Updates on the Prevention and Management of Post-Polypectomy Bleeding in the Colon - 21/02/24

Doi : 10.1016/j.giec.2023.09.008

Hisham Wehbe, MD ^a, Aditya Gutta, MD ^b, Mark A. Gromski, MD ^b,^⁎
^a Department of Internal Medicine, Indiana University School of Medicine, 550 University Boulevard, UH 3533, Indianapolis, IN 46202, USA
^b Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 550 North University Boulevard, Suite 4100 Indianapolis, IN 46202, USA

^∗Corresponding author. Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 550 North University Boulevard, Suite 4100, Indianapolis, IN 46202.Department of MedicineDivision of Gastroenterology and HepatologyIndiana University School of Medicine550 North University Boulevard, Suite 4100IndianapolisIN46202

Résumé

Post-polypectomy bleeding (PPB) remains a significant procedure-related complication, with multiple risk factors determining the risk including patient demographics, polyp characteristics, endoscopist expertise, and techniques of polypectomy. Immediate PPB is usually treated promptly, but management of delayed PPB can be challenging. Cold snare polypectomy is the optimal technique for small sessile polyps with hot snare polypectomy for pedunculated and large sessile polyps. Topical hemostatic powders and gels are being investigated for the prevention and management of PPB. Further studies are needed to compare these topical agents with conventional therapy.

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Keywords : Polypectomy, GI bleed, Snare resection, Bleeding prevention