ENDOSCOPIC LIGATION METHODS FOR COLONIC DIVERTICULAR BLEEDING

Abstract

Recently, the incidence of colonic diverticular bleeding (CDB) has been increasing due to aging and extensive use of non-steroidal anti-inflammatory drugs and antithrombotic drugs. While the clipping method is conventionally applied for endoscopic hemostasis of CDB, ligation method is also widely used clinically. The ligation method includes two techniques; endoscopic band ligation (EBL) using a rubber band and endoscopic detachable snare ligation (EDSL) using an endoloop. This method enables suction and inversion of a diverticular dome into an endoscopic attachment cap and ligation of the diverticular neck. In the ligation method, the risk of rebleeding was reported to be significantly lower compared with the conventional clipping method. Here, we review and discuss the EBL and EDSL techniques for CDB.