{"title":"Endohepatology in the Management of Liver Diseases.","authors":"Thomas J Wang, Ajaypal Singh","doi":"10.1055/a-2677-3773","DOIUrl":null,"url":null,"abstract":"<p><p>Endohepatology is an emerging field that encompasses various diagnostic and therapeutic endoscopic ultrasound (EUS) techniques for the management of liver disease. It encompasses diagnostic techniques for fibrosis staging and portal hypertension evaluation, as well as therapeutic interventions for conditions like variceal bleeding. Given the medical complexity and fragility that are often encountered in patients with liver disease, careful attention is of paramount importance to minimize risk and invasiveness when possible while extracting maximal value with a therapeutic intent. EUS-guided access to liver, bile ducts, and the hepatic vasculature provides the ability for diagnostic evaluation and interventions, which are not limited by body habitus and the need for central vascular access. Established EUS-guided techniques include liver biopsy, direct portal pressure gradient measurements, and gastric variceal coiling and injection therapies. More emerging techniques, including liver palpation, shear wave elastography, portal venous sampling, rectal variceal coiling, and partial splenic artery embolization, have also been described in the literature. This review details the rationale and evidence behind both established and emerging EUS-guided techniques, highlighting their current and potential future impact on endohepatology.</p>","PeriodicalId":21724,"journal":{"name":"Seminars in liver disease","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in liver disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2677-3773","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Endohepatology is an emerging field that encompasses various diagnostic and therapeutic endoscopic ultrasound (EUS) techniques for the management of liver disease. It encompasses diagnostic techniques for fibrosis staging and portal hypertension evaluation, as well as therapeutic interventions for conditions like variceal bleeding. Given the medical complexity and fragility that are often encountered in patients with liver disease, careful attention is of paramount importance to minimize risk and invasiveness when possible while extracting maximal value with a therapeutic intent. EUS-guided access to liver, bile ducts, and the hepatic vasculature provides the ability for diagnostic evaluation and interventions, which are not limited by body habitus and the need for central vascular access. Established EUS-guided techniques include liver biopsy, direct portal pressure gradient measurements, and gastric variceal coiling and injection therapies. More emerging techniques, including liver palpation, shear wave elastography, portal venous sampling, rectal variceal coiling, and partial splenic artery embolization, have also been described in the literature. This review details the rationale and evidence behind both established and emerging EUS-guided techniques, highlighting their current and potential future impact on endohepatology.
期刊介绍:
Seminars in Liver Disease is a quarterly review journal that publishes issues related to the specialties of hepatology and gastroenterology.
As the premiere review journal in the field, Seminars in Liver Disease provides in-depth coverage with articles and issues focusing on topics such as cirrhosis, transplantation, vascular and coagulation disorders, cytokines, hepatitis B & C, Nonalcoholic Steatosis Syndromes (NASH), pediatric liver diseases, hepatic stem cells, porphyrias as well as a myriad of other diseases related to the liver. Attention is also given to the latest developments in drug therapy along with treatment and current management techniques. Seminars in Liver Disease publishes commissioned reviews. Unsolicited reviews of an exceptional nature or original articles presenting remarkable results will be considered, but case reports will not be published.