{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:20:45Z","timestamp":1788992445782,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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\u2010EST bleeding remains unclear. This study aimed to identify the risk factors for post\u2010EST delayed bleeding when antithrombotic agents were administered according to the guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 na\u00efve papillae. We examined the incidence of post\u2010EST bleeding, endoscopic retrograde cholangiopancreatography procedure details, severity and timing of post\u2010EST delayed bleeding, hemostatic interventions, and factors related to post\u2010EST delayed bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 502 patients included, 76 (15%) were taking antithrombotic agents. Post\u2010endoscopic retrograde cholangiopancreatography\u00a0delayed 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\u2010day direct oral anticoagulants interruption (odds ratio: 20.5, 95% confidence interval: 3.33\u2013125,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0011) and dialysis (odds ratio: 38.7, 95% confidence interval: 2.4\u2013624,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0099) as significant risk factors for delayed bleeding. No thromboembolic events related to the discontinuation of antithrombotic drugs were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A 1\u2010day direct oral anticoagulants interruption and dialysis are independent risk factors for post\u2010EST delayed bleeding, necessitating careful consideration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70060","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T05:30:28Z","timestamp":1737005428000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Post\u2010endoscopic sphincterotomy delayed bleeding occurs in patients with just 1\u2010day interruption of direct oral anticoagulants or hemodialysis"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1671-0643","authenticated-orcid":false,"given":"Sho","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2482-6707","authenticated-orcid":false,"given":"Yusuke","family":"Kurita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuma","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Kanagawa 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Medicine  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itaru","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Yokohama City University Graduate School of Medicine  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noritoshi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Oncology Yokohama City University Graduate School of Medicine  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6767-0410","authenticated-orcid":false,"given":"Kensuke","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of 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