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rodriguez-de-santiago-et-al-2025-delphi-consensus-statement-for-the-management-of-delayed-post-polypectomy-bleeding.pdf (1.84 MB)

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Published version

Publication date

2025-04-01

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cc by-nc (c) Rodríguez de Santiago, Enrique et al., 2025
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/221933

Delphi consensus statement for the management of delayed post-polypectomy bleeding

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https://doi.org/10.1177/17562848251329145

Abstract

Background: Delayed post-polypectomy bleeding (DPPB) is the most common adverse event following colonic polypectomy, yet its management remains highly heterogeneous and lacks standardization. A considerable number of colonoscopies performed for DPPB may be unnecessary and do not result in hemostatic intervention.Objectives: To develop evidence-based statements to guide clinical decision-making in DPPB.Design: Multidisciplinary Delphi consensus statement.Methods: A panel of 29 experts in gastroenterology, hematology, radiology, and surgery was assembled. Through a systematic review of the literature and a modified Delphi process, consensus statements were developed through iterative rounds of anonymous voting. Statements were revised following anonymous voting and feedback at each round. Those achieving 80% agreement were accepted.Results: The expert panel reached a consensus on 36 statements, covering areas such as antithrombotic management, bowel preparation, colonoscopy indications, and therapeutic hemostatic modalities. Key recommendations include guidance for managing self-limited bleeding and risk stratification to reduce the rate of unnecessary colonoscopies, as well as recommendations for hemodynamically unstable patients who may require primary angioembolization. A practical clinical algorithm is proposed.Conclusion: This document provides a consensus-based framework for managing DPPB. These recommendations aim to improve patient outcomes and optimize healthcare resources while fostering a standardized approach to this common adverse event.

Subject

Colonoscòpia, Hemorràgia, Cirurgia colorectal

Subject (English)

colonoscopy, hemorrhage, Colorectal surgery

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citation

RODRÍGUEZ DE SANTIAGO, Enrique, et al. Delphi consensus statement for the management of delayed post-polypectomy bleeding. Therapeutic Advances in Gastroenterology. 2025. Vol. 18. [consulted: 15 of August of 2026]. Available at: https://hdl.handle.net/2445/221933

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