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Endoscopic clipping shows promise in diverticular disease
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Closing diverticula by endoscopic clipping could lead to resolution of diverticular disease, according to research published in Gut.
Amyn Haji, MD, of King’s Institute of Therapeutic Endoscopy in London, and colleagues wrote that their findings could have significant implications for the management of diverticular disease (DD).
“We have shown that endoscopic clipping of DD is feasible and safe using through-the-scope clips,” they wrote. “We hypothesize that diverticular endoscopic clipping leads to resolution of diverticula, but additional research needs to be done to delineate that relationship with the potential development of a new endoscopic treatment for DD.”
Haji and colleagues conducted a single-center study of nine patients previously hospitalized for lower gastrointestinal bleeding due to DD. Four of the nine patients had a diagnosis of diffuse colonic DD, three had left-sided involvement and two had a diagnosis of sigmoid-limited disease.
During colonoscopy, endoscopists closed all visible and accessible diverticula with through-the-scope clips. Overall, they closed 148 diverticula with 160 clips.
A follow-up colonoscopy 3 to 6 months later to identify the presence of DD confirmed that 129 of the diverticula were resolved (87.2%).
Haji and colleagues found no post-procedural complications and no diverticula-related problems during the follow-up. While none of the patients had to undergo surgery for DD-related problems, one patient treated for descending DD developed diverticula on the transverse and right colon, according to investigators.
“The preliminary results of our study are encouraging, showing a high rate of resolution of diverticulosis with luminal scarring,” the authors wrote. “Long-term outcomes must be evaluated.”
Haji and colleagues are planning a cohort study to prospectively evaluate symptoms of bloating, abdominal pain and diverticular complications, as well as lower GI bleeding before and after endoscopic clipping. – by Alex Young
Disclosures: The authors report no relevant financial disclosures
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