Endoscopic Band Ligation for Colonic Diverticular Hemorrhage Reduced Rebleeding From the Same Diverticula: Retrospective Pilot Chart Review

Abstract

Introduction: The endoscopic band ligation (EBL) has been used to achieve hemostasis in patients with colonic diverticular bleeding as several reports suggest that EBL might be superior to endoscopic clipping (EC) for hemostasis. One of the reasons for the better outcome with EBL compared to EC could be a superior effect on late bleeding, and this effect has not been clearly demonstrated. This retrospective study compared the re-bleeding rate in of the bleeding colon diverticulum treated with EBL compared to that treated with EC. Methods: This study included 176 patients with colonic diverticular hemorrhage from February 2012 to February 2017 in Saga Medical Center Koseikan, and 52 patients were treated with EBL and 34 patients were treated with EC. All the patients in each group were followed up after hemostasis for checking re-bleeding for one year. Results: Re-bleeding occurred in 4 out of 52 patients (7.7%) with EBL and in 13 out of 34 (38.2%) patients with EC. Each patient was checked the bleeding point and treated by endoscopic hemostasis. Regarding re-bleeding from the same diverticula, only 3.8% (2 out of 52 patients) was suffered after treatment with EBL hemostasis, whereas 17.6% (6 out of 34 patients) was suffered after EC hemostasis These differences were statistically significant (P=0.03). Conclusion: The present pilot examination suggested that EBL might be superior to EC in prevention from the same colon diverticula re-bleeding from the same diverticula, which warrant a clinical trial with multicenter study and/or randomized comparison in Japan.