Analysis of risk factors for post-endoscopic papillectomy bleeding

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Surgical Complications

Background:

• Endoscopic papillectomy (EP) is an effective treatment for ampullary lesions.
• EP is technically challenging due to anatomy, leading to a high rate of adverse events.
• Postoperative bleeding is a feared and potentially life-threatening complication of EP.

Purpose of the Study:

• To identify risk factors for postoperative bleeding after EP.
• To establish preventive measures for bleeding complications following EP.

Main Methods:

• Retrospective analysis of 173 patients undergoing EP from January 2006 to October 2020.
• Patients were categorized into bleeding and non-bleeding groups.
• Univariate and multivariate logistic regression analyses were used to identify risk factors.

Main Results:

• Postoperative bleeding occurred in 19.07% of patients (33/173).
• Intraoperative bleeding (OR: 4.38) and lack of endoscopic closure (OR: 0.25) were independent predictors of postoperative bleeding.
• Lesion size (≥3 cm) was associated with increased intraoperative bleeding risk (OR: 4.25).

Conclusions:

• Endoscopic closure is associated with a reduced risk of bleeding after EP.
• Intraoperative bleeding is a significant risk factor for postoperative bleeding.
• Lesion size may indirectly increase postoperative bleeding risk by elevating intraoperative bleeding risk.