Endoscopic Band Ligation in Nonvariceal Upper Gastrointestinal Bleeding

Kim, Tae Hyeon; Kim, Sang Wook; Seo, Geom Seog; Sim, Mi Ryeong; Choi, Suck Chei; Nah, Yong Ho

Abstract

BACKGROUND/AIMS: Endoscopic band ligation (EBL) has now emerged as the method of choice for treatment of esophageal variceal bleeding. However, only small numbers of patients with upper gastrointestinal (UGI) bleeding from non-esophageal varices have been treated in this way. We studied the usefulness of EBL in UGI bleeding without esophageal varices during emergency endoscopy.
METHODS
During January 1997 to December 2000, 28 patients (54.7 13.2 years, male:female=22:6) of non-variceal bleeding at upper GI tract were treated by endoscopic ligation, using Stiegmann-Goff clear view band ligation device. Bleeding was identified from gastric Dieulafoy's lesion (n=15), Mallory-Weiss syndrome (n=8), and small ulcer (n=5).
RESULTS
Ten of the 28 patients had underlying diseases, including liver cirrhosis (n=5), chronic renal failure (n=2), essential hypertension (n=2), and sepsis (n=1). The Dieulafoy's lesions were mostly located on the fundus and the body. There was active bleeding in 19 (spurting, 8: oozing, 11) and only exposed vessel in 9. EBL was successful in 27 of 28 cases (97%) during admission, and one patient had rebleeding during follow-up period ranging from 6 months to 24 months.
CONCLUSIONS
EBL is an available, inexpensive, and easily learned method of treatment for patients with non-variceal gastrointestinal hemorrhage such as Dieulafoy's lesion, Mallory-Weiss syndrome, and small ulcer with active bleeding.