Is it safe to perform endoscopic band ligation for the duodenum? A pilot study in ex vivo porcine models

Abstract

Aim: In the digestive tract, endoscopic band ligation (EBL) has been routinely used for the treatment of variceal bleeding and superficial malignancies. In recent years, endoscopic treatments for duodenal varices, adenoma, and cancer have also actively incorporated EBL. Although there have been a number of reports on the risks associated with the use of EBL in the esophagus, stomach, and colon, few studies have focused on EBL in the duodenum. We performed EBL procedures to evaluate the risks associated with the use of EBL in the duodenum. Material and methods: Overall, EBLs were performed at nine sites in duodenum sampled from a pig immediately after sacrifice. Submucosal saline injections were placed in three of the nine studied sites. Results: Regardless of saline injection, the full thickness of the duodenal wall was ligated in all attempts. Conclusions: Routine EBL is not recommended in the duodenum because the risk of perforation is unacceptably high.

Key words::

• Endoscopic band ligation
• duodenum
• endoscopic mucosal resection
• duodenal varices
• endoscopic treatment

Acknowledgements

We declare that this manuscript has not been published before and is not under consideration for publication elsewhere. There are no conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influences its outcome. I (as corresponding author) confirm that the manuscript has been read and approved by all the named authors.

Declaration of interest: All authors have no financial relationships relevant to this publication to disclose.