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Endoscopic detachable snare ligation: a new treatment method for colonic diverticular hemorrhage
Daisuke Akutsu1, Toshiaki Narasaka2, Mariko Wakayama3
1Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Insights
Endoscopic detachable snare ligation (EDSL) offers a safe and effective method for treating colonic diverticular hemorrhage, achieving sustained hemostasis in most patients with minimal procedure time.
Area of Science:
- Gastroenterology
- Endoscopic interventions
- Hemorrhage control
Background:
- Colonic diverticular hemorrhage is a frequent cause of lower gastrointestinal bleeding.
- Existing endoscopic treatments can be time-consuming.
- A need exists for convenient and reliable hemostatic methods.
Purpose of the Study:
- To develop a novel endoscopic detachable snare ligation (EDSL) technique.
- To evaluate the safety and efficacy of EDSL for colonic diverticular hemorrhage.
Main Methods:
- EDSL involves ligating the bleeding diverticulum with a detachable snare.
- The procedure is similar to endoscopic band ligation but avoids scope removal for device attachment.
- Eight patients with colonic diverticular hemorrhage were treated retrospectively.
Main Results:
- The mean procedure time for hemostasis was 5 ± 2 minutes.
- Sustained hemostasis was achieved in 7 out of 8 patients (88%).
- No complications were reported; one patient experienced early rebleeding.
Conclusions:
- EDSL appears to be a safe and effective treatment option for colonic diverticular hemorrhage.
- Further research is necessary to validate these preliminary findings.
Background And Study Aims:
Colonic diverticular hemorrhage is the most common cause of lower intestinal bleeding. We tried to develop a convenient and reliable hemostatic method, endoscopic detachable snare ligation (EDSL), to treat diverticular hemorrhage and retrospectively explored its safety and efficacy.
Patients And Methods:
The definitive bleeding diverticulum was ligated with a detachable snare, instead of a rubber band, in a procedure similar to endoscopic band ligation. Removal of the scope to attach a ligation device and reinsertion for treatment are not needed in this method.
Results:
From November 2013 to September 2014, EDSL was used to treat 8 patients with colonic diverticular hemorrhage. The mean procedure time required for hemostasis after identification of the bleeding diverticulum was 5 ± 2 minutes. Sustained hemostasis was achieved in 7 patients (88 %), and early rebleeding occurred in 1 patient, in whom the applied suction seemed inadequate. No complications occurred in any patient.
Conclusions:
EDSL may be a safe and effective treatment for colonic diverticular hemorrhage. However, additional studies are warranted to confirm these initial exploratory data.
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