Endoscopic band ligation in a porcine model

Dr. Ryan LawRyan Law, DO from the Division of Gastroenterology & Hepatology at the Mayo Clinic in Rochester, Minnesota, USA discusses his New Methods article “Endoscopic band ligation for closure of GI perforations in a porcine animal model (with video).”

We aimed to evaluate the efficacy of endoscopic band ligation for closure of acute gastrointestinal perforations using a porcine model. The primary endpoints were:

1) Immediate and delayed endoscopic closure of the perforation site

2) Evidence of clinical peritonitis during the 14 day follow-up

Table 1

We believe that endoscopic band ligation can be a useful technique for immediate closure of moderate sized (10mm to 20mm) perforations within the gastrointestinal tract. Currently available literature consists of only a small number of case reports/series which describe successful closure of perforations using band ligation either as primary treatment or as a rescue intervention when other techniques fail. Though this technique has been performed sparingly, it has not been formally studied.

Our results demonstrated that endoscopic band ligation effectively closes 10-20mm perforations of healthy tissue within the stomach, duodenum, and colon with the absence of clinically-relevant infections despite bacterial translocation from the gastrointestinal tract into the peritoneum. Closure of esophageal perforations was much more challenging and should only be considered for small (≤10mm) injuries. Endoscopic band ligation is widely available and taught to all gastroenterology trainees, whereas other endoscopic closure techniques may be limited. When considering the results of our study in conjunction with the available human literature, we believe this technique can be considered in certain patients.

Read the abstract for this article here.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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