Hwang JH, Hyun HK, Gwon SH, Son NH, Huh CW. Immediate post-polypectomy bleeding is associated with an increased risk of delayed post-polypectomy bleeding: A large retrospective cohort study. World J Gastroenterol 2026; 32(24): 118775 [DOI: 10.3748/wjg.v32.i24.118775]
Corresponding Author of This Article
Cheal Wung Huh, MD, PhD, Associate Professor, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Yongin 16995, Gyeonggi-do, South Korea. huhcw@yuhs.ac
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Hwang JH, Hyun HK, Gwon SH, Son NH, Huh CW. Immediate post-polypectomy bleeding is associated with an increased risk of delayed post-polypectomy bleeding: A large retrospective cohort study. World J Gastroenterol 2026; 32(24): 118775 [DOI: 10.3748/wjg.v32.i24.118775]
World J Gastroenterol. Jun 28, 2026; 32(24): 118775 Published online Jun 28, 2026. doi: 10.3748/wjg.v32.i24.118775
Immediate post-polypectomy bleeding is associated with an increased risk of delayed post-polypectomy bleeding: A large retrospective cohort study
Jin Ho Hwang, Hye Kyung Hyun, So Hyeon Gwon, Nak-Hoon Son, Cheal Wung Huh
Jin Ho Hwang, Hye Kyung Hyun, Cheal Wung Huh, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Gyeonggi-do, South Korea
So Hyeon Gwon, Nak-Hoon Son, Department of Statistics, Keimyung University, Daegu 42601, South Korea
Co-first authors: Jin Ho Hwang and Hye Kyung Hyun.
Co-corresponding authors: Nak-Hoon Son and Cheal Wung Huh.
Author contributions: Hwang JH, Hyun HK, and Huh CW designed the study, wrote and revised the manuscript; Hwang JH, Hyun HK, Son NH, Gwon SH, and Huh CW participated in the formal analysis and investigation; all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the Institutional Review Board of Yongin Severance Hospital (approval No. 9-2025-0210; date of registration: December 23, 2025).
Informed consent statement: Owing to the retrospective study design, the requirement for informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: The corresponding author will share the data underlying this article at a reasonable request.
Corresponding author: Cheal Wung Huh, MD, PhD, Associate Professor, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Yongin 16995, Gyeonggi-do, South Korea. huhcw@yuhs.ac
Received: January 12, 2026 Revised: February 3, 2026 Accepted: March 3, 2026 Published online: June 28, 2026 Processing time: 149 Days and 1.1 Hours
Abstract
BACKGROUND
Post-polypectomy bleeding is a common adverse event associated with colonoscopic polypectomy. Although various risk factors for delayed post-polypectomy bleeding (DPPB) have been identified, the relationship between immediate post-polypectomy bleeding (IPPB) and subsequent DPPB risk remains unclear. Furthermore, risk factors for DPPB specifically among patients who experience IPPB have not been systematically evaluated.
AIM
To investigate the association between IPPB and DPPB, hypothesizing that patients experiencing IPPB would have a higher risk of subsequent DPPB, and to identify independent risk factors for DPPB among patients who experienced IPPB.
METHODS
In this retrospective cohort study, we analyzed the data of patients who underwent colonoscopic polypectomies in the Republic of Korea between 2005 and 2022. Information on multiple covariates, including patient-, polyp-, and procedure-related factors, was collected. Patients were categorized based on IPPB occurrence, and DPPB incidence was compared between the groups. The McNemar test was used to assess the association between IPPB and DPPB. Logistic regression analysis was used to identify risk factors for DPPB among patients with IPPB.
RESULTS
Of the 16684 patients included, 933 (5.59%) experienced IPPB and 15751 (94.41%) did not. Among patients with IPPB, 35 (3.75%) developed DPPB, whereas 246 (1.56%) of patients without IPPB developed DPPB, demonstrating a statistically significant positive association between IPPB and DPPB [paired odds ratio (OR) = 3.65, 95% confidence interval (CI): 3.17-4.20, P < 0.001]. Following multivariable analysis among patients with IPPB, trainee-performed procedures was identified as the only independent risk factor for DPPB (OR = 3.091, 95%CI: 1.037-9.219, P = 0.043).
CONCLUSION
IPPB occurrence is significantly associated with an increased risk of DPPB, suggesting the need for careful preventive strategies, particularly for procedures performed by trainees.
Core Tip: Post-polypectomy bleeding is one of the most common adverse effects in colonoscopic polypectomies. In our study, we found that patients with immediate post-polypectomy bleeding have a higher risk of developing delayed post-polypectomy bleeding. Procedures performed by trainees were associated with a higher risk of delayed post-polypectomy bleeding, highlighting the need for careful preventive strategies, particularly in procedures performed by trainees.
