This medical illustration is for patient education regarding the endoscopic insertion of a double pigtailed stent into the gallbladder via the major duodenal papilla. This procedure is used when a patient is having trouble with gallstones that requires surgical intervention yet is a poor surgical candidate.
The orientation illustration of the normal anterior view shows the anatomy local to the gallbladder, including the liver, stomach, duodenum, gallbladder, pancreas and ducts.
The first step of the surgical procedure illustrates the insertion of a side view endoscope down the esophagus, through the stomach and into the duodenum, positioned next to the major duodenal papilla.
The second step of the surgical procedure illustrates the insertion of a guidewire through the major duodenal papilla, common bile duct and cystic duct into the gallbladder. It also shows how the double pigtailed stent is inserted over the guidewire.
The third step of the surgical procedure illustrates how once the stent has reached the gallbladder, the guidewire is removed, which allows the ends of the stent to curl up, holding the stent in place until a later time when it will be removed. The double pigtailed stent will continue to allow bile to drain from the gallbladder, even if the patient continues to produce gallstones.
Key Elements of image:
- Major duodenal papilla
- Common bile duct
- Cystic duct