Safety of band ligator use in the small bowel and the colon

Barker, Kevin B.; Arnold, Hays; Fillman, Eric P.; Palekar, Nicole; Gering, Scott A.; Parker, Allan

doi:10.1016/s0016-5107(05)00557-2

Cited by 42 publications

(12 citation statements)

References 6 publications

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“…Ex vivo colon specimen data have demonstrated serosal entrapment and inclusion of the muscularis propia post band ligation in the right colon. 85, 86 The left colon, likely due to its thicker mucosal wall, had limited submucosal involvement and only a single site of muscularis propria involvement. 85 …”

Section: Colonoscopymentioning

confidence: 99%

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ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding

Strate

Gralnek

2016

American Journal of Gastroenterology

439

440

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This guideline provides recommendations for the management of patients with acute overt lower gastrointestinal hemorrhage. Hemodynamic status should be initially assessed with intravascular volume resuscitation started as needed. Risk stratification based upon clinical parameters should be performed to help distinguish patients at high and low-risk of adverse outcomes. Hematochezia associated with hemodynamic instability may be indicative of an upper GI bleeding source and thus warrants an upper endoscopy. In the majority of patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 hours of patient presentation after adequate colon preparation. Endoscopic hemostasis therapy should be provided to patients with high risk endoscopic stigmata of bleeding including active bleeding, non-bleeding visible vessel, or adherent clot. The endoscopic hemostasis modality used (mechanical, thermal, injection or combination) is most often guided by the etiology of bleeding, access to the bleeding site, and endoscopist experience with the various hemostasis modalities. Repeat colonoscopy, with endoscopic hemostasis performed if indicated, should be considered for patients with evidence of recurrent bleeding. Radiographic interventions (tagged red blood cell scintigraphy, CT angiography, angiography) should be considered in high-risk patients with ongoing bleeding who do not respond adequately to resuscitation, and who are unlikely to tolerate bowel preparation and colonoscopy. Strategies to prevent recurrent bleeding should be considered. NSAID use should be avoided in patients with a history of acute lower GI bleeding particularly if secondary to diverticulosis or angioectasia. In patients with established cardiovascular disease who require aspirin (secondary prophylaxis), aspirin should not be discontinued. The exact timing depends on the severity of bleeding, perceived adequacy of hemostasis and the risk of a thromboembolic event. Surgery for the prevention of recurrent lower gastrointestinal bleeding should be individualized and the source of bleeding should be carefully localized prior to resection.

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Section: Colonoscopymentioning

confidence: 99%

“…85, 86 The left colon, likely due to its thicker mucosal wall, had limited submucosal involvement and only a single site of muscularis propria involvement. 85 …”

Section: Colonoscopymentioning

confidence: 99%

ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding

Strate

Gralnek

2016

American Journal of Gastroenterology

439

440

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“…Banded specimens also should not be endoscopically resected, as banded tissue sometimes contains muscularis propria and resection could lead to perforation. 6 , 9 EBL has also been used for the hemostasis of colonic diverticular hemorrhage. 3 - 6 The muscularis propria in the right colon and the submucosa in the left colon are included by O-band and are replaced with granulation tissue after EBL.…”

Section: Discussionmentioning

confidence: 99%

“… 3 - 6 The muscularis propria in the right colon and the submucosa in the left colon are included by O-band and are replaced with granulation tissue after EBL. 9 , 10 Therefore, it has been reported that the use of EBL is safe for the resolution of colonic diverticula. 3 - 6 It is important to note that pathology of the banded specimen cannot be assessed using this treatment because the banded specimen becomes necrotic and falls off the colonic wall after EBL.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Band Ligation For Treatment of a Colonic Polyp Extending Into the Colonic Diverticulum

Ishii

Fujita

2015

ACG Case Reports Journal

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“…The usual clinical manifestation is severe, intermittent bleeding. Endoscopic banding, clipping, electrocautery, laser therapy, heater probe, injection of sclerosants or epinephrine are all effective [66], however the use of epinephrine alone is associated with a higher risk of rebleeding [94] and band ligation may be associated with a higher risk of perforation in the small bowel and proximal colon [95]. GAVE or "water melon stomach" is seen in older women, in patients with cirrhosis and systemic sclerosis [96], and typically manifests as chronic blood loss with anemia.…”

Section: Endoscopic Therapy For Other Non-variceal Causes Of Upper Gimentioning

confidence: 99%

Diagnosis and Management of Non-Variceal Gastrointestinal Hemorrhage: A Review of Current Guidelines and Future Perspectives

Mujtaba

Chawla

Massaad

2020

JCM

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Non-variceal gastrointestinal bleeding (GIB) is a significant cause of mortality and morbidity worldwide which is encountered in the ambulatory and hospital settings. Hemorrhage form the gastrointestinal (GI) tract is categorized as upper GIB, small bowel bleeding (also formerly referred to as obscure GIB) or lower GIB. Although the etiologies of GIB are variable, a strong, consistent risk factor is use of non-steroidal anti-inflammatory drugs. Advances in the endoscopic diagnosis and treatment of GIB have led to improved outcomes. We present an updated review of the current practices regarding the diagnosis and management of non-variceal GIB, and possible future directions.

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Safety of band ligator use in the small bowel and the colon

Cited by 42 publications

References 6 publications

ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding

ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding

Endoscopic Band Ligation For Treatment of a Colonic Polyp Extending Into the Colonic Diverticulum

Diagnosis and Management of Non-Variceal Gastrointestinal Hemorrhage: A Review of Current Guidelines and Future Perspectives

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