Background/aims: The risk for colonoscopic postpolypectomy bleeding (PPB) in patients with chronic liver disease (CLD) remains unclear. We determined the incidence and risk factors for colonoscopic PPB in patients with CLD, especially those with liver cirrhosis.
Methods: We retrospectively reviewed the medical records of patients with CLD who underwent colonoscopic polypectomy at Seoul National University Hospital between 2011 and 2014. The study endpoints were immediate and delayed PPB.
Results: A total of 1,267 consecutive patients with CLD were included in the study. Immediate PPB occurred significantly more often in the Child- Pugh (CP) B or C cirrhosis group (17.5%) than in the CP-A (6.3%) and chronic hepatitis (4.6%) groups (p<0.001). Moreover, the incidence of delayed PPB in the CP-B or C cirrhosis group (4.4%) was significantly higher than that in the CP-A (0.7%) and chronic hepatitis (0.2%) groups (p<0.001). The independent risk factors for immediate PPB were CP-B or C cirrhosis (p=0.011), a platelet count <50,000/μL (p<0.001), 3 or more polyps (p=0.017), endoscopic mucosal resection or submucosal dissection (p<0.001), and polypectomy performed by trainees (p<0.001). The independent risk factors for delayed PPB were CP-B or C cirrhosis (p=0.009), and polyps >10 mm in size (p=0.010).
Conclusions: Patients with CP-B or C cirrhosis had an increased risk for bleeding following colonoscopic polypectomy.
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http://dx.doi.org/10.5009/gnl19131 | DOI Listing |
Metab Brain Dis
January 2025
Hepato-Neuro Laboratory, Centre Hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900, Rue Saint-Denis - Pavillon R, R08.422, Montréal (Québec), H2X 0A9, Canada.
Sarcopenia and hepatic encephalopathy (HE) are complications of chronic liver disease (CLD), which negatively impact clinical outcomes. Hyperammonemia is considered to be the central component in the pathogenesis of HE, however ammonia's toxic effects have also been shown to impinge on extracerebral organs including the muscle. Our aim was to investigate the effect of attenuating hyperammonemia with ornithine phenylacetate (OP) on muscle mass loss and associated molecular mechanisms in rats with CLD.
View Article and Find Full Text PDFEClinicalMedicine
February 2025
Faculty of Medicine, University of Queensland, Australia.
Background: Small Intestinal Bacterial Overgrowth (SIBO) has been implicated in the pathophysiology of chronic liver disease (CLD). We conducted a systematic review and meta-analysis to assess and compare the prevalence of SIBO among CLD patients (with and without with complications of end stage liver disease) and healthy controls.
Methods: Electronic databases were searched from inception up to July-2024 for case-control studies reporting SIBO in CLD.
BMC Health Serv Res
January 2025
Centre for the Business and Economics of Health (CBEH), The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.
Background: The purpose of this qualitative study was to focus on review and repeat review outpatients and the structural role they play in exacerbating waitlists for Specialist Outpatient (SOP) services in Queensland. Waitlists, which record the number of patients waiting for an initial consultation (new appointment), are an indicator of a health system under strain. Waiting too long to access SOP can have a detrimental effect on people's health outcomes.
View Article and Find Full Text PDFJ Clin Epidemiol
January 2025
Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Centre d'investigation clinique de Rennes (CIC1414), Rennes, France; Institut Universitaire de France (IUF), Paris, France.
Guided by the FAIR principles (Findable, Accessible, Interoperable, Reusable), responsible data sharing requires well-organized, high-quality datasets. However, researchers often struggle with implementing Data Management and Sharing Plans (DMSPs) due to lack of knowledge on how to do this, time constraints, legal, technical and financial challenges, particularly concerning data ownership and privacy. While patients support data sharing, researchers and funders may hesitate, fearing the loss of intellectual property or competitive advantage.
View Article and Find Full Text PDFClin Res Hepatol Gastroenterol
January 2025
Hepatology Unit, Bordeaux University Hospital, Pessac, France.
Purpose: Hepatoscope® is an ultraportable ultrasound system with 50 Hz two-dimensional transient elastography (2DTE) for liver stiffness measurement (LSM). It provides a quality index (QI) for individual stiffness values that is based on imaging features. This study evaluated the 2DTE intra- and inter-user repeatability in patients with chronic liver diseases (CLD) for novice and expert operators across various QI conditions.
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