Background and study aims: Long-term outcomes of endoscopic band ligation (EBL) for colonic diverticular hemorrhage
have not been reported to date. The aim of this study was to determine the long-term
outcomes of EBL and to retrospectively compare them with those of endoscopic clipping
(EC) in the treatment of colonic diverticular hemorrhage.
Patients and methods: The study included patients with colonic diverticular hemorrhage who were treated
with EBL or EC from January 2004 to November 2014 and followed up more than 1 year
(61 patients in the EBL group and 39 patients in the EC group). Time-to-event analysis
of rebleeding was performed with the Kaplan-Meier method. A follow-up colonoscopy
was performed to confirm the disappearance of the banded diverticula in the EBL group.
Results: Rebleeding occurred in 21 patients in the EBL group and in 26 patients in the EC
group. The cumulative incidence of rebleeding at 1, 12, 24, and 36 months after first
treatments was 14 %, 23 %, 26 %, and 41 % in the EBL group and 38 %, 49 %, 59 %, and
68 % in the EC group, respectively. Time-to-event analysis revealed statistically
significant data (Log-rank test, P = 0.0036). Scar formation with fold convergence at the previously banded site was
observed in 11 of 24 patients who underwent follow-up colonoscopy (46 %). However,
late rebleeding (rebleeding more than 30 days after EBL) occurred in five of these
11 cases.
Conclusions: EBL was superior to EC in the treatment of colonic diverticular hemorrhage. However,
the risk of rebleeding was not avoided even after the diverticula had been resolved
using EBL.
