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Related Concept Videos

Endoscopic Procedures II: Colonoscopy01:25

Endoscopic Procedures II: Colonoscopy

The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy
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Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Here are some common surgical interventions for IBD:
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

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Peptic Ulcer Disease III: Clinical Manifestations and Complications

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Related Experiment Videos

Meta-analysis: colonoscopic post-polypectomy bleeding in patients on continued clopidogrel therapy.

S Gandhi1, N Narula, W Mosleh

  • 1Division of Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.

Alimentary Pharmacology & Therapeutics
|March 28, 2013
PubMed
Summary

Continuing clopidogrel therapy during colonoscopic polypectomy increases the risk of delayed post-polypectomy bleeding. However, interrupting this antiplatelet medication may cause serious ischemic events in high-risk patients.

Related Experiment Videos

Area of Science:

  • Gastroenterology
  • Cardiology
  • Clinical Pharmacology

Background:

  • Current guidelines recommend discontinuing clopidogrel 5-10 days before colonoscopic polypectomy.
  • Recent studies suggest similar post-polypectomy bleeding (PPB) rates with continued clopidogrel compared to controls.

Purpose of the Study:

  • To assess the risk of colonoscopic post-polypectomy bleeding (PPB) in patients maintained on clopidogrel therapy.

Main Methods:

  • A meta-analysis of five observational studies involving 574 patients on clopidogrel and 6169 controls.
  • Primary outcome: pooled relative risk (RR) of PPB.
  • Secondary outcomes: comparison of immediate and delayed PPB.

Main Results:

  • Continued clopidogrel therapy was associated with a significantly increased overall risk of PPB (RR = 2.54).
  • Delayed PPB risk was significantly elevated (RR = 4.66), while immediate PPB risk was not significantly different (RR = 1.76).

Conclusions:

  • Continued clopidogrel therapy increases the risk of delayed post-polypectomy bleeding but not immediate bleeding.
  • For high-risk patients, clinicians must weigh the risk of bleeding against potential ischemic events from clopidogrel interruption.