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Incidence and risk factors of delayed postpolypectomy bleeding in patients with chronic liver disease.

Authors
 Hee Seung Lee  ;  Jae Jun Park  ;  Seung Up Kim  ;  Jeung Eun Lee  ;  Ga Lam Leem  ;  Yonsoo Kim  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han 
Citation
 SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, Vol.51(1) : 618-624, 2016 
Journal Title
 SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY 
ISSN
 0036-5521 
Issue Date
2016
MeSH
Chronic Disease ; Colectomy/adverse effects* ; Colonic Polyps/complications ; Colonic Polyps/surgery* ; Colonoscopy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Liver Diseases/complications* ; Liver Diseases/epidemiology ; Male ; Middle Aged ; Postoperative Hemorrhage/diagnosis ; Postoperative Hemorrhage/epidemiology* ; Postoperative Hemorrhage/etiology ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment/methods* ; Risk Factors ; Time Factors
Keywords
Chronic liver disease ; colonoscopy ; liver cirrhosis ; postpolypectomy bleeding
Abstract
OBJECTIVE: Hepatologists and colonoscopists often hesitate to perform a colonoscopic polypectomy in patients with chronic liver disease (CLD), especially those with cirrhosis, because of the risk of postpolypectomy bleeding (PPB). We aimed to investigate the incidence and risk factors of delayed PPB after a colonoscopic polypectomy in patients with CLD. MATERIALS AND METHODS: In total, 152 patients with CLD who underwent colonoscopic polypectomy from December 2005 to December 2012 were retrospectively reviewed. RESULTS: Cirrhosis was identified in 80 (52.6%) patients. During the study period, 442 polyps were removed and delayed PPB developed in 14 (9.2%) patients. The incidence of delayed PPB was significantly higher in patients with cirrhosis than in those without the disease (13.8% [n = 11] vs. 4.2% [n = 3], p = 0.041). The polyp size (odds ratio, 1.087; 95% confidence interval, 1.009-1.172) and cirrhosis (odds ratio, 8.535; 95% confidence interval, 2.417-30.140) were independent risk factors for delayed PPB. In patients with cirrhosis, the optimal cut-off size to identify high-risk polyps for delayed PPB was 10 mm (area under the receiver operating characteristics curve, 0.737; sensitivity, 52%; specificity, 88%). CONCLUSION: Caution is needed when colonoscopic polypectomy is planned in patients with CLD who have larger polyps and cirrhosis.
Full Text
http://www.tandfonline.com/doi/full/10.3109/00365521.2015.1121513
DOI
10.3109/00365521.2015.1121513
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Yon Soo(김연수)
Park, Jae Jun(박재준)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Jung Eun(이정은B)
Lee, Hee Seung(이희승) ORCID logo https://orcid.org/0000-0002-2825-3160
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147171
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