Endoscopic Band Ligation Versus Endoscopic Hemoclip Placement for Dieulafoy's Lesion: A Meta-Analysis

Author Type(s)

Resident/Fellow

Document Type

Article

Publication Date

September 2018

DOI

10.1097/MEG.0000000000001179

Journal Title

European Journal of Gastroenterology & Hepatology

Department

Medicine

Abstract

Dieulafoy lesions (DL) are abnormally large arterial lesions that fail to decrease in size as they emerge from the submucosa to the mucosal surface. Endoscopic treatment has become the mainstay of therapy for actively bleeding DL lesions. In this meta-analysis, we aim to assess the efficacy of both techniques in achieving primary hemostasis of actively bleeding DL lesions and their rates of rebleeding. Our search included the Pubmed, Scopus and CINAHL electronic databases. The initial search yielded 440 articles and after appropriate review by 2 individual reviewers, 5 studies met inclusion criteria. Review manager version 5.3 was used for statistical analysis. There were 75 patients treated with EBL and 87 patients treated with EHC. The success rate of primary hemostasis of EBL for bleeding DL lesions was 0.96 [95% confidence interval (CI): 0.88-0.99]. The success rate of primary hemostasis of EHC for bleeding DL lesions was 0.91 (95% CI: 0.83-0.96). The recurrence of bleeding for patients treated with EBL was 0.06 (95% CI: 0.02-0.15). The recurrence of bleeding for patients treated with EHC was 0.17 (95% CI: 0.10-0.28). There was no statistical significance in primary hemostasis or rebleeding in patients treated with EBL or EHC. There was no significant heterogeneity between studies included in the analysis. Endoscopic band ligation and endoscopic hemoclip placement are efficacious procedures for the treatment of NVUGIB secondary to DL with similar rates of primary hemostasis and rebleeding.

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