Post-ERCP Bleeding in the Era of Multiple Antiplatelet Agentsopen access
- Authors
- Oh, Hyoung-Chul; El Hajj, Ihab I.; Easler, Jeffrey J.; Watkins, James; Fogel, Evan L.; McHenry, Lee; Lehman, Glen A.; Choi, Jung Sik; Kang, Hyun; Sherman, Stuart
- Issue Date
- Mar-2018
- Publisher
- EDITORIAL OFFICE GUT & LIVER
- Keywords
- Cholangiopancreatography; endoscopic retrograde; Hemorrhage; Platelet aggregation inhibitors
- Citation
- GUT AND LIVER, v.12, no.2, pp 214 - 218
- Pages
- 5
- Journal Title
- GUT AND LIVER
- Volume
- 12
- Number
- 2
- Start Page
- 214
- End Page
- 218
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/1158
- DOI
- 10.5009/gnl17204
- ISSN
- 1976-2283
2005-1212
- Abstract
- Background/Aims: This study aimed to determine the risk of post-endoscopic retrograde cholangiopancreatography (post-ERCP) bleeding among patients taking antiplatelet agents (APAs), particularly in the era of multiple APAs. Methods: The primary outcomes were the frequency, type, and severity of ERCP-related bleeding according to the use of APAs. Results: The frequencies of post-ERCP bleeding among the four different groups were 16 of 2,083 (0.8%) in the no drug group, 12 of 256 (4.7%) in the aspirin group, 3 of 48 (6.3%) in the single APA group, and 4 of 48 (8.3%) in the multiple APA group (p<0.001). In the univariate analysis, post-ERCP bleeding was associated with age, pull-type sphincterotomy, and APA and was inversely associated with balloon dilation of the biliary orifice. In the multivariate analysis, pull-type sphincterotomy (odds ratio [OR], 7.829; 95% confidence interval [CI], 1.411 to 43.453; p=0.019) and country (Korea: OR, 0.124; 95% CI, 0.042 to 0.361; p<0.001) were associated with post-ERCP bleeding. Conclusions: The frequency of post-ERCP bleeding was statistically higher in patients on any APA within 6 days prior to ERCP. However, in the multivariate analysis, APA use was not associated with post-ERCP bleeding. Until a large, adequately powered study to detect differences is performed, caution is recommended when considering invasive procedures during ERCP in patients on APAs.
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