Endoscopic Ultrasound for the Hepatologist: A Comprehensive Review

2018 ◽  
Vol 38 (02) ◽  
pp. 145-159
Author(s):  
Mihai Rimbaş ◽  
Luca Di Maurizio ◽  
Gianenrico Rizzatti ◽  
Antonio Gasbarrini ◽  
Guido Costamagna ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Endoscopic Ultrasound ◽  
Liver Diseases ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Portal Vein Pressure ◽  
Comprehensive Review ◽  
Parenchymal Liver ◽  
Hypertension Portal

AbstractIn the last few years, the diagnostic and therapeutic utilization of endoscopic ultrasound (EUS) for a variety of liver conditions has exponentially grown. We performed a thorough search for all available studies on the performance of diagnostic and therapeutic EUS in the field of hepatology. This article reviews the indication of EUS in the evaluation and treatment of portal hypertension, portal vein pressure measurement, focal liver lesions, and parenchymal liver diseases, and presents all the clinical evidences available so far in this regard. All the review data suggest that EUS is becoming an increasingly important tool in the armamentarium of the hepatologists for the management of certain liver-related conditions. Implementation in the education of the hepatologists of means to become more familiar with both diagnostic and therapeutic capabilities of EUS is warranted.

scholarly journals The Surgical Treatment for Portal Hypertension: A Systematic Review and Meta-Analysis

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Lanning Yin ◽  
Haipeng Liu ◽  
Youcheng Zhang ◽  
Wen Rong
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Variceal Bleeding ◽  
Meta Analysis ◽  
Portal Pressure ◽  
Combined Treatment ◽  
Cochrane Library ◽  
Quality Of Reporting ◽  
Portal Vein Pressure ◽  
Shunt Procedure

Aim. To compare the effectiveness of surgical procedures (selective or nonselective shunt, devascularization, and combined shunt and devascularization) in preventing recurrent variceal bleeding and other complications in patients with portal hypertension. Methods. A systematic literature search of the Medline and Cochrane Library databases was carried out, and a meta-analysis was conducted according to the guidelines of the Quality of Reporting Meta-Analyses (QUOROM) statement. Results. There were a significantly higher reduction in rebleeding, yet a significantly more common encephalopathy () in patients who underwent the shunt procedure compared with patients who had only a devascularization procedure. Further, there were no significant differences in rebleeding, late mortality, and encephalopathy between selective versus non-selective shunt. Next, the decrease of portal vein pressure, portal vein diameter, and free portal pressure in patients who underwent combined treatment with shunt and devascularization was more pronounced compared with patients who were treated with devascularization alone (). Conclusions. This meta-analysis shows clinical advantages of combined shunt and devascularization over devascularization in the prevention of recurrent variceal bleeding and other complications in patients with portal hypertension.

THU-369-Efficacy and safety of endoscopic ultrasound-guided liver biopsies in parenchymal liver diseases: A systematic review and metaanalysis

2019 ◽  
Vol 70 (1) ◽  
pp. e316
Author(s):  
Anup Shah ◽  
Isabel Guerrido Martinez ◽  
Nelson Valentin ◽  
Melissa Hershman ◽  
Kelsey Collins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endoscopic Ultrasound ◽  
Liver Diseases ◽  
Efficacy And Safety ◽  
Ultrasound Guided ◽  
Parenchymal Liver ◽  
Liver Biopsies

Efficacy and Safety of Endoscopic Ultrasound-Guided Liver Biopsies in Parenchymal Liver Diseases: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S565-S566
Author(s):  
Anup Shah ◽  
Isabel C. Guerrido Martinez ◽  
Nelson Valentin ◽  
Shmuel Golfeyz ◽  
Kelsey E. Collins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endoscopic Ultrasound ◽  
Liver Diseases ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Ultrasound Guided ◽  
Parenchymal Liver ◽  
Liver Biopsies

scholarly journals Diagnostic yield of endoscopic ultrasound-guided biopsy of focal liver lesions

2019 ◽  
Vol 92 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Vlad Andrei Ichim ◽  
Romeo Ioan Chira ◽  
Petru Adrian Mircea
Keyword(s):  
Endoscopic Ultrasonography ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Ultrasound Guided ◽  
Clinical Role ◽  
Fine Needle

Endoscopic ultrasonography (EUS) has become an indispensable method for diagnosis and therapeutic procedures in gastroenterology. As experience with this technique grows, new indications continue to emerge. Due to the vicinity of the transducer to the liver, endoscopic ultrasonography provides detailed images of the liver segments and its vascular and biliary structures. Endosonographers have made an effort to define a clinical role for endoscopic ultrasound in liver diseases; however, not much is known about endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in hepatic focal lesions. This review summarizes the available evidence regarding the usefulness of endoscopic ultrasound-guided fine needle aspiration in patients with focal liver lesions.  

THE RESULTS OF SURGICAL TREATMENT OF VARIOUS FORMS OF FOCAL LESIONS OF THE LIVER

Vestnik ◽  
2021 ◽  
pp. 387-390
Author(s):  
М.М. Сахипов ◽  
В.М. Мадьяров ◽  
Г.Р. Жапаркулова
Keyword(s):  
Liver Disease ◽  
Surgical Treatment ◽  
Liver Diseases ◽  
Large Scale ◽  
Postoperative Mortality ◽  
Focal Liver Lesions ◽  
Technical Equipment ◽  
Liver Lesions ◽  
Focal Lesions

Объем резекции очень важен при хирургическом лечении очаговых заболеваний печени. Операции с использованием современного технического оборудования позволили снизить количество осложнений с 42,9% до 19,7%, а при масштабных резекциях - с 54,9% до 20,9%. Общая послеоперационная смертность снизилась с 7,1% до 2,5%. Долгосрочные улучшения результатов (с 74,3% до 89,6%) и снижение неудовлетворительных результатов с 17,6% до 5,8% могут быть достигнуты путем применения радикальных методов хирургического лечения различных форм очаговых поражений печени. У пациентов с заболеваниями печени может быть возможно улучшить выживаемость два и три года с 37,5% до 53,3% и с 25 до 40%. The volume of resection is very important in the surgical treatment of focal liver diseases. Operations using modern technical equipment allowed to reduce the number of complications from 42.9% to 19.7%, and with large-scale resections - from 54.9% to 20.9%. Total postoperative mortality decreased from 7.1% to 2.5%. Long-term improvement of results (from 74.3% to 89.6%) and a decrease in unsatisfactory results from 17.6% to 5.8% can be achieved by applying radical methods of surgical treatment of various forms of focal liver lesions. In patients with liver disease, it may be possible to improve survival for two and three years from 37.5% to 53.3% and from 25 to 40%.

scholarly journals A State-of-the-Art Review on the Evolving Utility of Endoscopic Ultrasound in Liver Diseases Diagnosis

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 512
Author(s):  
Wisam Sbeit ◽  
Anas Kadah ◽  
Mahmud Mahamid ◽  
Rinaldo Pellicano ◽  
Amir Mari ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Liver Diseases ◽  
Diagnostic Yield ◽  
Therapeutic Option ◽  
Focal Liver Lesions ◽  
Focal Lesions ◽  
Chronic Patients ◽  
Comprehensive Overview ◽  
Diagnostic Work ◽  
Complications Rate

Liver diseases are amongst the most common diseases worldwide and manifest as a parenchymatic and/or biliary injury due to several causes as well as focal liver lesions, ranging from benign to malignant ones. The diagnosis of liver diseases is based mainly on biochemical and advanced imaging studies and, when required, on liver biopsy. Endoscopic ultrasound (EUS), which combines endoscopy and ultrasonography, is one of the main examination techniques used in gastroenterology as it is applied to evaluate abnormalities in the lumen of the upper and lower gastrointestinal tract and to define pancreatic and hepato-biliary features, often in chronic patients. Given its high spatial resolution and its proximity to the liver, EUS is gaining popularity in the diagnostic work up of liver diseases. This is a comprehensive overview of the current literature on the diagnostic indications for EUS use in patients with liver diseases. We performed a MEDLINE\PubMed and Embase search, and all articles that were relevant, after reviewing abstracts, were assessed and the full text was analyzed to extract data regarding technical success, diagnostic yield, bioptic characteristics, and complications rate. EUS-guided imaging and biopsy techniques in liver diseases have shown consistent favorable promising results among the reports through the literature, with an excellent diagnostic yield and safety profile, especially in the context of focal lesions and portal hypertension. The application of EUS in the diagnosis of liver diseases is a promising technique and should be considered as a first-line therapeutic option in selected cases.

scholarly journals Evaluate the role of endoscopy and ultrasonography in patients of portal hypertension

2019 ◽  
Vol 6 (6) ◽  
pp. 2646
Author(s):  
Ghanshyam Das ◽  
Shweta Gautam ◽  
Vijay Pal
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Portal Vein Obstruction ◽  
Hepatic Portal Vein ◽  
Hepatic Portal ◽  
Severe Grade

Background: Aim of the study was to evaluate the role of endoscopy and ultrasonography in pediatric patients suffering from portal hypertension .subjects: children under 12 years of age hospitalized with any symptom or sign suggestive of portal hypertension.Methods: The study was conducted in 30 children with portal hypertension. They were divided into two groups on the basis of site of lesion: extrahepatic (extra hepatic portal vein obstruction) and intrahepatic (chronic liver diseases).Results: Mean age of children with EHPVO (extra hepatic portal vein obstruction) was 4 years and 4 months while that of children with CLD (chronic liver diseases) mean age was 8 years and 4 months. Endoscopic findings in patients with EHPVO have severe grade of varices as compared to those with CLD. In patients with EHPVO, the most common USG finding was nonvisualisation of the main portal vein or either branch (75-85%). Portal vein cavernoma was seen in 75% of these patients. Portosystemic collaterals were visualized in 23 patients  in which the left gastric collateral (60%) was the most common followed by short gastric collaterals in 11 children (55%).Conclusions: Endoscopy and ultrasonography are new and better modalities to assess the diagnosis and severity of portal hypertension. Extra hepatic portal vein obstruction is the commonest cause followed by intrahepatic obstruction (Chronic liver diseases).

scholarly journals Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2021
Author(s):  
Tajana Pavic ◽  
Ivana Mikolasevic ◽  
Dominik Kralj ◽  
Nina Blazevic ◽  
Anita Skrtic ◽  
...  
Keyword(s):  
Liver Disease ◽  
Endoscopic Ultrasound ◽  
Treatment Options ◽  
Endoscopic Examination ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Noninvasive Methods ◽  
Diffuse Liver Disease ◽  
Tissue Acquisition

As the burden of liver disease in the general populace steadily increases, so does the need for both advanced diagnostic and treatment options. Endoscopic ultrasound is a reliable diagnostic and therapeutic method that has an established role, foremost in pancreatobiliary pathology. This paper aims to summarize the growing role of endoscopic ultrasound in hepatology based on the search of the current literature. A number of applications of endoscopic ultrasound are reviewed, including both noninvasive methods and tissue acquisition in focal and diffuse liver disease, portal hypertension measurement, detection and management of gastric and esophageal varices, treatment of focal liver lesions and staging of pancreatobiliary malignancies, treatment of cystic and solid liver lesions, as well as liver abscess drainage. Both hepatologists and endoscopists should be aware of the evolving role of endoscopic ultrasound in liver disease. The inherent invasive nature of endoscopic examination limits its use to a targeted population identified using noninvasive methods. Endoscopic ultrasound is one the most versatile methods in gastroenterology, allowing immediate access with detection, sampling, and treatment of digestive tract pathology. Further expansion of its use in hepatology is immanent.

The role of endoscopic ultrasound elastography in differentiating focal liver lesions

2020 ◽  
Vol 32 (10) ◽  
pp. 1408-1408
Author(s):  
Apostolis Papaefthymiou ◽  
Michael Doulberis ◽  
Vassilios Papadopoulos ◽  
Fotis Tsiopoulos ◽  
Andreas Kapsoritakis ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Ultrasound Elastography ◽  
Focal Liver Lesions ◽  
Liver Lesions
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