| Abnormal clotting parameters before therapeutic ERCP: do they predict major bleeding? | |
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MedLine Citation:
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PMID: 10524637 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A total of 399 consecutive patients undergoing 598 ERCPs (endoscopic retrograde cholangiopancreatographies), including 88 pre-cut papillotomies and 206 conventional papillotomies, are described in a retrospective study. Clotting parameters, haemoglobin levels, indications for pre-cut and/or conventional papillotomy and the use of drugs assumed to interfere with blood clotting (anticoagulants, platelet-aggregation inhibitors, low-molecular-weight heparin) were evaluated in order to detect risk factors for ERCP-associated bleeding. The overall incidence of ERCP-associated bleeding was 18/598 (3.0%). The incidence of bleeding in the group without papillotomy was 7/346 (2.0%). This group consisted of patients who underwent only a diagnostic ERCP, patients who had undergone papillotomy previously, patients in whom a renewed attempt was made to extract biliary stones, and patients in whom removal or change of a stent was necessary. The incidence of papillotomy-associated bleeding was 11/252 (4.4%). Pre-cut papillotomy did and conventional papillotomy did not significantly increase the incidence of bleeding: 15.2% (P < 0.001) and 1.9% (P= 1.00) respectively. The incidence of ERCP-associated bleeding in the group not using any drugs interfering with blood clotting was 2.5%. The use of low-molecular-weight heparin (10.3%) during ERCP significantly increased the risk of bleeding (P= 0.01). However, the use of platelet aggregation inhibitors (2.4%) did not (P= 1.00). As the incidence of bleeding in patients with normal clotting parameters, including the patients with abnormal parameters which were well corrected (4.3%), was higher than in patients with abnormal haemostatic screens (2.7%), abnormal coagulation tests did not predict ERCP-associated bleeding. |
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Authors:
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A Oren; R Breumelhof; R Timmer; D H Biesma; J B Hoekstra |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of gastroenterology & hepatology Volume: 11 ISSN: 0954-691X ISO Abbreviation: Eur J Gastroenterol Hepatol Publication Date: 1999 Oct |
Date Detail:
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Created Date: 1999-12-17 Completed Date: 1999-12-17 Revised Date: 2009-10-16 |
Medline Journal Info:
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Nlm Unique ID: 9000874 Medline TA: Eur J Gastroenterol Hepatol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 1093-7 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine and Gastroenterology, Diakonessen Hospital, Utrecht, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anticoagulants
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adverse effects Blood Coagulation Tests Cholangiopancreatography, Endoscopic Retrograde / adverse effects* Hemorrhage / epidemiology*, etiology Hemorrhagic Disorders / diagnosis* Heparin, Low-Molecular-Weight / adverse effects Humans Incidence Intraoperative Complications / epidemiology Postoperative Complications / epidemiology Predictive Value of Tests Retrospective Studies Risk Sphincterotomy, Endoscopic / adverse effects* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Heparin, Low-Molecular-Weight |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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