Gut Liver.  2020 Nov;14(6):755-764. 10.5009/gnl19131.

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

• Soh H
• Chun Jy
• Hong SW
• Park Sn
• Lee YB
• Lee HJ
• Cho EJ
• Lee JH
• Yu SJ
• Im JP
• Kim YJ
• Kim JS
• Yoon JH

• KMID: 2508694
• DOI: http://doi.org/10.5009/gnl19131

Abstract

Background/Aims
The risk for colonoscopic postpolypec-tomy 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, espe-cially those with liver cirrhosis.
Methods
We retrospectively reviewed the medical records of patients with CLD who un-derwent colonoscopic polypectomy at Seoul National Univer-sity Hospital between 2011 and 2014. The study endpoints were immediate and delayed PPB.
Results
A total of 1,267 consecutive patients with CLD were included in the study. Im-mediate PPB occurred significantly more often in the ChildPugh (CP) B or C cirrhosis group (17.5%) than in the CP-A (6.3%) and chronic hepatitis (4.6%) groups (p<0.001). More-over, 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 per-formed by trainees (p<0.001). The independent risk factors for delayed PPB were CP-B or C cirrhosis (p=0.009), and pol-yps >10 mm in size (p=0.010).
Conclusions
Patients with CP-B or C cirrhosis had an increased risk for bleeding fol-lowing colonoscopic polypectomy.

Keyword

Hepatitis; chronic; Chronic liver disease; Colonos- copy; Liver cirrhosis; Postpolypectomy bleeding