Endo-hepatology: Updates for the clinical hepatologist

Lee, Frances; Rustagi, Tarun; Frederick, R. Todd

doi:10.1097/cld.0000000000000072

Cited by 2 publications

(6 citation statements)

References 37 publications

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“… 4 Although EUS-LB is an emerging method, it shows similar success rates with conventional biopsy methods in terms of both histologic performance and complete portal tract acquisition. 5 Endoscopic ultrasound-liver biopsy, which has been found to be safe in many studies, can be performed by most endoscopists if the patient’s platelet count is above 50 000, the INR value does not exceed the 1.5 threshold, and there are no major ascites. 5 , 6 Compared to conventional methods, EUS-LB provides accurate localization and identification of the lesion due to the imaging it provides.…”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“… 5 Endoscopic ultrasound-liver biopsy, which has been found to be safe in many studies, can be performed by most endoscopists if the patient’s platelet count is above 50 000, the INR value does not exceed the 1.5 threshold, and there are no major ascites. 5 , 6 Compared to conventional methods, EUS-LB provides accurate localization and identification of the lesion due to the imaging it provides. It also allows evaluation of both liver lobes in a less invasive manner.…”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“…From a patient welfare perspective, EUS-LB is more easily tolerated, has a faster recovery, and has fewer complications, making it a preferable option. 5 - 7 Endoscopic ultrasound is a versatile tool that allows many different procedures to be performed at once. It not only allows the target tissue to be visualized continuously under Doppler ultrasonography but also allows samples to be taken from both lobes.…”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“…The manometry device to be used for this measurement should include a noncompressible tube, heparinized saline, a digital manometer, and a 22-25G needle for FNA. 5 , 12 Endoscopic ultrasound-PPG has obvious advantages over conventional HPVG, such as being less invasive, reducing the patient’s radiation exposure, and showing PHT more accurately by directly calculating PPG. 11 Based on the literature, EUS-PPG has a very high success rate, ranging from 96% to 100%.…”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“…Despite this very high success rate, it cannot be used in patients with the most advanced stages of portal hypertension with platelet counts above 50 000/L, extended INR time, and the presence of a large volume of ascites in the abdomen. 5 In addition, the effects of other parameters (e.g., endoscope pressure, scope position, and tension on the scope) on the reliability and repeatability of pressure measurements are other limitations.…”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

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Endoscopic Ultrasonography In Diagnostic Endohepatology: The Hepatologist’s Swiss Army Knife

Albayrak

2024

The Eurasian Journal of Medicine

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In recent years, significant advances have been made in endoscopic ultrasonography (EUS) processors, transducers, and the instruments used. In parallel with these developments, the importance of EUS in the diagnosis, treatment, and management of chronic liver diseases has increased considerably. One of the most important advantages of EUS is that the ultrasound probe can examine the liver area under examination from a very close distance. Additionally, EUS provides the ability to provide excellent spatial files and real-time images; Doppler, elastography, and contrast methods are also widely used to increase diagnostic accuracy in EUS evaluations. Endoscopic ultrasound-guided procedures are an alternative method used when percutaneous approaches are not feasible. Endoscopic ultrasound-based advanced applications such as EUS-guided liver biopsy (LB), EUS-guided ascites assessment, the use of EUS in the evaluation of focal lesions of the liver, and EUS portal pressure gradient (EUS-PPG) measurements are becoming increasingly common and important. As a result of the developments in EUS devices and instruments, it is possible to perform all diagnostic procedures in hepatology with EUS. In other words, EUS can provide all the imaging and interventional procedures that a hepatologist would require for diagnosis in a single session, without the need for any other expertise other than the gastroenterologist (such as a radiologist, interventional radiologist, or surgeon). This is called the single-procedure diagnostic approach, or “all in one” in hepatology. From a hepatologist’s perspective, EUS can be thought of as the “hepatologist’s Swiss army knife.”

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Section: Clinical and Research Consequencesmentioning

confidence: 99%

Section: Clinical and Research Consequencesmentioning

confidence: 99%

Section: Clinical and Research Consequencesmentioning

confidence: 99%

Section: Clinical and Research Consequencesmentioning

confidence: 99%

Section: Clinical and Research Consequencesmentioning

confidence: 99%

See 3 more Smart Citations

Endoscopic Ultrasonography In Diagnostic Endohepatology: The Hepatologist’s Swiss Army Knife

Albayrak

2024

The Eurasian Journal of Medicine

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Endoscopic Ultrasound-Guided Tissue Sampling for the Cytohistological Diagnosis of Focal Liver Lesions

Lariño-Noia,

Jardi-Cuadrado,

Dominguez-Muñoz

et al. 2024

Diagnostics

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Background: Focal liver lesions (FLL) often require cytohistological evaluation. Endoscopic Ultrasound (EUS)-guided tissue acquisition (EUS-TA) is highly accurate in diagnosing pancreatic and gastrointestinal malignancies. The aim of our study was to evaluate the role of EUS-TA in the characterization of FLL. Methods: A retrospective analysis of a prospective database of patients who underwent EUS-TA for the evaluation of FLL. Diagnostic yield, adverse events and factors associated with diagnostic yield were evaluated as endpoints. The effect of variables such as needle size, lesion size, rapid on-site evaluation (ROSE) and the use of cytological or histological needles were analyzed. Results: A total of 114 cases were included (mean age 68.05 ± 11.35 years, 64 male). A correct diagnosis was made using EUS-TA in 100 of the 114 cases (diagnostic yield of 88%). The EUS-TA of additional extrahepatic lesions during the same EUS procedure increased the diagnostic yield to 94%. No adverse events were reported. Multivariate analysis did not identify any factor influencing the diagnostic yield. Conclusions: EUS-TA is a highly accurate and safe technique for the differential diagnosis of FLL and could be considered as the primary approach in this setting.

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Endo-hepatology: Updates for the clinical hepatologist

Cited by 2 publications

References 37 publications

Endoscopic Ultrasonography In Diagnostic Endohepatology: The Hepatologist’s Swiss Army Knife

Endoscopic Ultrasonography In Diagnostic Endohepatology: The Hepatologist’s Swiss Army Knife

Endoscopic Ultrasound-Guided Tissue Sampling for the Cytohistological Diagnosis of Focal Liver Lesions

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