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

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...

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Detalles Bibliográficos
Autores: Rodríguez de Santiago, Enrique, Pérez de la Iglesia, Sandra, Frutos, Diego de, Marín Gabriel, José Carlos, Mangas Sanjuan, Carolina, Honrubia López, Raúl, Uchima, Hugo, Aicart Ramos, Marta, Rodríguez Gandía, Miguel Ángel, Valdivielso Cortázar, Eduardo, Ramos Zabala, Felipe, Antonio Álvarez, Marco, Solano Sánchez, Marina, González Santiago, Jesús Manuel, Albéniz, Eduardo, Hijos Mallada, Gonzalo, Castro Quismondo, Nerea, Fraile López, Miguel, Martínez Ares, David, Tejedor Tejada, Javier, Hernández, Luis, Gornals, Joan B., Quintana Carbó, Sergi, Ocaña, Juan, Cunha Neves, João A., Martínez Martínez, Juan, López-Cerón Pinilla, María, Dolz Abadía, Carlos, Pellisé Urquiza, Maria, The Mucosal Resection and Third-Space Endoscopy Working Group from the Spanish Society of Gastrointestinal Endoscopy
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/221933
Acceso en línea:https://hdl.handle.net/2445/221933
Access Level:acceso abierto
Palabra clave:Colonoscòpia
Hemorràgia
Cirurgia colorectal
colonoscopy
hemorrhage
Colorectal surgery
Descripción
Sumario: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.

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