Endoscopic band ligation versus hot snare resection for hyperplastic gastric polyps in cirrhotic patients

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Hepatology

Background:

• Managing gastric hyperplastic polyps (GHPs) in patients with liver cirrhosis presents challenges due to associated coagulation disorders.
• Hot snare polypectomy (HSP), the standard GHP resection technique, carries risks in cirrhotic patients.
• Alternative endoscopic methods are needed to improve safety and efficiency.

Purpose of the Study:

• To compare the efficacy and safety of endoscopic band ligation (EBL) versus HSP for resecting GHPs in patients with liver cirrhosis.
• To evaluate procedural outcomes, complications, costs, and recurrence rates between EBL and HSP.

Main Methods:

• A randomized controlled trial involving 100 adult patients with liver cirrhosis and GHPs.
• Patients were assigned to either EBL (Group I) or HSP (Group II) for GHP resection.
• Data collected included demographics, clinical factors, pathological findings, hospitalization costs, and outcomes; follow-up endoscopy assessed recurrence.

Main Results:

• EBL demonstrated a significantly shorter mean operational time (15.1 min) compared to HSP (36.6 min) (p < 0.001).
• EBL had a lower complication rate (6% vs. 22% for HSP), with no bleeding reported in the EBL group (p = 0.003).
• EBL was significantly more cost-effective (280 EGP) than HSP (390 EGP) (p < 0.001); recurrence rates and sessions needed were similar.

Conclusions:

• Endoscopic band ligation (EBL) is a safer, more rapid, and economical endoscopic maneuver for resecting GHPs in cirrhotic patients.
• EBL offers a favorable alternative to HSP, minimizing risks associated with coagulation disorders in liver cirrhosis.
• Further research may explore long-term outcomes and broader applicability of EBL in complex endoscopic resections.