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International Session（Panel Discussion）2(JGES・JSGE・JSGS)
Sat. November 2nd   14:00 - 17:00   Room 9: Portopia Hotel Main Building Kairaku 3
IS-PD2-7_E
 Effectiveness of ligation method for colonic diverticular hemorrhage
Mari Iseki1, Katsumasa Kobayashi1, Seishin Azuma1
1Department of Gastroenterology, Tokyo Metropolitan Bokutoh Hospital
Objectives: Recently, endoscopic treatment for colonic diverticular hemorrhage (CDH) is widely used. We perform endoscopic detachable snare ligation (EDSL) as the first choice for CDH treatment. In the present study, we aimed to evaluate the optimal treatment strategy for CDH using our dataset.
Methods: The present study analyzed 839 patients hospitalized with CDH between April 2013 and October 2023. The patients' characteristics and clinical outcomes were retrospectively evaluated.
Results: Of the entire cohort, 784 patients underwent colonoscopy during hospitalization, and the bleeding site was identified in 381 of these patients. Clipping, ligation, and conservative treatment was administered to 170, 206, and five patients, respectively. Among the patients receiving ligation, four and 202 received a band ligation and EDSL, respectively. Compared to clipping, ligation reduced the early rebleeding rate (9.2% vs 18.8%; p<0.007) and decreased the length of hospital stay after treatment (p<0.001). When assessed by bleeding site and type, ligation reduced the early rebleeding rate in patients with active bleeding in the right-sided colon to a significantly greater degree than clipping while other combinations of sites and types were comparable. One patient (0.49%) treated with EDSL experienced colonic diverticulitis. There were no cases of colonic perforation.
Conclusion: Ligation was a safe and useful treatment for CDH. However, the optimal treatment might differ depending on the site and type of bleeding and should be considered individually for each case.
Index Term 1: colonic diverticular hemorrhage
Index Term 2: endoscopic detachable snare ligation
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