Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.127
Peer-review started: September 27, 2022
First decision: October 30, 2022
Revised: December 9, 2022
Accepted: February 7, 2023
Article in press: February 7, 2023
Published online: February 27, 2023
Processing time: 152 Days and 14.3 Hours
Cirrhotic patients with severe thrombocytopenia are at increased risk of bleeding during invasive procedures. The need for preprocedural prophylaxis aimed at reducing the risk of bleeding in cirrhotic patients with thrombocytopenia who undergo scheduled procedures is assessed via the platelet count; however, establishing a minimum threshold considered safe is challenging. A platelet count ≥ 50000/μL is a frequent target, but levels vary by provider, procedure, and specific patient. Over the years, this value has changed several times according to the different guidelines proposed in the literature. According to the latest guidelines, many procedures can be performed at any level of platelet count, which should not necessarily be checked before the procedure. In this review, we aim to investigate and describe how the guidelines have evolved in recent years in the evaluation of the minimum platelet count threshold required to perform different invasive procedures, according to their bleeding risk.
Core Tip: There are several reviews in the literature that deals with the management of thrombocytopenia in patients with cirrhosis undergoing scheduled invasive procedures. However, this review is one of the few to provide a comparison between the main guidelines concerning the platelet-count reference threshold to consider safely performing the various types of procedures.