Endoscopic ultrasound guided liver biopsy and portal pressure gradient: when, why and how? Can it become the standard of care in endo-hepatology?

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-02-25 DOI:10.1080/17474124.2025.2469838

Jahnvi Dhar, Amit Yadav, Suvradeep Mitra, Zaheer Nabi, Manik Aggarwal, Pankaj Gupta, Antonio Facciorusso, Stefano Francesco Crinò, Guru Trikudanathan, Jayanta Samanta

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引用次数: 0

Abstract

Introduction: The armamentarium of 'Endo-hepatology' is proliferating with the advancements in techniques and availability of new devices in the field of endoscopic ultrasound (EUS). This has resulted in the merger of multitude of diagnostic and therapeutic interventions, such as EUS-liver biopsy (LB), EUS-angioembolization of gastric varices, EUS-portal pressure gradient (PPG) measurement, and others into a 'one-stop-shop' for efficient patient management. Lack of standardization of these techniques forms a major hinderance in their widespread adoption.

Areas covered: A comprehensive literature search was undertaken across various databases on EUS-LB and EUS-PPG till November 2024 for reviews, observational studies, and randomized trials on EUS-LB and EUS-PPG, describing its indications, technique, and data of safety and efficacy, detailing its role in day-to-day clinical practice.

Expert opinion: EUS-LB and EUS-PPG have shown promise in the ever-growing field of endo-hepatology. EUS-LB has exhibited excellent safety profile and comparable tissue yield compared to its percutaneous counterpart. On the other hand, EUS-PPG seems to be a viable alternative although it needs to be standardized further. From a patient and hospital perspective, they might prove to be convenient and cost-effective. Nevertheless, more evidence is warranted before they can be labeled as the new standard of care.

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超声内镜下肝活检和门静脉压力梯度：何时、为何和如何？它能成为内源性肝病的标准治疗吗？

随着内镜超声（EUS）领域技术的进步和新设备的可用性，“内窥镜肝病学”的装备正在激增。这导致了多种诊断和治疗干预措施的合并，如eus -肝活检（LB）， eus -胃静脉曲张血管栓塞，eus -门静脉压力梯度（PPG）测量，以及其他“一站式服务”，以实现有效的患者管理。这些技术缺乏标准化是其广泛采用的主要障碍。涵盖领域：截至2024年11月，对EUS-LB和EUS-PPG的各种数据库进行了全面的文献检索，对EUS-LB和EUS-PPG进行了综述、观察性研究和随机试验，描述了其适应症、技术、安全性和有效性数据，详细说明了其在日常临床实践中的作用。专家意见：EUS-LB和EUS-PPG在日益增长的内肝学领域显示出前景。与经皮移植相比，EUS-LB具有优异的安全性和相当的组织产量。另一方面，EUS-PPG似乎是一种可行的替代方案，尽管它需要进一步标准化。从病人和医院的角度来看，它们可能被证明是方便和经济有效的。然而，在它们被标记为新的护理标准之前，还需要更多的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.