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Endoscopy 2015; 47(11): 1039-1042
DOI: 10.1055/s-0034-1392204
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic detachable snare ligation: a new treatment method for colonic diverticular hemorrhage

Daisuke Akutsu
1   Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
Toshiaki Narasaka
2   Division of Endoscopy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
,
Mariko Wakayama
3   Department of Gastroenterology, Koyama Memorial Hospital, Kashima, Ibaraki, Japan
,
Masahiko Terasaki
1   Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
Tsuyoshi Kaneko
1   Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
Hirofumi Matsui
1   Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
Hideo Suzuki
2   Division of Endoscopy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
,
Ichinosuke Hyodo
1   Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
Yuji Mizokami
2   Division of Endoscopy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
› Author Affiliations
Further Information

Publication History

submitted: 08 December 2014

accepted after revision: 01 April 2015

Publication Date:
28 May 2015 (online)

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Background and study aims: Colonic diverticular hemorrhage is the most common cause of lower intestinal bleeding. We tried to develop a convenient and reliable hemostatic method, endoscopic detachable snare ligation (EDSL), to treat diverticular hemorrhage and retrospectively explored its safety and efficacy.

Patients and methods: The definitive bleeding diverticulum was ligated with a detachable snare, instead of a rubber band, in a procedure similar to endoscopic band ligation. Removal of the scope to attach a ligation device and reinsertion for treatment are not needed in this method.

Results: From November 2013 to September 2014, EDSL was used to treat 8 patients with colonic diverticular hemorrhage. The mean procedure time required for hemostasis after identification of the bleeding diverticulum was 5 ± 2 minutes. Sustained hemostasis was achieved in 7 patients (88 %), and early rebleeding occurred in 1 patient, in whom the applied suction seemed inadequate. No complications occurred in any patient.

Conclusions: EDSL may be a safe and effective treatment for colonic diverticular hemorrhage. However, additional studies are warranted to confirm these initial exploratory data.

 

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