Prophylactic clip application does not decrease delayed bleeding after colonoscopic polypectomy

Risk Analysis of Colorectal Post-Polypectomy Bleeding Due to Antithrombotic Agent

“…On the other hand, malignant histology of carcinoma was not a risk factor for PPB in our study, which was contrary to the report by Dobrowolski et al [25]. Multivariate analysis showed that prophylactic clip was not independently associated with PPB, and this finding was consistent with the report by Shioji et al [38].…”

Colonoscopy with Polypectomy in Patients Taking Clopidogrel

“…It is plausible, although unproven, that these methods reduce the risk of wall injury and subsequent delayed bleeding [11]. Immediate clip application is also of unproven benefit, particularly since a randomized study in average bleeding-risk patients did not show a benefit in prevention of post-polypectomy bleeding [18]. However, anecdotally we commonly observed increased oozing following cold snare polypectomy in patients taking clopidogrel compared to average-risk patients, and in the absence of data on the bleeding risks we felt compelled to proceed with routine immediate clipping in all cases.…”

Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines

“…[99][100][101] One RCT of post-EMR defect closure by endoclips compared to no intervention failed to demonstrate any significant benefit. 101 The study was however under-powered for this outcome. Two other studies of prophylaxis of PPB included antiplatelet therapy and/ or anticoagulation users (47% and 10%, respectively).…”