Band Ligation Shown as Most Effective Therapy for Colonic Diverticular Bleeding

The comparative effectiveness of different endoscopic therapies for colonic diverticular bleeding has been assessed in a meta-analysis. A total of 16 observational studies comprising nearly 400 patients were included. Too few data were available to evaluate epinephrine injection alone or over-the-scope clips. The three modalities with sufficient data for analysis were bipolar coagulation, endoscopic clipping, and endoscopic ligation. Research on the latter included two studies of endoscopic loop application.

All three modalities were effective (and similarly so) in achieving initial hemostasis. The risk for recurrent bleeding (within 30 days of initial endoscopic therapy) was similar across therapies: 0.2 with coagulation, 0.2 with clipping,…