Gastrointestinal Unit 2, Università degli Studi di Milano and Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
Eur J Gastroenterol Hepatol. 2011 Sep;23(9):778-81. doi: 10.1097/MEG.0b013e32834928e8.
To investigate the rate of immediate persistent bleeding requiring haemostasis and of delayed bleeding after endoscopic sphincterotomy in liver transplanted patients.
Clinical records of patients who underwent endoscopic sphincterotomy at our Center between January 2003 and December 2009 were reviewed. Platelets count, international normalized ratio, aminosalicylic acid use, presence of cholangitis and use of precut were evaluated as risk factors for bleeding. Crude and adjusted risk ratios (RR) with 95% confidence interval were calculated, using Poisson model.
Forty-nine liver transplanted patients and 202 controls were studied. Rate of delayed bleeding, but not need of immediate haemostasis, was increased in liver transplanted patients, RRs of 11.0 (3.0-40.0) and 1.5 (0.7-3.4) respectively. The RR of delayed bleeding remained unchanged once adjusted for the other evaluated variables.
In liver transplanted patients, the risk of bleeding after endoscopic sphincterotomy is markedly increased. Reasons for this increase still need to be elucidated.
研究肝移植患者行内镜下括约肌切开术后即刻持续出血和延迟性出血的发生率。
回顾了 2003 年 1 月至 2009 年 12 月期间在本中心接受内镜下括约肌切开术的患者的临床记录。评估血小板计数、国际标准化比值、柳氮磺胺吡啶的使用、胆管炎的存在和预切开术作为出血的危险因素。使用泊松模型计算未经调整和调整后的风险比（RR）及其 95%置信区间。
研究了 49 例肝移植患者和 202 例对照者。延迟性出血的发生率增加，而非即刻止血的需要，肝移植患者的 RR 分别为 11.0（3.0-40.0）和 1.5（0.7-3.4）。一旦调整了其他评估变量，延迟性出血的 RR 仍然不变。
在肝移植患者中，内镜下括约肌切开术后出血的风险明显增加。需要进一步阐明这种增加的原因。
Zotero 插件