Endoscopic band ligation: alternative treatment method in nonvariceal upper gastrointestinal hemorrhage.
BACKGROUND
In the treatment of acute upper gastrointestinal (GI) bleeding, endoscopic band ligation (EBL) may be performed for nonfibrotic superficial lesions. This method has recently gained popularity in the treatment of nonvariceal upper GI bleeding.


METHODS
Band ligation was performed in 13 patients who were admitted with active upper GI bleeding between December 1998 and February 2001. The sources of the bleeding were Mallory-Weiss syndrome in four patients, Dieulafoy's ulcer in five patients, gastric ulcer near a gastrojejunostomy anastomosis in two patients, gastric angiodysplasia in one patient, and the primary repair site in the stomach of a gunshot wound in one.


RESULTS
Bleeding from all lesions except one was managed successfully with EBL. The single failure was in bleeding from a gastric Dieulafoy's lesion. Injection sclerotherapy with 1:10,000 epinephrine solution and EBL was not successful. Rebleeding occurred twice in one patient, and the second rebleeding necessitated surgical treatment.


CONCLUSIONS
Our results revealed that EBL is a very promising technique in acute nonvariceal upper GI bleeding. Its effectiveness and safety with few complications will allow this modality to be used more widely.
Ertekin
Cemalettin
C
Department of General Surgery, University of Istanbul, Istanbul Medical School, Turkey. certekin@iname.com
Taviloglu
Korhan
K
Barbaros
Umut
U
Guloglu
Recep
R
Dolay
Kemal
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; 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; D016896:Treatment Outcome