Usefulness of endoscopic band ligation for bleeding small bowel vascular lesions.
BACKGROUND
The optimal therapy for bleeding small bowel vascular lesions is controversial. This study investigated the efficacy and safety of endoscopic band ligation in this clinical condition.


METHODS
Fourteen patients bleeding from angiodysplasia and 4 bleeding from Dieulafoy's lesions located in the small bowel were included in this pilot study. Endoscopic band ligation was performed by using less than 200 mBar negative pressure in suctioning the target lesion into the ligation cap just before band release. Mean follow-up was 18 months (range 6-31 months).


METHODS
Endoscopic band ligation achieved hemostasis in a single session in all patients. No adverse events occurred except for mild abdominal pain in two patients. Mortality was null, and no patient required further blood transfusion during the 40 days after endoscopic band ligation. No patient with Dieulafoy's lesion had further bleeding, whereas bleeding recurred in 6 of 14 (43%) patients with angiodysplasia during long-term follow-up.


CONCLUSIONS
Endoscopic band ligation is safe and effective for treatment of acutely bleeding small bowel vascular lesions. Although endoscopic band ligation is definitive therapy for Dieulafoy's lesion, long-term efficacy in the treatment of GI bleeding from angiodysplasia is limited.
Junquera
Félix
F
Endoscopy Unit, UDIAT-CD, Corporació Parc Taulí, Sabadell, Spain.
Brullet
Enric
E
Campo
Rafel
R
Calvet
Xavier
X
Puig-Diví
Valentí
V
Vergara
Mercedes
M
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000601:surgery*; D016888:Angiodysplasia / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply*; D008026:Ligation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012449:Safety; D016896:Treatment Outcome