Which endoscopic procedures are most associated with significant bleeding risk?

The option that highlights polypectomy and biliary sphincterotomy as the procedures most associated with significant bleeding risk is accurate because both of these interventions involve removing tissue or altering anatomy in ways that can compromise blood vessels.

Polypectomy often involves excising potentially precancerous polyps from the colon, which can lead to bleeding due to the manipulation of the vascular structures in the intestinal wall. These procedures can be straightforward but include a risk of significant hemorrhage, particularly if the polyp is large or has a stalk.

Biliary sphincterotomy, performed during endoscopic retrograde cholangiopancreatography (ERCP), involves cutting the sphincter muscle to facilitate stone removal or drainage of bile. This also has a bleeding risk, especially in patients with underlying coagulopathy or other factors that predispose to hemorrhage.

The other options, while they may have some risks, do not typically present the same level of concern for significant bleeding as polypectomy and biliary sphincterotomy. Biopsy and diagnostic endoscopies tend to have lower bleeding risks, especially when performed in stable patients. Enteroscopy and stent placement can carry risks as well, but these are often more about perforation and complications related to the