Efficacy of endoscopic band ligation in the treatment of colonic diverticular hemorrhage

Abstract

We examined the efficacy of endoscopic band ligation(EBL), as compared to the clip method, for the treatment of colonic diverticular hemorrhage. Colonic diverticular hemorrhage was defined as evidence of active bleeding or a visible nonbleeding vessel in a diverticulum on endoscopy. A total of 37 patients were treated by EBL (EBL group) and 11 patients by the clip method(Clip group). The rate of transfusion was 37.8% in the EBL group and 54.5% in the Clip group. The duration of hospitalization was 6.6 days in the EBL group and 11.5 days in the Clip group. On follow-up endoscopy, the rate of disappearance of the diverticulum was 81% in the EBL group. Rebleeding occurred in 2 patients(5.4%) of the EBL group and 4 patients(36.4%) of the Clip group. The hospitalization cost was 375,570 yen per patient in the EBL group and 617,060 yen per patient in the Clip group. The rebleeding rate was low due to the disappearance of the diverticulum in the EBL group, and the medical costs were reduced by the shorter duration of hospitalization. Thus, EBL may be the treatment procedure of first choice for colonic diverticular hemorrhage.