| International Session（Panel Discussion）2(JGES・JSGE・JSGS) |
| Sat. November 2nd 14:00 - 17:00 Room 9: Portopia Hotel Main Building Kairaku 3 |
| Comparison with Endoscopic Band Ligation (EBL) and Over-The-Scope Clip (OTSC) endoscopic hemostasis for colonic diverticular bleeding (CBD) | |||
| Takayasu Ideta1, Yasuhiro Oshima1, Hiroshi Sugiyama1 | |||
| 1Department of Gastroenterology, Central Japan International Medical Center | |||
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| Purpose: Clip, EBL and OTSC can be applied for CBD. It was previously reported that the early (within 30 days) rebleeding rate of EBL was significantly lower than Clip. However, the first choice of endoscopic hemostasis remains unclear. We compared the early rebleeding rate of EBL and OTSC. Methods: A total of 299 cases were applied EBL (n=227) and OTSC (n= 72) endoscopic hemostasis between August 2014 and December 2023. Result: Median age (EBL/ OTSC) 71 /77 years, Male 66.5/58.3%, Use of antithrombotic drugs n=76/30, NSAIDs n=24/10, CBD history n=91/33. The early rebleeding rate was n= 24/227(10.6%) in EBL and n=1/72(1.4%) in OTSC. It was significantly lower in OTSC than in EBL (p<0.05). Risk factors for early rebleeding in EBL were past history of CBD (Odds ratio (OR) 4.27, p<0.01) and Use of NSAIDs (OR 4.95, p<0.01) in multivariate analysis. In cases with the risk factors, the early rebleeding rate was also significantly lower in OTSC (n=1/41 (2.4%)) than EBL (n=9/109(17.4%)). Adverse events were diverticulitis (1.3%) and colonic penetration (0.4%) in EBL and diverticulitis (1.4%) and colonic stenosis (1.4%) in OTSC. All cases improved by conservative treatment. Conclusion: OTSC maybe the first choice for CBD with the early rebleeding risk factors of EBL. |
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Index Term 1: colonic diverticular bleeding Index Term 2: OTSC |
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