title: Role of endoscopic band ligation in management of non-variceal upper gastrointestinal bleeding.
abstract: BACKGROUND
  Acute non-variceal upper GI bleeding (NVUGIB) is a challenging emergency condition. Early endoscopic therapy has been recommended as the first-line of treatment for upper GI bleeding (UGIB) as it has been shown to reduce recurrent bleeding. We aimed to determine the various causes of NVUGIB and discuss the role of band ligation.
  
  
  METHODS
  A total of 74 patients with NVUGIB who had been treated with endoscopic band ligation (EBL), between November 2006 and December 2011, were included in the study. Bleeding lesions included Dieulafoy lesion (DL), Mallory-Weiss tears (MWTs), duodenal ulcer, post-surgical anastomosis bleed and gastric ulcer after polypectomy. After the basic life support was provided, all patients underwent emergent and elective endoscopy.
  
  
  RESULTS
  The study comprised 49 (66.2%) men and 25 (33.8%) women. The mean age was 48.2 +/- 6.4 years for men and 40.6 +/- 2.2 years for women. MWTs and DL constituted the majority of bleeding lesions, of these 26 and 17, respectively required EBL. Other causes were: prepyloric ulcer 11; duodenal ulcer 9; ulcers in antrum 5; post-polypectomy bleed 3; anastomosis bleed 1; and malignant lesions 2. Bleeding stopped after endoscopic therapy in 96.5% of patients. The single failure was in bleeding from a pre-pyloric lesion which was treated by using injection sclerotherapy with 1:10,000 adrenaline solution where EBL was not successful.
  
  
  CONCLUSIONS
  EBL provides safe and effective modality for haemostasis in patients with NVUGIB. EBL could be considered as an alternative method of choice for treatment of endoscopic haemostasis in patients with NVGIB.
authors.affiliation: Centre for GI bleed & Institute of Surgical Gastroenterology and Liver Transplant, Stanley Medical College Hospital, Chennai, India. dr.arunkumarpillai@gmail.com
authors.forename: Arunkumar
authors.initials: A
authors.lastname: Krishnan
authors.forename: Vimalraj
authors.initials: V
authors.lastname: Velayutham
authors.forename: Jeswanth
authors.initials: J
authors.lastname: Satyanesan
authors.forename: Selvakumar
authors.initials: S
authors.lastname: Eswaran
authors.forename: Surendran
authors.initials: S
authors.lastname: Rajagopal
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D041742:Upper Gastrointestinal Tract / Q000601:surgery*