The validation of JGES guidelines concerning the management of anticoagulants during endoscopic sphincterotomy

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  • Hosaka Shosuke
    Department of Gastroenterology, Chiba Nishi General Hospital
  • Ono Satoshi
    Department of Gastroenterology, Chiba Nishi General Hospital
  • Maejima Kyohei
    Department of Gastroenterology, Chiba Nishi General Hospital
  • Ito Shun
    Department of Gastroenterology, Chiba Nishi General Hospital
  • Umeki Kiyotaka
    Department of Gastroenterology, Chiba Nishi General Hospital
  • Sato Shin-ichiro
    Department of Gastroenterology, Chiba Nishi General Hospital

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  • 当院のEST症例における抗凝固薬ガイドラインの妥当性に関する検討

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<p>Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) is an established endoscopic treatment for common bile duct stones and acute cholangitis. However, there is only a limited number of reports of the validation of Japan Gastrointestinal Endoscopy Society (JGES) guidelines concerning the management of anticoagulants during EST. An analysis of a total of 683 patients of EST including 57 patients taking anticoagulants revealed that there were no significant differences in the bleeding rate although the blood transfusion rate was significantly higher in the DOAC group (5.6%) and antiplatelet drug combination cases (7.7%) compared to other cases (0.5%). Multivariate analysis revealed that the DOAC and hemodialysis were significant risk factors of severe bleeding requiring blood transfusion. Thus, the management based upon JGES guidelines might not increase the bleeding rate but the severe bleeding rate requiring blood transfusion.</p>

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