Gallstone treatment. Endoscope view of a papillot- omy (sphincterotomy) operation to unblock the common bile duct, which is blocked by gallstones. The bile duct opens into the small intestine at the ampulla of Vater. Gallstones are hard lumps formed by the gall bladder as it stores and concentrates bile. These can get stuck in the ducts, causing severe pain and jaundice (bile pigments in the blood). The sphincter muscle closing the ampulla has been cut, and a balloon catheter (lower right) is being used to extract the stone (yellow) from the ampulla. This operat- ion is performed when removal of their entire gall bladder (the usual treatment) is not feasible.
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