Diagram of an<unk>  <unk>  The patient is sedated or anaesthetized. Then a flexible camera (endoscope) is inserted through the mouth, down the esophagus, into the stomach, through the pylorus into the duodenum where the ampulla of Vater (the union of the common bile duct and pancreatic duct) exists. The sphincter of Oddi is a muscular valve that controls the opening to the ampulla. The region can be directly visualized with the<unk>  camera while various procedures are performed. A plastic catheter or cannula is inserted through the ampulla, and radiocontrast is injected into the bile ducts and/or pancreatic duct. Fluoroscopy is used to look for blockages, or other lesions such as stones. When needed, the sphincters of the ampulla and bile ducts can be enlarged by a cut (sphincterotomy) with an electrified wire called a sphincterotome for access into either so that gallstones may be removed or other therapy performed. Other procedures associated with<unk>  include the trawling of the common bile duct with a basket or balloon to remove gallstones and the insertion of a plastic stent to assist the drainage of bile. Also, the pancreatic duct can be cannulated and stents be inserted. The pancreatic duct requires visualisation in cases of pancreatitis. In specific cases, other specialized or ancillary endoscopes may be used for<unk> . These include mother-daughter and SpyGlass cholangioscopes (to help in diagnosis by directly visualizing the duct as opposed to only obtaining X-ray images) as well as balloon enteroscopes (e.g. in patients with post-Whipple or Roux-en-Y surgical anatomy).
Endoscopic retrograde cholangiopancreatography
Biliary endoscopic sphincterotomy
Cholecystectomy
Cholecystostomy
Cholecystenterostomy
Percutaneous transhepatic cholangiography
Splenic aspiration
Perihepatic packing