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Surgical Endoscopy

Published in:

01-08-2016

Clinical outcome of endoscopic management of duodenal Dieulafoy’s lesions: endoscopic band ligation versus endoscopic hemoclip placement

Authors: Jeong-Seon Ji, Hyung-Keun Kim, Sung Soo Kim, Hiun-Suk Chae, Hyunjung Cho, Young-Seok Cho

Published in: Surgical Endoscopy | Issue 8/2016

Abstract

Background

The most appropriate type of endoscopic hemostasis for bleeding due to duodenal Dieulafoy’s lesions (DLs) is not yet established. The aim of this study was to assess the efficacy of mechanical endoscopic hemostasis for duodenal DLs and long-term outcome after successful hemostasis, as well as to compare the efficacy and safety of endoscopic band ligation (EBL) and endoscopic hemoclip placement (EHP).

Methods

Patients admitted to the emergency unit with acute upper gastrointestinal bleeding from duodenal DLs were enrolled in this study. The data were collected prospectively, but data analysis was performed retrospectively. Twenty-four patients with duodenal DLs were treated with EBL (n = 11) or EHP (n = 13).

Results

There were no significant differences between groups with respect to clinical or endoscopic characteristics, apart from the number of epinephrine (three cases with EBL vs. 11 cases with EHP; p = 0.011). Primary hemostasis was achieved in all patients. Recurrent bleeding was observed in one patient (9.1 %) from the EBL group and in five patients (38.5 %) from the EHP group (p = 0.166). The recurrent bleeding in the patient from the EBL group was treated by EHP. In the EHP group, all five patients achieved successful secondary hemostasis by endoscopic treatment (EBL in two patients and EHP in three patients). There were no differences in secondary outcomes between the two groups, including the number of endoscopic sessions required, need for angiographic embolization or emergent surgery, transfusion requirements, or length of hospital stay. No complications occurred, and there was no recurrence of bleeding in either group during the follow-up period.

Conclusions

Mechanical endoscopic treatments are effective and safe for the treatment of bleeding duodenal DLs. A large-scale, randomized, controlled study is required to confirm the efficacy and safety of EBL and EHP for the management of bleeding duodenal DLs.

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Title: Clinical outcome of endoscopic management of duodenal Dieulafoy’s lesions: endoscopic band ligation versus endoscopic hemoclip placement
Authors: Jeong-Seon Ji
Hyung-Keun Kim
Sung Soo Kim
Hiun-Suk Chae
Hyunjung Cho
Young-Seok Cho
Publication date: 01-08-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 8/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4642-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical outcome of endoscopic management of duodenal Dieulafoy’s lesions: endoscopic band ligation versus endoscopic hemoclip placement

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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