WASHINGTON – Your patient has cirrhosis, platelets 60,000 mm3, an INR of 2.0, serum creatinine of 1.2 mg/dL, and requires an endoscopic retrograde cholangiopancreatography with sphincterotomy.
What do you do next?
Management of a patient such as this is challenging, but not just because of the long-perceived risk for bleeding, Dr. Patrick S. Kamath of the Mayo Clinic in Rochester, Minn., said during a clinical symposium at the annual Digestive Disease Week.
Several other factors must be considered, including the clotting risk in patients with liver disease and the fact that procedure-related bleeding risk cannot be adequately determined preprocedure. Transfusions also carry their own dangers in this patient population and should be approached with caution, he said.
To hear more from this world-renowned liver expert, check out our interview as we sat down with Dr. Kamath at this year’s DDW.
Dr. Kamath reported no relevant financial conflicts.
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