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Child-Pugh Score Is an Independent Risk Factor for Immediate Bleeding after Colonoscopic Polypectomy in Liver Cirrhosis

 Sangheun Lee  ;  Soo Jung Park  ;  Jae Hee Cheon  ;  Tae Il Kim  ;  Won Ho Kim  ;  Dae Ryong Kang  ;  Sung Pil Hong 
 YONSEI MEDICAL JOURNAL, Vol.55(5) : 1281-1288, 2014 
Journal Title
Issue Date
Aged ; Colonoscopy/adverse effects* ; Female ; Gastrointestinal Hemorrhage/epidemiology* ; Humans ; Incidence ; Liver Cirrhosis/complications ; Liver Cirrhosis/surgery* ; Male ; Middle Aged ; Postoperative Hemorrhage/epidemiology* ; Retrospective Studies ; Risk Factors ; Time Factors
Bleeding ; colonoscopy ; colorectal polyps ; liver cirrhosis ; polypectomy
PURPOSE: Post-polypectomy bleeding is the most common colonoscopic polypectomy complication. However, the risk of post-polypectomy bleeding in liver cirrhosis is unknown. We aimed to evaluate the risk of post-polypectomy bleeding in patients with liver cirrhosis. MATERIALS AND METHODS: We included 89 patients with liver cirrhosis who received colonoscopic polypectomy between January 2006 and October 2012. Three hundred forty-eight subjects without liver disease who underwent colonoscopic polypectomy comprised the control group. Risks of post-polypectomy bleeding were analyzed according to patient- and polyp-related factors. RESULTS: Among 89 patients, 75 (84.3%) were Child-Pugh class A, 10 (11.2%) were class B, and 4 (4.5%) were class C. Incidence of immediate post-polypectomy bleeding was significantly increased in cirrhosis with Child-Pugh class B or C compared to liver cirrhosis with Child-Pugh class A or control group [hazard ratio (HR) 3.5; p<0.001]. Polyp size (HR 3.6; p=0.032) and pedunculated polyps (HR 2.4; p=0.022) were also significant risk factors for immediate post-polypectomy bleeding in multivariate analysis. CONCLUSION: Cirrhotic patients with Child-Pugh class B or C have a high risk of immediate post-polypectomy bleeding. Thus, endoscopists should be cautious about performing colonoscopic polypectomy in patients with Child-Pugh class B or C.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Park, Soo Jung(박수정)
Lee, Sang Heun(이상헌)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
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