Is it safe to perform endoscopic band ligation for the duodenum? A pilot study in ex vivo porcine models.
OBJECTIVE
In the digestive tract, endoscopic band ligation (EBL) has been routinely used for the treatment of variceal bleeding and superficial malignancies. In recent years, endoscopic treatments for duodenal varices, adenoma, and cancer have also actively incorporated EBL. Although there have been a number of reports on the risks associated with the use of EBL in the esophagus, stomach, and colon, few studies have focused on EBL in the duodenum. We performed EBL procedures to evaluate the risks associated with the use of EBL in the duodenum.


METHODS
Overall, EBLs were performed at nine sites in duodenum sampled from a pig immediately after sacrifice. Submucosal saline injections were placed in three of the nine studied sites.


RESULTS
Regardless of saline injection, the full thickness of the duodenal wall was ligated in all attempts.


CONCLUSIONS
Routine EBL is not recommended in the duodenum because the risk of perforation is unacceptably high.
Department of Endoscopy, The JikeiUniversity School of Medicine, Tokyo, Japan. endosc-kaku@jikei.ac.jp
Hiroshi
H
Kakutani
Shigemasa
S
Sasaki
Kaoru
K
Ueda
Kazuki
K
Takakura
Kazuki
K
Sumiyama
Hiroo
H
Imazu
Syoryoku
S
Hino
Muneo
M
Kawamura
Hisao
H
Tajiri
D000818:Animals; D004384:Duodenoscopy / Q000009:adverse effects / Q000379:methods*; D004386:Duodenum / Q000098:blood supply*; D007416:Intestinal Perforation / Q000517:prevention & control; D008026:Ligation / Q000379:methods; D010865:Pilot Projects; D013552:Swine; D014648:Varicose Veins / Q000601:surgery*