Institutional members access full text with Ovid®

Share this article on:

Endoscopic band ligation versus endoscopic hemoclip placement for Dieulafoy’s lesion: a meta-analysis

Barakat, Mohameda; Hamed, Ahmede; Shady, Ahmedc; Homsi, Maherd; Eskaros, Saphwatb

European Journal of Gastroenterology & Hepatology: September 2018 - Volume 30 - Issue 9 - p 995–996
doi: 10.1097/MEG.0000000000001179
Review Articles

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.

aDepartment of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center

bIcahn School of Medicine at Mount Sinai, Queens Hospital Center, Gastroenterology Division, Jamaica

cDepartment of Internal Medicine, Metropolitan Hospital Center, New York Medical College, Valhalla

dDepartment of Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, New York

eDepartment of Internal Medicine, East Carolina University, Greenville, North Carolina, USA

Correspondence to Mohamed Barakat, MD, Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, 82-68 164th Street, Jamaica, NY 11432, USA Tel: +1 718 883 4050; fax: +1 718 883 6197; e-mail: mo_barakat@hotmail.com

Received April 9, 2018

Accepted April 27, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.