{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T13:14:53Z","timestamp":1746191693472},"reference-count":51,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T00:00:00Z","timestamp":1654819200000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["(NSFC 81670486, 82070540)"],"award-info":[{"award-number":["(NSFC 81670486, 82070540)"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Key Research and Development Program of China","award":["2017YFC0110003"],"award-info":[{"award-number":["2017YFC0110003"]}]},{"name":"Fundamental Research Funds of Shandong University","award":["2017JC036"],"award-info":[{"award-number":["2017JC036"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Bleeding is a common complication of following endoscopy sphincterotomy (EST), and antithrombotic therapy use during the procedure often increases risk of it. Although several guidelines have been released regarding the use of antithrombotic agents during EST, many issues about it remain controversial. We carried out a systematic review and meta-analysis to evaluate the effect of antithrombotic medication on the risk of EST bleeding.<\/jats:p><jats:p>\n          Methods\u2002A structured literature search was carried out in Web of Science, EMBASE, PubMed, and Cochrane Library databases. RevMan 5.2 was used for meta-analysis to investigate the rate of post-EST bleeding.<\/jats:p><jats:p>\n          Results\u2002Seven retrospective articles were included. Compared with patients who had never taken antithrombotic drugs, patients who discontinued antithrombotic drugs 1 day before the procedure had a significantly increased risk of post-EST bleeding (OR, 1.95; 95\u200a%CI, 1.57\u20132.43), particularly for severe bleeding (OR, 1.83; 95\u200a%CI, 1.44\u20132.34). In addition, compared with patients who discontinued antithrombotic therapy for at least 1 day, patients who continued taking antithrombotic drugs did have an increased risk of post-EST bleeding (OR, 0.70; 95\u200a%CI, 0.40\u20131.23).<\/jats:p><jats:p>\n          Conclusions\u2002The use of antithrombotic drugs may increase the bleeding rate of EST, but discontinuing therapy 1 day before endoscopy does not significantly reduce the bleeding rate.<\/jats:p>","DOI":"10.1055\/a-1793-9479","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T23:00:38Z","timestamp":1654902038000},"page":"E865-E873","source":"Crossref","is-referenced-by-count":1,"title":["Effects of antithrombotic therapy on bleeding after endoscopic sphincterotomy: A systematic review and meta-analysis"],"prefix":"10.1055","volume":"10","author":[{"given":"Gang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng-Yu","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"An","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Si","family":"Ai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan-Bo","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,6,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.amjsurg.2019.10.001","article-title":"Antithrombotic prescriptions for many general surgery patients significantly increases the likelihood of post-operative bleeding complications","volume":"219","author":"A L Wiegmann","year":"2020","journal-title":"Am J Surgery"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1136\/gutjnl-2017-313999","article-title":"Therapeutic endoscopy-related GI bleeding and thromboembolic events in patients using warfarin or direct oral anticoagulants: results from a large nationwide database analysis","volume":"67","author":"N Nagata","year":"2018","journal-title":"Gut"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"365830","DOI":"10.1155\/2013\/365830","article-title":"Gastric ESD under heparin replacement at high-risk patients of thromboembolism is technically feasible but has a high risk of delayed bleeding: Osaka University ESD Study Group","volume":"2013","author":"T Yoshio","year":"2013","journal-title":"Gastroenterol Res Pract"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1056\/NEJMra1505202","article-title":"Acute pancreatitis","volume":"375","author":"C E Forsmark","year":"2016","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1038\/ajg.2013.218","article-title":"American College of Gastroenterology guideline: management of acute pancreatitis","volume":"108","author":"S Tenner","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1053\/j.gastro.2018.01.032","article-title":"American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis","volume":"154","author":"S D Crockett","year":"2018","journal-title":"Gastroenterology"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/S0016-5107(74)73914-1","article-title":"Endoscopic sphincterotomy of the ampulla of Vater","volume":"20","author":"K Kawai","year":"1974","journal-title":"Gastrointest Endosc"},{"key":"ref8","first-page":"34","article-title":"Endoscopic sphincterotomy of the ampulla of Vater and removal of common duct stones","volume":"64","author":"M Nakajima","year":"1975","journal-title":"Am J Gastroenterol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1056\/NEJM199609263351301","article-title":"Complications of endoscopic biliary sphincterotomy","volume":"335","author":"M L Freeman","year":"1996","journal-title":"N Engl J Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1055\/s-2002-35834","article-title":"Complicaions of endoscopic sphincterotomy: results from a single tertiary referral 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Endosc"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.clinre.2012.04.010","article-title":"Do aspirin and non-steroidal anti-inflammatory drugs increase the risk of post-sphincterotomy hemorrhage--a case-control study","volume":"37","author":"I K Onal","year":"2013","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/j.1365-2036.2006.03225.x","article-title":"The safety of endoscopic sphincterotomy in patients receiving antiplatelet agents - a case-control study","volume":"25","author":"N Hussain","year":"2007","journal-title":"Aliment Pharmacol Therap"},{"key":"ref38","first-page":"2150","article-title":"The safety of endoscopic sphincterotomy in patients receiving antiplatelet therapy","volume":"56","author":"T Tomoda","year":"2014","journal-title":"Gastroenterol Endosc"},{"key":"ref39","first-page":"7","article-title":"Gastrointestinal endoscopy in patients on anticoagulant therapy and antiplatelet agents","volume":"30","author":"A Zullo","year":"2017","journal-title":"Ann Gastroenterol"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.cgh.2013.05.020","article-title":"New anticoagulant and antiplatelet agents:  a primer for the gastroenterologist","volume":"12","author":"T H Baron","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1161\/CIRCULATIONAHA.111.090464","article-title":"Periprocedural bleeding and thromboembolic events with dabigatran compared with warfarin:  results from the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) randomized trial","volume":"126","author":"J S Healey","year":"2012","journal-title":"Circulation"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1093\/eurheartj\/eht557","article-title":"Peri-interventional management of novel oral anticoagulants in 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