{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:16:48Z","timestamp":1777929408602,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Photomedicine and Laser Surgery"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Objective:<\/jats:italic>\n                    <\/jats:bold>\n                    We investigated the impact of direct peroral cholangioscopy (POC)-based holmium laser lithotripsy using an ultrathin endoscope with direct irrigation via a 2-mm-diameter working channel to remove difficult common bile duct (CBD) stones without a separate biliary catheter.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Background data:<\/jats:italic>\n                    <\/jats:bold>\n                    Few clinical studies have reported the successful removal of difficult CBD stones by direct POC-based laser lithotripsy using an ultrathin upper endoscope. Previous studies used a separate biliary catheter to ensure continuous irrigation.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Methods:<\/jats:italic>\n                    <\/jats:bold>\n                    Ten patients (6 males; mean age 63.3 years) with difficult CBD stones who were not amenable to conventional endoscopic procedures were examined. Direct POC using an ultrathin upper endoscope was performed in all patients. Holmium laser lithotripsy with direct saline irrigation via the operating channel of an ultrathin endoscope was performed until stone fragments were captured in a basket.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    <\/jats:bold>\n                    The overall success rate of bile duct clearance was 90% (9 of 10 patients) and the mean number of treatment sessions was 1.2 (range, 1\u20132). Mechanical lithotripsy was performed to complete stone removal in one patient (10%) who had a distal CBD stricture. One patient experienced mild cholangitis following laser lithotripsy.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    <\/jats:bold>\n                    Holmium laser lithotripsy under direct POC using an ultrathin upper endoscope may be an effective and safe technique for removal of difficult CBD stones. Direct irrigation via the 2-mm-diameter working channel of the ultrathin endoscope provides sufficient fluid medium and affords good endoscopic viewing to assure stone fragmentation without any need for a separate biliary catheter.\n                  <\/jats:p>","DOI":"10.1089\/pho.2011.3094","type":"journal-article","created":{"date-parts":[[2011,11,1]],"date-time":"2011-11-01T11:35:53Z","timestamp":1320147353000},"page":"31-36","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Direct Cholangioscopy-Based Holmium Laser Lithotripsy of Difficult Bile Duct Stones by Using an Ultrathin Upper Endoscope Without a Separate Biliary Irrigating Catheter"],"prefix":"10.1177","volume":"30","author":[{"given":"Tae Yoon","family":"Lee","sequence":"first","affiliation":[{"name":"Konkuk University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Koog","family":"Cheon","sequence":"additional","affiliation":[{"name":"Konkuk University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won Hyeok","family":"Choe","sequence":"additional","affiliation":[{"name":"Konkuk University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan Sup","family":"Shim","sequence":"additional","affiliation":[{"name":"Konkuk University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.03.1170"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.2863"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1055\/s-0029-1215353","article-title":"Endoscopic treatment of difficult bile duct stones by using a double-lumen basket for laser lithotripsy\u2014a case series","volume":"42","author":"Lee J.E.","year":"2010","unstructured":"Lee J.E., , Moon J.H., , Choi H.J. et al. 2010. Endoscopic treatment of difficult bile duct stones by using a double-lumen basket for laser lithotripsy\u2014a case series. Endoscopy, 42:169\u2013172.","journal-title":"Endoscopy"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.435"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-008-9953-5"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.gie.2008.11.019","article-title":"Intraductal balloon-guided direct peroral cholangioscopy with an ultraslim upper endoscope (with videos)","volume":"70","author":"Moon J.H.","year":"2009","unstructured":"Moon J.H., , Ko B.M., , Choi H.J. et al. 2009. Intraductal balloon-guided direct peroral cholangioscopy with an ultraslim upper endoscope (with videos) Gastrointest. Endosc., 70:297\u2013302.","journal-title":"Gastrointest. Endosc."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1010293"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/S0016-5107(04)02012-7","article-title":"Endoscopic treatment of retained bile-duct stones by using a balloon catheter for electrohydraulic lithotripsy without cholangioscopy","volume":"60","author":"Moon J.H.","year":"2004","unstructured":"Moon J.H., , Cha S.W., , Ryu C.B. et al. 2004. Endoscopic treatment of retained bile-duct stones by using a balloon catheter for electrohydraulic lithotripsy without cholangioscopy. Gastrointest. Endosc., 60:562\u2013566.","journal-title":"Gastrointest. Endosc."},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1136\/gut.29.6.746","article-title":"Laser lithotripsy of common bile duct stones","volume":"29","author":"Ell C.","year":"1988","unstructured":"Ell C., , Lux G., , Hochberger J., , Muller D., , Demling L. 1988. Laser lithotripsy of common bile duct stones. Gut, 29:746\u2013751.","journal-title":"Gut"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20545"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1007\/s00464-009-0837-0","article-title":"Video. Laparoscopic common bile duct exploration and holmium laser lithotripsy: a novel approach to the management of common bile duct stones","volume":"24","author":"Varban O.","year":"2010","unstructured":"Varban O., , Assimos D., , Passman C., , Westcott C. 2010. Video. Laparoscopic common bile duct exploration and holmium laser lithotripsy: a novel approach to the management of common bile duct stones. Surg. Endosc., 24:1759\u20131764.","journal-title":"Surg. Endosc."},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.gassur.2003.10.007","article-title":"Management of complex biliary tract calculi with a holmium laser","volume":"8","author":"Shamamian P.","year":"2004","unstructured":"Shamamian P., , Grasso M. 2004. Management of complex biliary tract calculi with a holmium laser. J. Gastrointest. Surg., 8:191\u2013199.","journal-title":"J. Gastrointest. Surg."},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1136\/gut.34.3.415","article-title":"Laser lithotripsy of difficult bile duct stones under direct visual control","volume":"34","author":"Neuhaus H.","year":"1993","unstructured":"Neuhaus H., , Hoffmann W., , Zillinger C., , Classen M. 1993. Laser lithotripsy of difficult bile duct stones under direct visual control. Gut, 34:415\u2013421.","journal-title":"Gut"},{"key":"e_1_3_2_15_2","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/S0016-5107(94)70058-3","article-title":"Laser lithotripsy of difficult biliary stones","volume":"40","author":"Prat F.","year":"1994","unstructured":"Prat F., , Fritsch J., , Choury A.D., , Frouge C., , Marteau V., , Etienne J.P. 1994. Laser lithotripsy of difficult biliary stones. Gastrointest. Endosc., 40:290\u2013295.","journal-title":"Gastrointest. Endosc."},{"key":"e_1_3_2_16_2","doi-asserted-by":"crossref","first-page":"2330","DOI":"10.1111\/j.1572-0241.2004.40251.x","article-title":"Electrohydraulic lithotripsy in 111 patients: a safe and effective therapy for difficult bile duct stones","volume":"99","author":"Arya N.","year":"2004","unstructured":"Arya N., , Nelles S.E., , Haber G.B., , Kim Y.I., , Kortan P.K. 2004. Electrohydraulic lithotripsy in 111 patients: a safe and effective therapy for difficult bile duct stones. Am. J. Gastroenterol., 99:2330\u20132334.","journal-title":"Am. J. Gastroenterol."},{"key":"e_1_3_2_17_2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.gie.2009.08.009","article-title":"Is it necessary to insert a nasobiliary drainage tube routinely after endoscopic clearance of the common bile duct in patients with choledocholithiasis-induced cholangitis? A prospective, randomized trial","volume":"71","author":"Lee J.K.","year":"2010","unstructured":"Lee J.K., , Lee S.H., , Kang B.K. et al. 2010. Is it necessary to insert a nasobiliary drainage tube routinely after endoscopic clearance of the common bile duct in patients with choledocholithiasis-induced cholangitis? A prospective, randomized trial. Gastrointest. Endosc., 71:105\u2013110.","journal-title":"Gastrointest. 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