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Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy.

Authors
  • Soh, Hosim1
  • Chun, Jaeyoung1, 2
  • Hong, Seung Wook1
  • Park, Seona1
  • Lee, Yun Bin1
  • Lee, Hyun Jung1
  • Cho, Eun Ju1
  • Lee, Jeong-Hoon1
  • Yu, Su Jong1
  • Im, Jong Pil1
  • Kim, Yoon Jun1
  • Kim, Joo Sung1
  • Yoon, Jung-Hwan1
  • 1 Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. , (North Korea)
  • 2 Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
Type
Published Article
Journal
Gut and liver
Publication Date
Nov 15, 2020
Volume
14
Issue
6
Pages
755–764
Identifiers
DOI: 10.5009/gnl19131
PMID: 31816672
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The risk for colonoscopic postpolypectomy bleeding (PPB) in patients with chronic liver disease (CLD) remains unclear. We determined the incidence and risk factors for colonoscopic PPB in patients with CLD, especially those with liver cirrhosis. We retrospectively reviewed the medical records of patients with CLD who underwent colonoscopic polypectomy at Seoul National University Hospital between 2011 and 2014. The study endpoints were immediate and delayed PPB. A total of 1,267 consecutive patients with CLD were included in the study. Immediate PPB occurred significantly more often in the Child- Pugh (CP) B or C cirrhosis group (17.5%) than in the CP-A (6.3%) and chronic hepatitis (4.6%) groups (p<0.001). Moreover, the incidence of delayed PPB in the CP-B or C cirrhosis group (4.4%) was significantly higher than that in the CP-A (0.7%) and chronic hepatitis (0.2%) groups (p<0.001). The independent risk factors for immediate PPB were CP-B or C cirrhosis (p=0.011), a platelet count <50,000/μL (p<0.001), 3 or more polyps (p=0.017), endoscopic mucosal resection or submucosal dissection (p<0.001), and polypectomy performed by trainees (p<0.001). The independent risk factors for delayed PPB were CP-B or C cirrhosis (p=0.009), and polyps >10 mm in size (p=0.010). Patients with CP-B or C cirrhosis had an increased risk for bleeding following colonoscopic polypectomy.

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