Evidence map›Paper›PMID 39822950›Full record

ArticleDEN open2025

Post-endoscopic sphincterotomy delayed bleeding occurs in patients with just 1-day interruption of direct oral anticoagulants or hemodialysis.

Sho Hasegawa, Yusuke Kurita, Yuma Yamazaki, Shinichi Nihei, Takeshi Iizuka, Noboru Misawa, Kunihiro Hosono, Itaru Endo, Noritoshi Kobayashi, Kensuke Kubota and 1 more

Abstract read
In one paragraph

Article in DEN open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sho HasegawaDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.ORCID https://orcid.org/0000-0002-1671-0643
Yusuke KuritaDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.ORCID https://orcid.org/0000-0003-2482-6707
Yuma YamazakiDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.
Shinichi NiheiDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.
Takeshi IizukaDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.
Noboru MisawaDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.
Kunihiro HosonoDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.
Itaru EndoDepartment of Gastroenterological Surgery Yokohama City University Graduate School of Medicine Kanagawa Japan.
Noritoshi KobayashiDepartment of Oncology Yokohama City University Graduate School of Medicine Kanagawa Japan.
Kensuke KubotaDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.ORCID https://orcid.org/0000-0001-6767-0410
Atsushi NakajimaDepartment of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine Kanagawa Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Endoscopic sphincterotomy (EST), especially when anticoagulants are used, carries a significant risk of delayed bleeding. However, the relationship between the use of antithrombotic agents, including direct oral anticoagulants, and post-EST bleeding remains unclear. This study aimed to identify the risk factors for post-EST delayed bleeding when antithrombotic agents were administered according to the guidelines. Methods: We analyzed cases of patients who underwent endoscopic retrograde cholangiopancreatography and EST between January 2018 and August 2022, focusing on those with normal anatomy and naïve papillae. We examined the incidence of post-EST bleeding, endoscopic retrograde cholangiopancreatography procedure details, severity and timing of post-EST delayed bleeding, hemostatic interventions, and factors related to post-EST delayed bleeding. Results: Among the 502 patients included, 76 (15%) were taking antithrombotic agents. Post-endoscopic retrograde cholangiopancreatography delayed bleeding was noted in seven patients (1.4%). Mild, moderate, and severe delayed bleeding occurred in four, one, and two cases, respectively. Hemostatic injection completely controlled cases of delayed bleeding. Multivariate analysis identified a 1-day direct oral anticoagulants interruption (odds ratio: 20.5, 95% confidence interval: 3.33-125, Conclusion: A 1-day direct oral anticoagulants interruption and dialysis are independent risk factors for post-EST delayed bleeding, necessitating careful consideration.

Indexed as

bleedingdialysisendoscopic sphincterotomyERCPoral anticoagulant

Identifiers

PMID39822950
PMCPMC11736286

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.