Child-Pugh Score Is an Independent Risk Factor for Immediate Bleeding after Colonoscopic Polypectomy in Liver Cirrhosis.
10.3349/ymj.2014.55.5.1281
- Author:
Sangheun LEE
1
;
Soo Jung PARK
;
Jae Hee CHEON
;
Tae Il KIM
;
Won Ho KIM
;
Dae Ryong KANG
;
Sung Pil HONG
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. SPHONG@yuhs.ac
- Publication Type:Original Article
- Keywords:
Bleeding;
colonoscopy;
liver cirrhosis;
colorectal polyps;
polypectomy
- MeSH:
Aged;
Colonoscopy/*adverse effects;
Female;
Gastrointestinal Hemorrhage/*epidemiology;
Humans;
Incidence;
Liver Cirrhosis/complications/*surgery;
Male;
Middle Aged;
Postoperative Hemorrhage/*epidemiology;
Retrospective Studies;
Risk Factors;
Time Factors
- From:Yonsei Medical Journal
2014;55(5):1281-1288
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
