Clin Endosc.  2022 May;55(3):408-416. 10.5946/ce.2021.200.

Comparison of conventional and new endoscopic band ligation devices for colonic diverticular bleeding

• Takasu A
• Ikeya T
• Shiratori Y

• KMID: 2529963
• DOI: http://doi.org/10.5946/ce.2021.200

Abstract

Background/Aims
Endoscopic band ligation (EBL) is used to treat colonic diverticular bleeding (CDB). An endoscopic variceal ligation device for esophageal varices is used as a conventional EBL device (C-EBL). A new EBL device (N-EBL) was developed by Sumitomo Bakelite Co. in August 2018. We aimed to evaluate the clinical outcomes of N-EBL compared with those of C-EBL.
Methods
Seventy-nine patients who underwent EBL for CDB at St. Luke’s International Hospital, Japan, between 2017 and 2020 were included in this retrospective study. Patients were divided into the C-EBL and N-EBL groups. Their clinical outcomes, including achieving initial hemostasis, early rebleeding, procedure time, and EBL-associated adverse events, were evaluated.
Results
Of the 79 patients, 36 (45.6%) were in the C-EBL group and 43 (54.4%) were in the N-EBL group. The rate of achieving initial hemostasis was 100% in the C-EBL group and 93.0% in the N-EBL group. No significant difference was noted in the early rebleeding rate between the groups (p=0.24). The N-EBL group achieved a shorter median EBL procedure time than the C-EBL group (18.2 minutes vs. 14.2 minutes, p=0.02). No adverse events were observed in either group.
Conclusions
The N-EBL device is safe and useful and may reduce EBL procedure time.

Keyword

Colonoscopy; Diverticulum; Gastrointestinal hemorrhage

Figure

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  Fig. 1. (A) The appearance of a new endoscopic band ligation device. (B) The appearance of a conventional endoscopic band ligation device.

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  Fig. 2. (A) The view of the new endoscopic band ligation device. (B) The view of the conventional endoscopic band ligation device.

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  Fig. 3. (A) Examples of complete inversion. (B) Incomplete inversion.

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  Fig. 4. Time frame of the endoscopic band ligation (EBL) procedure.

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  Fig. 5. (A) Incomplete inversion of the diverticulum after endoscopic band ligation. (B) The ulceration of dimpling area caused a few days after endoscopic band ligation.

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  Fig. 6. The recommended method for device attachment. (A, C) The tip of the endoscope (yellow triangle) is positioned on the white line of the hood (white triangle), which can achieve complete inversion. (B, D) If the tip of the endoscope is located beyond the white line of hood, incomplete inversion may result.

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