Association between Administration of Antithrombotics and Intraperitoneal Hemorrhage in Patients Undergoing Percutaneous Interventions for Liver Diseases

Currently, percutaneous interventions are essential for diagnosis and treatment of liver diseases. The most frequent complication of percutaneous interventions is intraperitoneal hemorrhage. Recently, the number of patients with liver diseases on antithrombotics has been increasing. This retrospective cohort study aimed to evaluate the risk factors for intraperitoneal hemorrhage in patients after percutaneous interventions for liver diseases. This study included 1025 patients who underwent percutaneous interventions for liver diseases from April 2015 to March 2020. All interventions were performed using an ultrasound-guided approach. The influence of antithrombotic drug administration in patients, who underwent percutaneous interventions according to the guidelines for the American Association for the Study of Liver Disease, was evaluated. Intraperitoneal hemorrhage after percutaneous interventions was detected by computed tomography. Intraperitoneal hemorrhage occurred in nine patients (0.88%); however, these adverse events were not severe. We compared clinical characteristics between the patients with and without intraperitoneal hemorrhage. Although, there was no difference based on the administration of antithrombotics (p = 0.1961), seven of nine patients who showed intraperitoneal hemorrhage received percutaneous treatments (radio frequency ablation or microwave ablation). Therefore, we divided patients who underwent treatments and liver biopsy and then investigated the influence of antithrombotics on the intraperitoneal hemorrhage. After propensity score matching in each patient group, the administration of antithrombotics was not identified as a risk factor for hemorrhage in patients who underwent interventional treatments and patients who underwent liver biopsy. When the antithrombotics were discontinued, according to the guidelines, it may not increase the risk factor for hemorrhage in patients of liver disease who underwent percutaneous interventions.

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Administration of Antithrombotic Treatment Was a Risk Factor for Intraperitoneal Hemorrhage in Patients Undergoing Percutaneous Interventions for Liver Diseases.

10.21203/rs.3.rs-150259/v1 ◽

2021 ◽

Author(s):

Akira Asai ◽

Keisuke Yokohama ◽

Hideko Ohama ◽

Yusuke Tsuchimoto ◽

Shinya Fukunishi ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Liver Diseases ◽

Retrospective Cohort ◽

Clinical Characteristics ◽

Ultrasound Guided ◽

Antithrombotic Treatment ◽

Percutaneous Interventions ◽

Intraperitoneal Hemorrhage ◽

Number Of Patients

Abstract Percutaneous interventions for liver diseases are currently essential for diagnosis and treatment. The most frequent complication of percutaneous interventions is intraperitoneal hemorrhage. Recently, the number of patients with liver diseases and administered antithrombotics has been increasing. This retrospective cohort study aimed to evaluate the risk factors for intraperitoneal hemorrhage after percutaneous interventions for liver diseases. This study recruited 1025 patients who underwent percutaneous interventions for liver diseases from April 2015 to March 2020. All interventions were performed using an ultrasound-guided approach. Intraperitoneal hemorrhage after percutaneous interventions was detected by abdominal computed tomography. Intraperitoneal hemorrhage occurred in 9 patients (0.88%), and these adverse events weren’t severe. We compared clinical characteristics between the patients with intraperitoneal hemorrhage and without. There were differences regarding patients who underwent percutaneous treatments of liver tumor (p = 0.1271), administration of antithrombotics (p = 0.1961), and prothrombin time (p = 0.1683). Thereafter, to evaluate the influence of antithrombotics on hemorrhage, we compared the patients with antithrombotics and without. After propensity score matching, hemorrhage in patients treated with antithrombotics was significantly increased than in those without (p = 0.0407). The administration of antithrombotics was a risk factor for intraperitoneal hemorrhage in patients undergoing percutaneous interventions for liver diseases.

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Primary Biliary Cirrhosis

10.2310/gastro.5494 ◽

2015 ◽

Author(s):

Daniel S. Pratt ◽

Lindsay Y. King

Keyword(s):

Differential Diagnosis ◽

Liver Disease ◽

Primary Biliary Cirrhosis ◽

Liver Diseases ◽

American Association ◽

Cholestatic Liver Disease ◽

Biliary Cirrhosis ◽

Common Cause ◽

History Of

Primary biliary cirrhosis (PBC) is a progressive autoimmune disease of the liver. It is the most common cause of chronic intrahepatic cholestatic liver disease in adults. This review addresses the epidemiology, etiology and genetics, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, complications, and prognosis of PBC. Figures show the pathogenesis and natural history of PBC and histologic features of the four stages of PBC. Tables list diagnostic criteria for PBC via the American Association for the Study of Liver Diseases, differential diagnosis for PBC, medications used to treat PBC, secondary therapy for PBC, and follow-up of patients with PBC. This review contains 2 highly rendered figures, 5 tables, and 45 references.

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The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases

Clinical Liver Disease ◽

10.1002/cld.722 ◽

2018 ◽

Vol 11 (4) ◽

pp. 81-81 ◽

Cited By ~ 3

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Liver Diseases ◽

American Association ◽

Nonalcoholic Fatty Liver ◽

Diagnosis And Management

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Su1326 DIAGNOSTIC YIELD OF TWO ENDOSCOPIC ULTRASOUND-GUIDED LIVER BIOPSY TECHNIQUES (“WET SALINE” AND “WET HEPARIN”) FOR PARENCHYMAL LIVER DISEASE

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2020.03.2172 ◽

2020 ◽

Vol 91 (6) ◽

pp. AB333

Author(s):

Hamzeh Saraireh ◽

Thaer Abdelfattah ◽

Puneet Puri ◽

Robert Lippman ◽

Pritesh R. Mutha ◽

...

Keyword(s):

Liver Disease ◽

Liver Biopsy ◽

Endoscopic Ultrasound ◽

Diagnostic Yield ◽

Ultrasound Guided ◽

Parenchymal Liver

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Two Birds with One Stone

Gastroenterology Open Access Open Journal ◽

10.33169/gastro.goaoj-2-112 ◽

2021 ◽

Vol 2 (2) ◽

pp. 50-51

Author(s):

Payal Saxena

Keyword(s):

Liver Biopsy ◽

Liver Diseases ◽

Diagnostic Methods ◽

Patient Comfort ◽

Pressure Measurements ◽

Ultrasound Guided ◽

Effective Technique ◽

Portal Vein Pressure ◽

Liver Biopsies ◽

Lower Endoscopy

Despite improved serological and imaging diagnostic methods, liver biopsy remains an essential tool in diagnosing, evaluating and managing liver diseases. Endoscopic ultrasound-guided liver biopsy (EUS-LB) has been demonstrated to be a safe, feasible and effective technique with at least comparable or even better samples than transjugular or percutaneous liver biopsies.1-3 EUS-LB has various advantages: better patient comfort, if needed portal vein pressure measurements can be conducted simultaneously and different regions in the liver can be easily sampled. Moreover, as demonstrated in this case, EUS-LB can be performed concomitantly with an upper, lower endoscopy or EUS.

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Chapter of Gastroenterologists professional guidance for management of patients with liver disease in Singapore during the COVID-19 pandemic

Singapore Medical Journal ◽

10.11622/smedj.2020069 ◽

2020 ◽

Vol 61 (12) ◽

pp. 619-623

Author(s):

PE Chang ◽

YJ Wong ◽

WL Yang ◽

KBL Lim ◽

PS Tan ◽

...

Keyword(s):

Liver Disease ◽

Chronic Liver Disease ◽

Liver Diseases ◽

European Association ◽

American Association ◽

Chronic Liver ◽

Published Data ◽

Professional Guidance

In this paper, we aim to provide professional guidance to clinicians who are managing patients with chronic liver disease during the current coronavirus disease 2019 (COVID-19) pandemic in Singapore. We reviewed and summarised the available relevant published data on liver disease in COVID-19 and the advisory statements that were issued by major professional bodies, such as the American Association for the Study of Liver Diseases and European Association for the Study of the Liver, contextualising the recommendations to our local situation.

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Association of liver cirrhosis severity with type 2 diabetes mellitus in hepatocellular carcinoma

Experimental Biology and Medicine ◽

10.1177/1535370217744511 ◽

2017 ◽

Vol 243 (4) ◽

pp. 323-326

Author(s):

Ankita Makol ◽

Shruthi Kanthaje ◽

Radha K Dhiman ◽

Naveen Kalra ◽

Yogesh K Chawla ◽

...

Keyword(s):

Diabetes Mellitus ◽

Hepatocellular Carcinoma ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Liver Cirrhosis ◽

Risk Factor ◽

Liver Disease ◽

Prior History ◽

Number Of Patients

Type 2 diabetes mellitus (T2DM) is a major risk factor associated with hepatocellular carcinoma (HCC). However, the association of T2DM with liver cirrhosis and therapy response in HCC patients is not clear. Hence, in this study, we have evaluated the influence of T2DM on liver cirrhosis severity of HCC and sorafenib response. HCC patients were divided in two groups: T2DM (n = 20) and non-T2DM (nT2DM; n = 50). We found significantly higher number of patients in T2DM group had decompensated liver disease with Child–Turcotte–Pugh score ≥ 7. Additionally, 71.4% patients were observed to be sorafenib sensitive in T2DM group which was significantly higher as compared to 30% in nT2DM group. This study has highlighted the predisposition of HCC patients with T2DM toward more severe liver disease who were found to be better respondents of sorafenib. Impact statement We have explored the association of type 2 diabetes mellitus (T2DM) on liver cirrhosis severity along with response toward sorafenib in hepatocellular carcinoma (HCC). Most HCC patients exhibit prior history of liver cirrhosis that results following long span of chronic liver disease. T2DM constitutes as an important risk factor for HCC development which is known to elevate its incidence. Further, sorafenib is the FDA approved therapy for HCC whose therapeutic outcome is not investigated in HCC patients with T2DM till date. This observation-based study has unveiled a positive association between T2DM and severity of liver cirrhosis as well as sorafenib response in HCC as examined in a clinical setting.

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