Year 2021 / Volume 113 / Number 8
Original
Predictive factors for post-ERCP bleeding. Influence of direct oral anticoagulants

591-596

DOI: 10.17235/reed.2020.7547/2020

Ernesto Parras Castañera, Pelayo Rodríguez López, Alberto Álvarez, Fernando Muñoz Núñez, Fernando Geijo Martínez, Antonio Velasco Guardado,

Abstract
Introduction: there is a rising number of patients receiving antiplatelet and anticoagulation therapy who require endoscopic retrograde cholangiopancreatography (ERCP), probably due to the increased morbidity of older patients. Considering the increasing use of direct oral anticoagulants (DOACs), this study aimed to determine the influence of these factors on the possibility of hemorrhage after ERCP in our center. Material and methods: data were collected from all the examinations carried out in 2017 and 2018, which included 797 examinations on 588 patients. Collected data included personal history of the patients, results of the test and follow-up. Results: the percentage of post-ERCP bleeding was 4.6 % (n = 37). With regard to the severity, the bleeding was mild in 21.6 % (n = 8) of the cases, moderate in 59.5 % (n = 22) and severe in 18.9 % (n = 7). Previous cardiopathy antiplatelet therapy, anticoagulation therapy, treatment with DOACs, having a pancreatic stent and lithiasis removal doubled the risk of bleeding after ERCP. Having a sphincterotomy increased the risk by over five-fold. Conclusion: according to the multivariate analysis, a statistically significant increase of bleeding among patients treated with DOACs was observed compared to patients who received anticoagulation with acenocoumarol or low-molecular-weight heparins (LMWH).
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11/01/2022 21:34:37
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Parras Castañera E, Rodríguez López P, Álvarez A, Muñoz Núñez F, Geijo Martínez F, Velasco Guardado A, et all. Predictive factors for post-ERCP bleeding. Influence of direct oral anticoagulants. 7547/2020


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Publication history

Received: 23/09/2020

Accepted: 17/11/2020

Online First: 29/12/2020

Published: 28/07/2021

Article revision time: 44 days

Article Online First time: 97 days

Article editing time: 308 days


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