2010 Volume 52 Issue 12 Pages 3337-3346
We herein explain the technique of transpapillary gallbladder drainage. The pattern of bifurcation of the cystic duct is mainly divided into 3 types : 1, right cranial type ; 2, right caudal type ; and 3, left type. We should perform transpapillary gallbladder drainage using the appropriate accessories according to the type being operated on. In particular, in the case of the right caudal type, a flexible tip catheter or papillotome should be employed. A Radifocus® guidewire is useful for identifying bifurcation of the cystic duct using the techniques of rotation and looping of the tip. The Radifocus® guidewire should be replaced with a stiff type guidewire for stable procedures. Finally, a pig tailed naso-gallbladder catheter (5-6 Fr) or a double pig tailed plastic stent (5-7 Fr) is placed.
