Comparison of endoscopic band ligation and endoclip closure of colonic perforation: Technical feasibility and efficacy in an ex vivo pig model

Background and Aim Recent reports have indicated several instances of successful treatment of bowel perforation by using endoscopic band ligation (EBL) when treatment with endoclipping is unsuccessful, but this salvage method has not been investigated in any prospective model. Herein we aimed to com...

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Bibliographic Details
Published in:Digestive endoscopy 2014-09, Vol.26 (5), p.659-664
Main Authors: Lee, Tae Hoon, Han, Joung-Ho, Jung, Yunho, Lee, Suck-Ho, Kim, Dae Hoon, Shin, Ji Yun, Lee, Tae Soo, Kim, Myunghwan, Choi, Seok-Hwa, Kim, Hyun, Park, Seonmee, Youn, Seijin
Format: Article
Language:English
Subjects:
Animals
colon
Colon - injuries
Colon - surgery
colonic perforation
Colonoscopy - methods
Disease Models, Animal
endoclip
endoscopic band ligation
endoscopic treatment
Feasibility Studies
Intestinal Perforation - surgery
Ligation - methods
Suture Techniques - instrumentation
Swine
Treatment Outcome
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Summary:Background and Aim Recent reports have indicated several instances of successful treatment of bowel perforation by using endoscopic band ligation (EBL) when treatment with endoclipping is unsuccessful, but this salvage method has not been investigated in any prospective model. Herein we aimed to compare the technical feasibility and efficacy of EBL and endoclip use in intraluminal closure of colon perforation, in an ex vivo model. Methods Standardized colonic perforations were created using fresh porcine colon and subsequently closed by full‐thickness interrupted sutures, endoclip (QuickClip2TM), or EBL. Each closure site was tested with compressed air by using a digital pressure monitor for evaluating leak pressure. Results No significant differences were noted between the endoclip and EBL in leak pressures. Mean (± SD) pressures for air leakage from the perforations closed using the different devices were as follows: normal colon samples, 52.0 ± 13.2 mmHg; perforations closed with hand‐sewn sutures, 32.3 ± 8.3 mmHg; perforations closed with endoclipping, 53.5 ± 22.7 mmHg; and perforations closed with EBL, 50.4 ± 12.5 mmHg. Time taken for closure by EBL was significantly less than that for closure by endoclipping (3.2 ± 1.7 min vs 6.8 ± 1.3 min, P 
ISSN:0915-5635
1443-1661
DOI:10.1111/den.12266