Methods, Devices, Kits and Systems for Defunctionalizing the Gallbladder

Abstract

The application discloses devices, systems, kits and methods for treating biliary disease. Device comprise, for example, a component configured for deployment to a lumen of a gallbladder or gallbladder duct which has a proximal end and a distal end with a lumen extending therethrough and a fluid or gas delivery apparatus at its distal end.

1 . A device for treating biliary disease comprising: a component configured for defunctionalizing a gallbladder of a patient which has a proximal end and a distal end with a lumen extending therethrough and one or more apertures at a distal end adaptable to deliver a material to a lumen within the gallbladder or a gallbladder duct. 
   
   
       2 . The device of  claim 1  wherein the distal end has an angular orientation relative to a length of the component. 
   
   
       3 . The device of  claim 1  wherein the distal end is adapted to deliver a material with at least one of a 360 degree radial pattern, a sharp stream, and a cone shape. 
   
   
       4 . The device of  claim 1  wherein the distal end has an articulating member. 
   
   
       5 . The device of  claim 1  further is adapted to apply a vacuum. 
   
   
       6 . The device of  claim 1  wherein the distal end is adapted to apply an adhesive to a lumen of the gallbladder. 
   
   
       7 . The device of  claim 1  wherein the device is configured for deployment by an endoscope. 
   
   
       8 . The device of  claim 1  wherein the device is configured for deployment using at least one of a needle, guidewire, or guidance catheter. 
   
   
       9 . The device of  claim 1  wherein the lumen is configurable to provide restrictable fluid flow. 
   
   
       10 . The device of  claim 9  further comprising one or more fluid control components. 
   
   
       11 . The device of  claim 1  further comprising a valve. 
   
   
       12 . The device of  claim 11  wherein the valve is at least one of a flow-restrictor or one-way valve. 
   
   
       13 . The device of  claim 1  wherein the device is flexible. 
   
   
       14 . The device of  claim 1  wherein the device is an elongate tube adapted and configured to extend into the gastrointestinal tract. 
   
   
       15 . A method of treating biliary disease comprising:
 a. accessing a lumen associated with a gallbladder or a gallbladder duct;   b. defunctionalizing at least one of the gallbladder duct or the gallbladder; and   c. leaving the gallbladder in situ.   
   
   
       16 . The method of  claim 15  wherein the step of defunctionalizing the gallbladder further comprising the step of delivering a substance to at least one of the gallbladder duct or the gallbladder. 
   
   
       17 . The method of  claim 16  wherein the substance occupies, or substantially occupies, a lumen of at least one of the gallbladder duct or the gallbladder. 
   
   
       18 . The method of  claim 16  wherein the substance is one or more of antibiotics, inflammatory agents, and anti-inflammatory agents. 
   
   
       19 . The method of  claim 15  further comprising the step of preventing bile from entering the gallbladder lumen. 
   
   
       20 . The method of  claim 15  further comprising the step of localizing the gallbladder via endoscopic ultrasound. 
   
   
       21 . The method of  claim 15  further comprising the step of accessing the gallbladder via the gastrointestinal tract. 
   
   
       22 . The method of  claim 21  wherein the step of accessing is performed in the gastrointestinal tract at a duodenum. 
   
   
       23 . The method of  claim 15  wherein the step of defunctionalizing at least one of the gallbladder duct or the gallbladder further comprises one or more of sclerosing, necrotizing or ablating tissue. 
   
   
       24 . The method of  claim 23  wherein an ablation technique is selected from the group comprising cryoablation, thermal ablation, chemical ablation, radio frequency ablation, microwave ablation, and ultrasound ablation. 
   
   
       25 . The method of  claim 15  further comprising the step of delivering a fluid with an angular orientation relative to a length of body of a fluid delivery device. 
   
   
       26 . The method of  claim 15  further comprising the step of delivering a fluid with at least one of a 360 degree radial pattern, a sharp stream, and a cone shape. 
   
   
       27 . The method of  claim 15  further comprising the step of delivering a fluid with a device comprising an articulating member. 
   
   
       28 . The method of  claim 15  wherein the step of defunctionalizing at least one of the cystic duct or the gallbladder further comprises applying a vacuum to a lumen of the cystic duct or the gallbladder. 
   
   
       29 . The method of  claim 28  further comprising the step of applying an adhesive to the lumen of the gallbladder duct or the gallbladder. 
   
   
       30 . The method of  claim 15  wherein the step of defunctionalizing at least one of the gallbladder duct or the gallbladder further comprises physically blocking a lumen of the gallbladder duct or the gallbladder. 
   
   
       31 . The method of  claim 15  further comprising the step of removing gallstones. 
   
   
       32 . The method of  claim 15  further comprising the step of altering gallstones. 
   
   
       33 . The method of  claim 32  further comprising the step of removing the altered gallstones. 
   
   
       34 . The method of  claim 15  further comprising the step of clearing obstructions within the gallbladder. 
   
   
       35 . The method of  claim 15  further comprising the step of visualizing a treatment area. 
   
   
       36 . The method of  claim 15  further comprising the step of delivering a device via an endoscope. 
   
   
       37 . The method of  claim 15  further comprising the step of delivering a device via a needle, guidewire or guidance catheter. 
   
   
       38 . The method of  claim 15  further comprising the step of restricting fluid flow from the gallbladder lumen to the gastrointestinal tract. 
   
   
       39 . The method of  claim 38  further comprising the step of operating a valve to restrict fluid flow. 
   
   
       40 . The method of  claim 15  further comprising the step of defunctionalizing the gallbladder in situ. 
   
   
       41 . The method of  claim 40  wherein the step of defunctionalizing is achieved by delivering a substance into a space within the gallbladder. 
   
   
       42 . The method of  claim 41  wherein the delivered substance is selected from the group consisting of gel and foam. 
   
   
       43 . The method of  claim 41  further comprising the step of activating the delivered substance in situ. 
   
   
       44 . The method of  claim 41  further comprising delivering an amount of substance sufficient to fill or substantially fill the gallbladder lumen. 
   
   
       45 . The method of  claim 15  wherein the step of defunctionalizing is achieved by one or more of sclerosing or necrotizing a tissue within the gallbladder. 
   
   
       46 . The method of  claim 45  wherein the step of sclerosing or necrotizing can be achieved by an ablation technique. 
   
   
       47 . The method of  claim 45  wherein the ablation technique is selected from cryoablation, thermal ablation, chemical ablation, radio frequency ablation, ultrasound ablation, and microwave ablation. 
   
   
       48 . A kit for treating biliary disease comprising: (a) a device adaptable to deliver to a lumen of a gallbladder or gallbladder duct; and optionally (b) a compound for delivery to a tissue. 
   
   
       49 . The kit of  claim 48  further comprising a catheter. 
   
   
       50 . The kit of  claim 48  further comprising one or more of a needle, a guidewire, and a guidance catheter. 
   
   
       51 . The kit of  claim 48  further comprising an ablation device. 
   
   
       52 . The kit of  claim 48  wherein the compound comprises a sclerosing agent. 
   
   
       53 . The kit of  claim 48  wherein the compound comprises antibiotics. 
   
   
       54 . The kit of  claim 48  wherein the compound comprises one or more of inflammatory agents and anti-inflammatory agents. 
   
   
       55 . The kit of  claim 48  further comprising one or more biocompatible gels and biocompatible foams. 
   
   
       56 . The kit of  claim 48  further comprising one or more of a pair of scissors, a scalpel, a swab, a syringe, a hemostat, a lubricant, a needle, a snare, an antiseptic, and an anesthetic.