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Method for retrieving pancreatic juice utilizing and endoscopically wire-guided catheter
| Details |
Inventors: Waxman, Irving; Freedman, Steven;
Assignee: The Beth Israel Hospital Association (Boston, MA)
Primary Examiner: Rimell; Sam
Assistant Examiner: Wingood; Pamela Y.
Attorney, Agent or Firm: Lorusso & Loud
A method for accurately and quickly positioning a double lumen gastroduodenal tube into predetermined locations utilizing an endoscopically placed guide wire to retrieve duodenal fluid uncontaminated by gastric fluid, with little or no discomfort to the patient, and minimal radiation exposure. Specifically, an endoscope is passed through a patent's esophagus and stomach into the duodenum such that its distal end is located at a predetermined location, such as the fourth portion of the duodenum. While the endoscope is held in place, a guide-wire is passed through its center instrument channel to position a distal end of the guide-wire adjacent to the distal end of the endoscope. The endoscope is then withdrawn from the patient, leaving the guide-wire. A double lumen gastroduodenal tube is then threaded over the guide-wire such that gastric ports are aligned with the stomach and duodenal ports are aligned with the fourth portion of the duodenum so that upon aspiration of the gastric ports, the gastric fluid is prevented from entering the duodenum and contaminating the duodenal fluid. |
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DETAILED DESCRIPTION The present invention is an improved method for accurately and quickly positioning a double lumen gastroduodenal tube into predetermined locations utilizing an endoscopically placed guide wire to retrieve duodenal fluid uncontaminated by gastric fluid, with little or no discomfort to the patient.
Specifically, the endoscopic guide-wire placement method of the present invention includes a series of steps, the first of which is the feeding of an endoscope through the patient's esophagus and stomach into the duodenum.
The endoscope is positioned such that its distal end is located at a predetermined location in the duodenum.
The endoscope is then held in place while a guide-wire is passed through a center instrument channel of the endoscope to position a distal end of the guide-wire adjacent to the distal end of the endoscope.
Once it is verified that the guide-wire is properly placed, the endoscope is withdrawn from the patient, leaving the guide-wire.
The position of the guide-wire is then verified by fluoroscopy.
A double lumen gastroduodenal tube is then threaded over the guide-wire.
The tube includes a duodenal lumen disposed adjacent to a separate gastric lumen for removing duodenal and gastric fluids, respectively.
In an alternative embodiment, the duodenal lumen is concentrically disposed within the separate gastric lumen.
The gastric lumen has gastric ports at its distal end for receiving gastric fluid.
Similarly, duodenal ports are placed at a distal end of the duodenal lumen, which extends beyond the gastric lumen, for receiving duodenal fluid.
Proper placement of the tube is achieved when the gastric ports are aligned with the stomach and the duodenal ports are aligned with a predetermined portion of the duodenum.
This placement may be verified by fluoroscopy.
Once the proper location of the ports is verified, the guide-wire is withdrawn from the patient.
To retrieve uncontaminated duodenal fluids, the gastric fluids are continuously aspirated through the gastric ports to prevent the gastric fluids from entering the duodenum
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Obesity Surgery 
