Abstract
Administration of anticoagulants and antiplatelets is suspended during endoscopic treatment to prevent hemorrhagic complications. However, cessation of the drugs increases the risk of thromboembolism. In the Western guidelines, prevention of thromboembolism outweighs the risk of continuous bleeding. In Japan, the guidelines for management of anticoagulant and antiplatelet therapy in cardiovascular disease and the Japanese guidelines for the management of stroke which are areas of use of these drugs are not consistent with the guidelines issued by the Japan Gastroenterological Endoscopy Society. Furthermore, the new guidelines issued by the Society in 2005, guidelines that give consideration to the prevention of thrombosis, have not yet found a sufficient level of diffusion. This is an area in which it is difficult to build up evidence with the result that evidence is in short supply worldwide and these difficulties are an ineluctable problem in terms of safe endoscopic treatment. To meet this challenge, an “Examination Group for the Temporary Cessation of Safe Antithrombolytic Treatment” was set up by the Departments using antithrombotic drugs in combination with the Gastroenterology Departments in the area around Sapporo city to prepare Guidelines on the Temporary Cessation of Anticoaglants and Antiplatelets Administration, known as the “Sapporo Consensus”. Focusing mainly on the details of this consensus, we have given a general outline of the implications associated with the cessation of anticoagulant and antiplatelet drug administration in therapeutic endoscopy.
