary catheter is detachably connected in communication with a pump for subcutaneous implantation.