Endoscopic band ligation for control of nonvariceal upper GI hemorrhage: comparison with bipolar electrocoagulation.
BACKGROUND
Despite advances in endoscopic treatment methods for upper GI hemorrhage, hemostasis is often difficult to achieve. This study evaluated the usefulness of endoscopic band ligation for upper GI hemorrhage exclusive of hemorrhage from chronic gastroduodenal ulcer and varices.


METHODS
This prospective study included 27 patients who underwent endoscopic band ligation and 31 patients in whom bipolar electrocoagulation was performed for upper GI hemorrhage. In both groups, the causes of hemorrhage included Dieulafoy's ulcer, Mallory-Weiss tear, gastric ulcer after polypectomy, and gastric angiodysplasia. Patients with esophageal varices and those with chronic gastroduodenal ulcer were excluded.


RESULTS
Hemostasis was achieved in all 27 patients in the endoscopic band ligation group and in 26 of 31 patients (83.9%) in the bipolar electrocoagulation group. The median procedure time required for achieving hemostasis was 17.0 minutes (interquartile range: 11.5-23.5) in the endoscopic band ligation group versus 27.0 minutes (interquartile range: 20.5-40.0) in the electrocoagulation group. No major complications occurred in either group.


CONCLUSIONS
Endoscopic band ligation is efficient, simple, and safe. Therefore, this technique should be considered as a treatment option for nonvariceal, nonchronic gastroduodenal ulcer upper GI hemorrhage.
Matsui
Shigenaga
S
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osakasayama, Japan.
Kamisako
Toshinori
T
Kudo
Masatoshi
M
Inoue
Ryoichi
R
D000328:Adult; D000368:Aged; D004564:Electrocoagulation / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D005773:Gastroscopy; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006801:Humans; D008026:Ligation / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome