After performing a sphincterotomy, when should anti-platelet therapy be resumed after ERCP?

Resuming anti-platelet therapy after endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy requires careful consideration to balance the risk of bleeding with the benefits of continuation. After a sphincterotomy, there is an increased risk of post-procedural bleeding due to the trauma inflicted on the duodenal wall and the papilla.

It is generally recommended to resume anti-platelet therapy after a safe interval to allow initial healing and mitigate this risk. Resuming therapy too early can lead to complications such as bleeding, which can complicate recovery. The timeframe of 5 to 7 days post-procedure is aligned with this approach, as it allows sufficient time for the tissue to begin healing while still considering the need to prevent thrombotic events that could arise from interrupted anti-platelet therapy.

This strategy is designed to ensure that patients receive the benefits of necessary anti-platelet medication while minimizing the risks associated with the procedure itself. Thus, resuming therapy after 5 to 7 days strikes an appropriate balance between these competing considerations.