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Utility of the Gel Immersion Method for Treating Massive Colonic Diverticular Bleeding
Kazuki Yamamoto,Yasutoshi Shiratori,Takashi Ikeya 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.2
Background/Aims: In Asia, right-sided diverticular bleeding is more common than that of the left side. It often causes massivebleeding and difficulties in identifying the stigmata of recent hemorrhage (SRH) of colonic diverticular bleeding (CDB). This caseseries demonstrates the efficacy of the gel immersion method using OS-1 Jelly (Otsuka Pharmaceuticals Factory, Tokushima, Japan)in patients with CDB. Methods: This retrospective case series analyzed data of patients with CDB who underwent the gel immersion method fromApril 2016 to February 2020 at St. Luke’s International Hospital, Japan. All patients diagnosed with CDB who underwent the gelimmersion method were included. We collected data on the site of bleeding, identification of SRH, and efficacy of the method fromthe electronic medical records. Results: A total of 9 patients (including 7 with right-sided CDB) underwent gel immersion method and were included in this study. SRH were successfully found in 66.7% (6/9) of patients. Moreover, effective hemostasis was achieved in 85.7% (6/7) of patients withright-sided CDB. There were no adverse events. Conclusions: The gel immersion method was found to be effective, especially for massive right-sided CDB.
Ayaka Takasu,Takashi Ikeya,Yasutoshi Shiratori 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.3
Background/Aims: Endoscopic band ligation (EBL) is used to treat colonic diverticular bleeding (CDB). An endoscopic variceal ligationdevice for esophageal varices is used as a conventional EBL device (C-EBL). A new EBL device (N-EBL) was developed by SumitomoBakelite Co. in August 2018. We aimed to evaluate the clinical outcomes of N-EBL compared with those of C-EBL. Methods: Seventy-nine patients who underwent EBL for CDB at St. Luke’s International Hospital, Japan, between 2017 and 2020 wereincluded in this retrospective study. Patients were divided into the C-EBL and N-EBL groups. Their clinical outcomes, includingachieving initial hemostasis, early rebleeding, procedure time, and EBL-associated adverse events, were evaluated. Results: Of the 79 patients, 36 (45.6%) were in the C-EBL group and 43 (54.4%) were in the N-EBL group. The rate of achieving initialhemostasis was 100% in the C-EBL group and 93.0% in the N-EBL group. No significant difference was noted in the early rebleedingrate between the groups (p=0.24). The N-EBL group achieved a shorter median EBL procedure time than the C-EBL group (14.2 minutesvs. 18.2 minutes, p=0.02). No adverse events were observed in either group. Conclusions: The N-EBL device is safe and useful and may reduce EBL procedure time.