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US-12622776-B2 - Cholecystitis treatment via gallbladder occlusion or sealing

US12622776B2US 12622776 B2US12622776 B2US 12622776B2US-12622776-B2

Abstract

A method comprises obstructing at least a portion of an inside of a gallbladder using a barrier, and suppressing, using the barrier, contacting at least a portion of an interior wall of the gallbladder with a bile from a cystic duct.

Inventors

  • Tomofumi Katayama
  • Takahiro Suzuki

Assignees

  • OLYMPUS MEDICAL SYSTEMS CORP.

Dates

Publication Date
20260512
Application Date
20230217

Claims (14)

  1. 1 . A method comprising: obstructing at least a portion of an inside of a gallbladder using a barrier; and suppressing, using the barrier, contacting at least a portion of an interior wall of the gallbladder with a bile from a cystic duct, wherein the barrier comprises a bag configured to cover an interior of the gallbladder, the bag having an opening.
  2. 2 . The method according to claim 1 , comprising draining a bile from the gallbladder before the obstructing, wherein the draining comprises: transporting bile from the gallbladder via a tube placed at least partially within the cystic duct.
  3. 3 . The method according to claim 2 , wherein the draining further comprises: advancing a guidewire, via an endoscope having a distal portion located in a duodenum, from a duodenal papilla to the gallbladder, and placing a tube at least partially within the cystic duct using the guidewire.
  4. 4 . The method according to claim 2 , comprising draining a bile from a gallbladder before the obstructing, wherein the draining comprises: advancing a needle into the gallbladder through a duodenum via an endoscope having a distal portion located in the duodenum; advancing a guidewire from the endoscope to the gallbladder using the needle; retracting the needle into the endoscope; and placing a tube from the duodenum to the gallbladder using the guidewire.
  5. 5 . The method according to claim 1 , wherein the obstructing at least a portion of an inside of the gallbladder using a barrier comprises: advancing a catheter and the barrier from an endoscope to the gallbladder through a duodenal papilla; retracting the catheter to expose the barrier.
  6. 6 . The method according to claim 1 , wherein the barrier further comprises: a ring fixed to the opening.
  7. 7 . The method of claim 6 , comprising attaching the ring to at least one of an inside of a cystic duct and an inside of the gallbladder.
  8. 8 . The method according to claim 1 , wherein the obstructing comprises: applying an adhesive to an inside of the gallbladder.
  9. 9 . A method of cholecystitis treatment, comprising: a removal step of removing contents of a gallbladder; a bile suppression step of arranging a member in the gallbladder, wherein the member is a sack; and a sealing step of closing a gap between the member and the gallbladder, or between the member and a cystic duct.
  10. 10 . The method of cholecystitis treatment according to claim 9 , wherein the member is inflatable, and in the sealing step, the gap is closed by contact between the inflated member and the gallbladder, or the inflated member and the cystic duct.
  11. 11 . The method of cholecystitis treatment according to claim 10 , wherein in the sealing step, the gap between an opening of the sack and the gallbladder, or between an opening of the sack and the cystic duct is closed.
  12. 12 . The method of cholecystitis treatment according to claim 11 , wherein the sealing step comprises joining between the opening and the gallbladder, or between the opening and the cystic duct.
  13. 13 . The method of cholecystitis treatment according to claim 11 , wherein the sealing step comprises placing a stent in the opening.
  14. 14 . The method of cholecystitis treatment according to claim 9 , wherein, the member is introduced into the gallbladder using a guide wire inserted into a bile duct from the gallbladder and protruding from a duodenal papilla as a guide.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application is based upon and claims the benefit of priority to U.S. Provisional Application Ser. No. 63/268,545, filed on Feb. 25, 2022, and U.S. Provisional Application Ser. No. 63/362,618, filed on Apr. 7, 2022, the entire contents of which is incorporated herein by reference. FIELD OF THE DISCLOSURE This document relates to systems, devices, and methods of cholecystitis treatment. BACKGROUND The gallbladder exists as a sac-like part in the bile duct system, which is a luminal organ. Acute cholecystitis, which is one of the diseases of the gallbladder, often occurs when calculus generated in the gallbladder moves to a cystic duct. The current standard of cholecystitis treatment is laparoscopic cholecystectomy, which invasively removes the gallbladder. In the laparoscopic cholecystectomy, there is no risk of recurrence because the gallbladder is removed, but there is room for improvement in terms of invasiveness to the patient because it is an invasive surgical procedure. In the treatment of cholecystitis, a less invasive treatment method than laparoscopic cholecystectomy is being sought. U.S. Pat. No. 8,460,314 describes a method of puncturing the gallbladder from the gastrointestinal tract under ultrasonic endoscopy and eliminating the function of the gallbladder mucosa by cauterization or the like. By eliminating the function of the gallbladder mucosa, bile is not concentrated and the formation and growth of calculus are suppressed. SUMMARY This document describes, among other things, systems, devices, and methods of cholecystitis treatment, such as via gallbladder occlusion or sealing. A method comprises obstructing at least a portion of an inside of a gallbladder using a barrier, and suppressing, using the barrier, contacting at least a portion of an interior wall of the gallbladder with a bile from a cystic duct. A method of cholecystitis treatment comprises a removal step of removing contents of a gallbladder, and a bile suppression step of arranging a member in the gallbladder, and a sealing step of closing a gap between the member and the gallbladder, or between the member and a cystic duct. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an illustration showing an example of an access operation to the gallbladder. FIG. 2 is an illustration showing an example of an access operation to the gallbladder. FIG. 3 is an illustration showing a state in which the gallbladder and the duodenum communicate with each other by a stent. FIG. 4 is an illustration showing an example of a bile suppression step B according to a first embodiment of the present disclosure. FIG. 5 is an illustration showing an example of a process of bile suppression step B. FIG. 6 is an illustration showing an example of a process of a bile suppression step B. FIG. 7A is an illustration showing an example of an opening of a sack after a sealing step C. FIG. 7B is an illustration showing an example of an opening of a sack after a sealing step C. FIG. 7C is an illustration showing an example of an opening of a sack after a sealing step C. FIG. 8 is an illustration showing a state in which a bile barrier such as a sack is placed in the gallbladder. FIG. 9 is an illustration that shows an example of a state after completion of a treatment method according to a second embodiment of the present disclosure. DETAILED DESCRIPTION A method of cholecystitis treatment according to a first embodiment of the present invention will be described with reference to FIGS. 1 to 8. First, the contents of the gallbladder are removed in a removal step (step A). The contents of the gallbladder are mainly bile and gall calculus (calculus). The bile can be removed by passive or active (e.g., suction) gallbladder drainage, such as can include transporting bile from the gallbladder via a tube or stent or the like, and the calculus, if any, can be removed using various lithotripsy or extraction or other treatment tools. In an example, a portion of the tube can be placed at least partially within the cystic duct to drain or otherwise transport bile from the gallbladder via the cystic duct. There are roughly two types of access routes to the gallbladder for performing gallbladder drainage, and in this embodiment, any route may be used. In the transpapillary access route (hereinafter, may be referred to as route A), as shown in FIG. 1, a guide wire Gw can be inserted into the duodenal papilla Dp from a distal portion of an endoscope Es introduced and located into the duodenum such as by a similar procedure as ERCP (endoscopic retrograde cholangiopancreatography). Then, the distal end of the guide wire Gw is brought into the gallbladder Gb, and the drainage tube is placed along the guide wire. In the transperitoneal access route (hereinafter, may be referred to as route B), such as while confirming the position of the gallbladder with the image from the ultrasonic endoscope introduced into the duodenum, the puncture needle p