Comparison of endoscopic band ligation versus over-the-scope clip for colonic diverticular bleeding: A propensity score-matched cohort analysis

Endoscopic hemostatic techniques, such as endoscopic band ligation (EBL) and over-the-scope clip (OTSC), have emerged as effective endoscopic hemostatic treatments for colonic diverticular bleeding (CDB). However, their comparative effectiveness remains unclear. In this retrospective study, we investigated the effectiveness of EBL and OTSC using the propensity score matching method. We analyzed the data of patients with CDB who underwent EBL or OTSC between August 2014 and December 2023 and compared initial hemostasis, early (30-day) recurrent bleeding, requirements for interventional radiology (IVR) or surgery, length of hospital stay, requirements f or red blood cell transfusion, and AEs between the two groups. A total of 303 cases (247 patients) were enrolled in the study, with the EBL (231 cases) and OTSC (72 cases) groups comprising 68 cases each in the propensity score-matched cohort. OTSC was associated with significantly low early recurrent bleeding rate (odds ratio [OR] 0.16; 95% confidence interval [CI], 0.02-0.77; P=0.017) and the length of hospital stay (P=0.026) compared with EBL. No significant differences in initial hemostasis, requirements for IVR or surgery, requirements of red blood cell transfusion, and adverse events were observed between the two groups. OTSC was more effective than EBL for reducing early recurrent bleeding rate in endoscopic hemostasis for CDB.