Reduction effect of bacterial counts by preoperative saline lavage of the stomach in performing laparoscopic and endoscopic cooperative surgery

Figure 2 Duodenal balloon occlusion to prevent bile and pancreatic juice. A: A nylon thread was made as loop at the tip of the balloon to facilitate firm grasping. B: The balloon was passed through to the bulbus duodeni. C: The balloon was inserted into the descending part of the duodenum and pulled up to the bulbus. D: The balloon was inflated and fixed in place by injecting it with 60-70 mL of air to prevent refluxed bile and pancreatic juice.