Future of Endoscopy in Surveillance of Esophageal Varices.

Q1 Medicine

Current Gastroenterology Reports Pub Date : 2025-03-29 DOI:10.1007/s11894-025-00976-6

Carlos Moctezuma-Velazquez, Juan G Abraldes

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引用次数: 0

Abstract

Purpose of review: tTo assess the evolving role of endoscopy assessment for esophageal varices in cirrhosis.

Recent findings: The approach to screening endoscopy for varices has significantly changed in the last 10 years with the refinement of non-diagnostic tests. Non-invasive diagnostic methods have reduced the need of upper endoscopies for variceal screening in patients with compensated cirrhosis, focusing primarily on those with ambiguous risk assessments or contraindications to non-selective beta-blockers (NSBBs). In contrast, decompensated cirrhosis patients require more frequent endoscopic evaluations due to their heightened risk of complications and the potential benefit of combination therapy (NSBBs + variceal ligation). In patients with hepatocellular carcinoma (HCC) the performance of non-invasive tests is suboptimal and most patients require endoscopy. Emerging applications of artificial intelligence (AI) can assist in patient triage and the interpretation of endoscopic findings, potentially improving care. Further research is essential to validate these technologies within clinical practice and optimize their integration into patient management strategies.

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内镜在食管静脉曲张监测中的应用前景。

本综述的目的：探讨肝硬化患者食管静脉曲张内镜评估的演变作用。最近的发现：在过去的10年里，随着非诊断性检查的改进，筛选静脉曲张的方法发生了显著的变化。非侵入性诊断方法减少了代偿性肝硬化患者对上腔内窥镜进行静脉曲张筛查的需要，主要关注那些风险评估不明确或非选择性β受体阻滞剂（NSBBs）禁忌症的患者。相比之下，失代偿期肝硬化患者需要更频繁的内窥镜检查，因为他们的并发症风险更高，联合治疗（NSBBs +静脉曲张结扎）的潜在益处也更高。在肝细胞癌（HCC）患者中，非侵入性检查的效果不理想，大多数患者需要内窥镜检查。人工智能（AI）的新兴应用可以帮助患者分诊和解释内窥镜检查结果，从而有可能改善护理。进一步的研究对于在临床实践中验证这些技术并优化其与患者管理策略的整合至关重要。

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

Current Gastroenterology Reports Medicine-Gastroenterology

CiteScore

7.80

自引率

0.00%

发文量

期刊介绍： As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.