Endoscopic Band Ligation for Acute Lower Gastrointestinal Bleeding

Intern Med. 2019;58(24):3505-3508. doi: 10.2169/internalmedicine.3185-19. Epub 2019 Dec 15.

Abstract

Objective Endoscopic band ligation (EBL) is commonly performed to treat colonic diverticular bleeding (CDB). However, EBL is not suitable for other disorders that cause acute lower gastrointestinal bleeding (ALGIB), and the safety and efficacy of the procedure are not well known. This study aimed to evaluate the efficacy and safety of EBL for non-colonic diverticular bleeding (non-CDB) and investigate the application of EBL to ALGIB. Methods This study was a retrospective evaluation of the success rate of EBL, the rate of early re-bleeding (within 30 days of the initial EBL), and complications such as perforation and abscess formation. Patients Thirty patients who presented with non-CDB and underwent EBL as the first-line treatment in our hospital from June 2009 to December 2017 were included in the present study. Results The success rate of EBL was 93% (28/30). The rate of early re-bleeding after EBL was 20% (6/30). Repeat EBL, endoscopic clipping, or conservative therapy was performed in the event of re-bleeding. No emergency surgery or interventional hemostatic treatments were required for hemostasis. No complications such as perforation or abscess formation were observed in any patient. Conclusion Our results suggest that EBL is an effective and safe endoscopic treatment for non-CDB.

Keywords: acute hemorrhagic rectal ulcer; acute lower gastrointestinal bleeding; endoscopic band ligation; endoscopic hemostasis; therapeutic endoscopy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastrointestinal Hemorrhage / surgery*
  • Hemostasis, Endoscopic / adverse effects
  • Hemostasis, Endoscopic / methods*
  • Humans
  • Ligation / adverse effects
  • Ligation / methods*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Recurrence
  • Retrospective Studies