The risk of postpolypectomy bleeding during colonoscopy in patients with early liver cirrhosis.
BACKGROUND
Colonoscopists are often hesitant to perform endoscopic polypectomy in patients with liver cirrhosis (LC) because of the risk for postpolypectomy bleeding (PPB). However, little is known about the risk of PPB in these patients.


METHODS
We performed a retrospective study of patients with early LC who underwent colonoscopic polypectomy at a single center between September 2006 and May 2011. We investigated the incidence of immediate PPB (IPPB) and delayed PPB (DPPB) in these patients. In addition, we investigated which LC-related and polyp-related factors were associated with IPPB.


RESULTS
Thirty patients with LC were included in our study, and 29 (96.7 %) of them were classified in Child-Pugh class A or B. The mean prothrombin time was 1.27 ± 0.23, and the mean platelet count was 136.77 ± 106.49 × 10(3)/L. A total of 66 polyps in 30 patients were removed. In terms of IPPB, only 2 (3.03 %) of the 66 removed polyps presented with mild oozing and were controlled by hemostatic procedures using hemoclips. DPPB did not occur in any of the patients in the IPPB or the non-IPPB group. Although the IPPB polyp group was too small to detect statistical significance, the IPPB polyps were larger than the non-IPPB polyps (22.5 ± 10.61 vs. 7.22 ± 3.01 mm), and the gross morphology of both IPPB polyps was the pedunculated type. However, LC-related variables such as platelet counts and Child-Pugh scores did not significantly differ between the IPPB and non-IPPB groups.


CONCLUSIONS
In patients with early LC, the risk of postpolypectomy bleeding was acceptably low and there was no case with DPPB. Therefore, polypectomy can be performed with caution. IPPB was associated with the size and the gross morphology of the polyps. However, LC-related variables in patients with early LC did not impact IPPB.
Department of Internal Medicine, College of Medicine, Kyung Hee University, 149 Sangil-dong, Gangdong-gu, Seoul, 134-727, Korea.
Jung Won
JW
Jeon
Hyun Phil
HP
Shin
Joung Il
JI
Lee
Kwang Ro
KR
Joo
Kwan Mi
KM
Pack
Jae Myung
JM
Cha
Jae Jun
JJ
Park
Jun Uk
JU
Lim
Kyuseong
K
Lim
D016063:Blood Loss, Surgical; D003111:Colonic Polyps / Q000150:complications* / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors