Efficacy and safety of endoscopic biliary lithotripsy using FREDDY laser with a radiopaque mark under fluoroscopic guidance.

To date no clinic trials have reported on the safety and effectiveness of the use of a frequency-doubled double pulse neodymium YAG (FREDDY) laser with a radiopaque mark under fluoroscopic guidance to treat bile duct stones that are untreatable by conventional endoscopic therapy. We report the cases of 30 patients with impacted or large common bile duct (CBD) stones (> 1.5 cm) treated by endoscopic lithotripsy using FREDDY laser with a radiopaque mark under fluoroscopic guidance. During the procedure, the tip of the laser fiber was packaged with a radiopaque ring mark that was detectable by fluoroscopy. In these patients, complete bile duct clearance was achieved in 27 of the 30 patients (90 %). The majority of patients (18/30) were treated in a single session; the mean number of sessions needed to clear the bile ducts completely was 1.4 ± 0.6. Adverse events were noted in two patients, who both developed acute mild pancreatitis. © Georg Thieme Verlag KG Stuttgart · New York.