title: Clinical role of frequency-doubled double-pulsed yttrium aluminum garnet laser technology for removing difficult bile duct stones (with videos).
abstract: BACKGROUND
  Very few clinical trials have reported on the success rate of frequency-doubled double-pulse yttrium aluminum garnet (YAG) laser (FREDDY) technology for removal of difficult bile duct stones.
  
  
  OBJECTIVE
  Our purpose was to evaluate the role of FREDDY technology for removing difficult bile duct stones.
  
  
  METHODS
  Nonrandomized, retrospective study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Fifty-two patients with difficult bile duct stones were treated via the transpapillary route by using a FREDDY system. The inclusion criteria were impacted or large common bile duct stones (>15 mm, mean 23.5 mm, range 15-35 mm, mean number of stones 1.7, range 1-4). Laser lithotripsy was performed with cholangioscopy guidance in 7 patients and fluoroscopic guidance alone in 45 patients.
  
  
  METHODS
  The success rate of complete stone removal and the complication rate related to the procedure.
  
  
  RESULTS
  Of the 52 patients treated via the transpapillary route, complete stone removal was achieved in 48 patients (92.3%). The complete removal of stones required a mean of 1.4 (range 1-2) endoscopic sessions. The rate of complications related to laser lithotripsy was 23.0% (acute pancreatitis, 3 cases; transient hemobilia, 8 cases; acute cholangitis, 1 case).
  
  
  CONCLUSIONS
  Nonrandomized, retrospective design.
  
  
  CONCLUSIONS
  Laser lithotripsy by using the FREDDY system seems safe and effective and allows "blind" fragmentation of bile duct stones under fluoroscopic guidance only.
authors: Department of Internal Medicine, Institute for Digestive Research, Soon Chun Hyang University, College of Medicine, Seoul, Korea. ydcho@hosp.sch.ac.kr
authors: Young Deok
authors: YD
authors: Cho
authors: Young Koog
authors: YK
authors: Cheon
authors: Jong Ho
authors: JH
authors: Moon
authors: Soung Won
authors: SW
authors: Jeong
authors: Jae Young
authors: JY
authors: Jang
authors: Joon Seong
authors: JS
authors: Lee
authors: Chan Sup
authors: CS
authors: Shim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D053844:Lasers, Solid-State; D017602:Lithotripsy, Laser; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies