(A) The distal common bile duct (CBD; arrows) was cannulated via a trans-duodenal puncture, and methylene blue was added to the infusate. The CBD was ligated close to the ampulla (large arrow head). (B) Images of the pancreas at laparotomy 24 hr after the surgical procedure show that distal CBD ligation, or BDL, causes massive CBD dilation (dotted red lines). NS, normal saline; TC, sodium taurocholate; P, pancreas; D, duodenum.