The Safety of Endoscopic Sphincterotomy in Patients Taking Aspirin

Hwang, Jong Ho; Kang, Dae Hwan; Kim, Hyung Wook; Choi, Choel Woong; Park, Soo Bum

Abstract

BACKGROUND/AIMS
Endoscopic sphincterotomy (EST) is a common therapeutic technique for biliary and pancreatic disease, but it can cause several complications. Although the literature suggests that there is no need for patients to stop taking aspirin before undergoing EST, there are no definite guidelines on this in Korea. Consequently, we compared the frequency of bleeding and safety between aspirin users and nonusers undergoing EST.
METHODS
This retrospective study recruited 1003 patients who underwent EST at our hospital between 1 February 2005 and 30 September 2008. Thirteen patients continued to take aspirin until the day of the sphincterotomy (group 1), and 990 patients had not taken aspirin before the sphincterotomy (group 2). The incidence of post-sphincterotomy bleeding was compared between the two groups retrospectively.
RESULTS
There was no significant difference in age or gender between the two groups. The indications for EST included common bile duct stones in 12 patients (92.3%, 12/13) in group 1 and 706 patients (71.3%, 706/990) in group 2 (p = 0.124). Regarding combined disease, cholangitis was observed in 11 patients (84.6%, 11/13) in group 1 and 815 patients (82.3%, 815/990) in group 2 (p = 0.974). Clinically significant post-sphincterotomy bleeding was observed in three patients in group 2 (0.3%, 3/990) versus none in group 1.
CONCLUSIONS
Taking aspirin does not appear to clinically increase bleeding after EST. Therefore, there is no definite need to stop aspirin before undergoing EST.