< Back

your limit has been reached. plz Donate us to allow your ip full access, Email: sshnevis@outlook.com

Procedure-related bleeding risk from gastrointestinal procedures

Higher-risk procedures

Polypectomy*

Biliary or pancreatic sphincterotomy

Treatment of varices

PEG placement^¶

Therapeutic balloon-assisted enteroscopy

EUS with FNA^Δ

Endoscopic hemostasis

Tumor ablation

Cystgastrostomy

Ampullary resection

EMR

Endoscopic submucosal dissection

Pneumatic or bougie dilation

PEJ

Low-risk procedures

Diagnostic (EGD, colonoscopy, flexible sigmoidoscopy) including mucosal biopsy

ERCP with stent (biliary or pancreatic) placement or papillary balloon dilation without sphincterotomy

Push enteroscopy and diagnostic balloon-assisted enteroscopy

Capsule endoscopy

Enteral stent deployment (controversial)

EUS without FNA

Argon plasma coagulation

Barrett's ablation

EGD: esophagogastroduodenoscopy; ERCP: endoscopic retrograde cholangiopancreatography; PEG: percutaneous endoscopic gastrostomy; EUS: endoscopic ultrasound; FNA: fine-needle aspiration; EMR: endoscopic mucosal resection; PEJ: percutaneous endoscopic jejunostomy.
* Among patients undergoing colonic polypectomy, the size of the polyp influences the risk of bleeding, and it may be more appropriate to categorize polyps less than 1 cm in size as low risk for bleeding.
¶ PEG on aspirin or clopidogrel therapy is low risk. Does not apply to dual antiplatelet therapy.
Δ EUS-FNA of solid masses on aspirin/nonsteroidal anti-inflammatory drugs is low risk.

Reproduced from: ASGE Standards of Practice Committee, Acosta RD, Abraham NS, et al. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc 2016; 83:3. Table used with the permission of Elsevier Inc. All rights reserved.

Graphic 50700 Version 8.0