Safety of endoscopic sphincterotomy in patients under dual antiplatelet therapy.
Dual antiplatelet therapy has to be used for at least one month after placement of bare metal coronary stents and for a minimum of one year after placement of drug eluting stents. Because of the higher risk of bleeding, guidelines strongly recommend to delay elective surgery until dual antiplatelet therapy is terminated. However, no data are available regarding the bleeding risk in patients on combined aspirin/clopidogrel therapy undergoing high-risk endoscopic procedures, such as emergency endoscopic biliary sphincterotomy. We retrospectively analyzed the medical reports of patients who had to undergo endoscopic retrograde cholangiography with endoscopic sphincterotomy (ES) while on dual antiplatelet therapy in our unit between January 2009 and December 2011. In our series, ES was safely performed in eight consecutive patients on dual antiplatelet therapy with no evidence of bleeding. ES may be safely performed in patients on dual antiplatelet therapy.